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Amegakaryocytic Thrombocytopenia in Systemic Lupus Erythematosus

Paul F. Griner, MD; Leon W. Hoyer, MD
Arch Intern Med. 1970;125(2):328-332. doi:10.1001/archinte.1970.00310020134020.
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Thrombocytopenia is a common feature of systemic lupus erythematosus (SLE). It is generally regarded as a manifestation of increased platelet destruction.1-8 This conclusion is based upon the observation of normal to increased numbers of megakaryocytes on bone marrow examination, information from platelet survival and kinetic studies in patients with this disease,9 and a generally good response to treatment with steroids or splenectomy. The frequency of antibodies directed against tissue components in SLE offers a possible explanation for shortened platelet survival, although these antibodies have not been demonstrated in vitro. In striking contrast to the usual findings associated with thrombocytopenia in SLE are those we have recently observed in a young woman with this illness. Selective bone marrow aplasia with absence of megakaryocytes was documented in this instance. In addition, the survival of transfused platelets did not suggest immune destruction. To our knowledge, this observation has not been previously

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