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Current Rheumatology Reports

, Volume 13, Issue 4, pp 291–299 | Cite as

Clinical Assessment and Management of Cytopenias in Lupus Patients

  • Alana B. LevineEmail author
  • Doruk Erkan
Article

Abstract

Anemia, leukopenia, and/or thrombocytopenia can occur as a result of non-immune- and immune-mediated mechanisms in patients with systemic lupus erythematosus. Although the differential diagnosis of these cytopenias is broad and warrants a thorough evaluation, lupus disease activity and medications are common etiologic factors. Corticosteroids are the mainstay of initial treatment for immune-mediated hemolytic anemia and severe thrombocytopenia; immunosuppressive agents such as mycophenolate mofetil or azathioprine are often added for their steroid-sparing effects. Rituximab and intravenous immunoglobulin can be considered for refractory cytopenias based on a large body of anecdotal evidence and case series. Newer biologic agents such as belimumab or epratuzumab have yet to be studied specifically in systemic lupus erythematosus–mediated hematologic disorders.

Keywords

Systemic lupus erythematosus Cytopenia Thrombocytopenia Lupus Hemolytic anemia Leukopenia Neutropenia Lymphopenia 

Notes

Disclosure

Dr. Erkan has served as an investigator for multiple lupus clinical trials (Genentech, Human Genome Sciences, Merck & Co., EMD Serono, and Eli Lilly and Company); has served as a consultant for Genentech; and has received research grant support from the Lupus Clinical Trials Consortium. Dr. Levine reported no potential conflicts of interest relevant to this article.

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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Division of RheumatologyHospital for Special Surgery, Weill Medical College of Cornell UniversityNew YorkUSA

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