Evaluation of the frequency and results of immune thrombocytopenia in patients with Systemic Lupus Erythematosus

Jafarli. L. Evaluation of the Frequency and Results of Immune Thrombocytopenia in Patients with Systemic Lupus Erythematosus. Eskishehir Osmangazi University Faculty of Medicine Department of Internal Medicine Specialization Thesis in Medicine, Eskishehir 2024. Systemic lupus erythematosus (SLE) is a chronic, systemic autoimmune disease that causes increased morbidity and mortality as a result of involvement of many organs and systems. Thrombocytopenia is one of the important hematological involvements. It is often seen as immune thrombocytopenic purpura (ITP). Our aim was to evaluate the frequency and consequences of ITP in SLE patients. For this purpose, patients diagnosed with SLE and platelet level (PLT) <100,000/mm3 were identified and those diagnosed with ITP were evaluated retrospectively. Among 480 patients diagnosed with SLE, we found the frequency of thrombocytopenia to be 17.9% and the frequency of ITP to be 8.75%. Patients were divided into groups according to the time of ITP diagnosis; the number of patients diagnosed with ITP simultaneously with SLE was 21 (50%), the number of patients diagnosed with ITP after SLE was 12 (28.6%), and the number of patients diagnosed with ITP before SLE was 9 (21.4%). At the time of ITP diagnosis, 33.3% of patients were asymptomatic in terms of bleeding, while 46% of symptomatic patients had ecchymosis. The mean PLT value at the time of ITP diagnosis was found to be 14.14±11.47 10^3/uL. In terms of clinical, laboratory, treatment agents and treatment response we did not detect any statistical difference between the 3 groups according to the time of ITP diagnosis. For the treatment of ITP, steroids were used in all patients, azathioprine (AZA) in 54.8%, intravenous immunoglobulin (IVIG) in 42.9%, mycophenolate mofetil (MMF) in 19% and rituximab (RTX) in 14.3%. Eltrombopag was given to 5 patients for resistant ITP. As a result, SLE-related ITP has an important place among the causes of secondary ITP. ITP may occur before, simultaneously, or after diagnosis of SLE. In patients with SLE-associated ITP, a long-acting immunosuppressive agent should be added to the treatment along with steroids. Eltrombopag may be an option in refractory or unresponsive patients Key Words: Systemic lupus erythematosus, immune thrombocytopenia, eltrombopag, treatment.