Reports effective use of low-dose splenic irradiation to improve platelet recovery in autoimmune thrombocytopenia linked to systemic lupus erythematosus, suggesting a viable treatment pathway.
Severe autoimmune thrombocytopenia (ATP) in systemic lupus erythematosus (SLE) patients can be life‐threatening when refractory to standard treatments. Low‐dose splenic irradiation (LDSI) can provide temporary platelet recovery before definitive splenectomy. A 26‐year‐old woman with newly diagnosed SLE presented with severe thrombocytopenia (12,000/μL) and life‐threatening bleeding. Despite multiple therapies, including prednisolone, cyclophosphamide, cyclosporine A, danazol, rituximab, and high‐dose IVIg, thrombocytopenia persisted. LDSI (15 Gy in 15 fractions over 5 weeks) was performed, leading to rapid platelet recovery and enabling safe splenectomy, resulting in long‐term remission. LDSI can serve as an effective bridging therapy in refractory ATP associated with SLE, allowing safer splenectomy and sustained remission.
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Ryosuke Hanaoka (2025) studied this question.
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