Hematologic Findings in Systemic Lupus Erythematosus

Lee, Soo Youn; Chi, Hyun Sook

Abstract

INTRODUCTION : Patients with systemic lupus erythematosus (SLE) frequently have hematologic abnormalities as one of the presenting features or during the course of disease. So bone marrow examination is needed. But the variety and lack of specificity of marrow findings make the interpretation difficult. We analyzed the causes of cytopenia through the review of bone marrow findings in patients with SLE and persued to influence on the diagnosis or management.
MATERIALS AND METHODS
Forty-two patients with SLE who performed bone marrow study during the period from June 1989 to February 1996 in Asan Medical Center were reviewed. We performed a retrospective study through the examination of the bone marrow and peripheral blood findings. Other laboratory findings including reticulocyte count, Coombs' test, antiplatelet antibody, anti-ds-DNA, complement, antiphospholipid antibody, and ESR were also analyzed.
RESULTS
Searching for the causes of fever or cytopenia, 42 (18.2%) of 231 patients with SLE performed bone marrow study at or before the diagnosis (35 cases, 83.3%) and after the confirmation of SLE (7 cases, 18.7%). Pancytopenia or cytopenia of at least one hematopoietic series is found in all cases. The most common bone marrow findings were reactive histiocytosis (65.2%), reactive plasmacytosis (47.8%), increased storage iron (45.7%), and decreased cellularity (43.4%). The causes of cytopenias were hypoplastic anemia, anemia of chronic disorder, autoimmune hemolytic anemia, hemophagocytic histiocytosis, and idiopathic thrombocytopenic purpura.
CONCLUSION
Bone marrow studies were performed in 42 (18.2%) out of 231 patients with SLE in order to find the causes of cytopenia or fever. None of the bone marrow findings is specific for SLE. Nevertheless, they can be of clinical significance with integrated analysis of bone marrow and other laboratory findings such as peripheral blood smear, Coombs' test, antiplatelet antibody, and DIC study.