Clinical characteristics of systemic lupus erythematosus complicated with thrombocytopenia

Abstract Objective:To explore the clinical characteristics and treatment outcomes of systemic lupus erythematosus (SLE) complicated with thrombocytopenia (TP). Methods:The clinical data of SLE patients with TP were collected. These TP patients were matched with SLE patients without TP in the same period at a 1:1 ratio. Multivariate logistic regression analysis was used for comparison. Results: The incidence of leukopenia, anemia, lupus nephritis, and hyper-IgG in the TP group increased significantly. Additionally, the SLEDAI score in the TP group was higher (P<0.05), while the incidence of anti-u1-RNP antibody and anti-SSA antibody was lower than that in the non-TP group (P<0.05). Multivariate logistic analysis revealed that leukopenia, anemia, and lupus nephritis were independent risk factors for TP (P < 0.05). There were 67 patients with mild and moderate TP (PLT > 20×10^9/L), and 40 patients with severe TP (PLT ≤ 20×10^9/L). The number of bone marrow megakaryocytes (MK) in the mild and moderate TP group [19.5 (8, 41.25)] was lower than that in the severe TP group [55 (13, 142)] (P = 0.007). Platelet MK production in the mild and moderate TP group was significantly higher than that in the severe TP group (P=0.028). Intravenous immunoglobulin (IVIG), high-dose glucocorticoids, and tacrolimus were more commonly utilized in the severe TP group, whereas mycophenolate mofetil (MMF) was more frequently used in the mild and moderate TP groups (P < 0.05). The effective rate of patients with severe TP was lower than that of patients with mild and moderate TP (P < 0.05). Conclusions: TP often accompanied with anemia, leukopenia, and a high SLE Disease Activity Index (SLEDAI) score. Leukopenia, anemia, and lupus nephritis are independent risk factors for TP. Patients with severe TP tend to use high-dose glucocorticoids and IVIG, and the effective rate of treatment for mild and moderate TP is higher. The recurrence frequency of patients with severe TP after complete remission is significantly higher than that of patients with mild and moderate TP.