The Hematologic Aspects of Disseminated (Systemic) Lupus Erythematosus

Abstract

1. The hematologic data in 111 cases of disseminated (systemic) lupus erythematosus are presented. 2. Anemia occurred in practically all patients at some time during their course. 3. Leukopenia was seen initially in about one-third of the patients and developed subsequently in about one-half at some time during their course. Many responded to infection with leukocytosis. 4. Thrombocytopenia occurred its about one-third of the patients on initial counts and developed subsequently in about one-half at some time its their course. Thrombocytopenia was often seen without leukopenia. Marked thrombocytopenia, simulating "idiopathic" thrombocytopenia purpura, was seen in two cases. 5. There was poor correlation between splenomegaly and a reduction in the formed elements of the blood. 6. Bone marrow differential counts were not helpful in making the diagnosis but an increase in plasma cells was frequent. 7. The Hargraves test was an extremely valuable diagnostic aid. 8. Treatment with ACTH and cortisone did not produce any striking hematologic changes. 9. Five cases of unusual interest, including three with hemolytic anemia, were presented.

The immune haemolytic anaemias: a century of exciting progress in understanding

“…The first reports date from the late 1940s and early 1950s (Aegerter & Long, 1949; Zoutendyk & Gear, 1950). Occasionally, haemolytic anaemia dominates the clinical picture; it may even antedate the development of overt SLE by many months or even years (Michael et al , 1951; Wasserman et al , 1955; Videbaek, 1962b). Early data on the incidence of a positive DAT in SLE were provided by Harvey et al (1954)– in six out of 34 patients tested the DAT had been positive.…”

Depressed in Vitro B—Lymphocyte Differentiation in Systemic Lupus Erythematosus

“…Cultured peripheral blood leukocytes from patients with active Arthritis and Rheumatism, Vol. 20 SLE synthesize increased a m o u n t s of Ig in vitro (15) a n d cells resembling p l a s m a cells can occasionally be identified o n smears o f peripheral blood (16).…”

Reversible Bone Marrow Dysplasia in Patients with Systemic Lupus Erythematosus

“…In the literature, reports dealing with the bone marrow findings of patients with SLE have been sparse and inconsistent. Initially, Michael et al stated that there were no specific abnormalities in the bone marrow of patients with SLE (8). In 1965, Burkhardt found that severely hypoplastic marrow was associated with vasculitis in SLE patients (9).…”

“…Immunosuppressive reagents were used for maintenance therapy in 6 of 12 patients with dysplasia and 2 of 5 patients without dysplasia. Cases 5,8,9, and 10 had an acute flare of SLE during follow-up (5 years, 3 years, 4 years, and 5 months, respectively). Cases 5 and 10 were treated with steroid only at the time of the first episode and were given immunosuppressive reagents at the time of the flare.…”