Prevalence and outcome of thrombocytopenia in systemic lupus erythematous: single-centre cohort analysis

Abstract

Objectives: To characterize the frequency of thrombocytopenia in patients with SLE and determine its time of onset during the course of the disease, severity and impact on mortality. Methods:This was a single centre cohort analysis of 707 patients with SLE followed for up to 40 years. We reviewed the patients' clinical notes identifying the presence of thrombocytopenia, its time of onset and ascertained other clinical and serological features of the disease. Thrombocytopenia was classified as mild (100-149x10 9 /L), moderate (31-99x10 9 /L) or severe (≤30x10 9 /L platelets). It was also classified as asymptomatic, with minor bleeding or with major bleeding.Results: 22.9% of patients (n=162) had thrombocytopenia prior to or during the course of SLE. Twenty three patients (14.2%) had isolated ITP before the diagnosis of SLE. Median follow-up time was 19 years (IQR=13). Most patients (N=67, 41.4%) had mild thrombocytopenia. More than half the patients (n=98, 60.5%) developed asymptomatic thrombocytopenia and only 6 patients (3.7%) had major bleeding events in the context of thrombocytopenia. The development of severe thrombocytopenia anytime during the course of SLE was associated with an increased risk of death (HR=3.57, p=0.025). There was an increased risk of death for male patients (HR=3.41, p=0.036) who develop thrombocytopenia and for those who presented with concomitant haemolytic anaemia (HR=3.07, p=0.027). Conclusion:The presence of severe thrombocytopenia (platelets ≤30x10 9 ) in patients with SLE is associated with an increased risk of death, regardless of bleeding events. Male patients with SLE and thrombocytopenia had an increased mortality risk, as have those who develop concomitant thrombocytopenia and haemolytic anaemia.

Thrombocytopenia in Patients with Systemic Lupus Erythematosus

“…Thrombocytopenia is characterized by platelet counts below 100 × 10 9 /L and can be observed in 10%-40% of SLE patients. 7 , 8 Severe thrombocytopenia affects approximately 3%-20% of individuals with SLE and is often associated with a chronic disease course. 9 Thrombocytopenia can present as an initial clinical finding in approximately 5%-16% of patients with SLE.…”

Prevalence of oral mucosal lesions in patients with systemic Lupus Erythematosus: a systematic review and meta-analysis

“…For the diagnosis of SLE, all studies except five [24][25][26][27][28] met the American College of Rheumatology (ACR) 1997/1982 [29,30] and/or Systemic Lupus International Collaborating Clinics (SLICC) 2012 [31] classification criteria for SLE or were based on clinical examination by a qualified physician or rheumatologist.…”

The use of belimumab on patients with both systemic lupus erythematosus and immune thrombocytopenia: A retrospective cohort study

“…ITP can occur before or during the course of SLE, and approximately 22.9% of SLE patients experience ITP before or after diagnosis. 1,2 Studies have shown that thrombocytopenia in SLE patients is associated with high disease activity, and severe thrombocytopenia at any point during the disease increases the risk of death. 1,2 Therefore, managing thrombocytopenia in SLE patients is crucial for improving their prognosis.…”