Platelet reduction indicates low platelet levels. This condition is common in people with lupus, an autoimmune disease that can affect multiple body organs and systems. Platelets are blood cells that help clot the blood. Less than 150,000 platelets per microliter of circulating blood mean low levels. In this article, we examine whether lupus affects lowering platelet levels and the link between the two states.
Can lupus cause thrombocytopenia?
Thrombocytopenia is caused by one of the following:
· When the body can't make enough platelets,
· When the body destroys the platelets it makes,
· When the spleen has too many platelets,
In the case of lupus, the body destroys platelets because this disease is an autoimmune disease. In autoimmune diseases, the immune system mistakenly attacks healthy cells in the body. According to medical experts, platelet reduction occurs in about 20-40% of lupus patients.
Relationship between lupus and thrombocytopenia
Platelet reduction is a common blood disorder associated with lupus. According to research data published in 2017, the earlier thrombocytopenia appears during lupus, the worse the symptoms are and the prognosis is poor. For example, a 2016 study found that patients with lupus had a significantly higher risk of death if thrombocytopenia was severe. The risk was almost twice as high, and 9% to 15% lupus patients are more likely to die if they do not experience complete remission of thrombocytopenia during treatment.
About 16% thrombocytopenia is the first sign of lupus. It may take up to 10 years to be diagnosed with lupus. In addition, some studies have reported that certain immunosuppressants used by doctors to treat lupus may cause thrombocytopenia. Examples include azathioprine and methotrexate.In rare cases, lupus treatment containing hydroxychloroquine can also cause thrombocytopenia.
Risk factors for lupus disease
Platelet reduction is a common blood disorder in lupus patients. However, certain risk factors can increase the likelihood of severe or chronic thrombocytopenia. In a study conducted in 2016, the association between lupus and 230 people with thrombocytopenia was confirmed.Studies have found that severe thrombocytopenia is more likely to develop in the following people.
1. You are old when you have lupus.
2. The gender is female at birth.
3. There are kidney, heart, or nervous system problems.
What are the symptoms?
Lupus-related thrombocytopenia does not always cause symptoms, but sometimes the following signs of low platelet levels may appear.
· bleeding from the gums or nose
· prolonged bleeding from a wound
· Blood from feces, urine or vomit
· A red, purple, or brown, spotted rash, called a spot haemorrhage, can occur anywhere, but usually appears under the arms, neck, and legs.
· Hematoma (a lump caused by blood clotting under the skin)
· frequent bruises
· rectal bleeding
· a feeling of great fatigue
· enlargement of the spleen
a method of treatment
Treatment may not be necessary to manage the condition if the symptoms of thrombocytopenia are mild to moderate. However, doctors may recommend regular monitoring of the patient's platelet count. Children usually improve without treatment over weeks or months. This condition tends to worsen over time and can become chronic or severe. Severe thrombocytopenia requires immediate treatment and careful management.
1. Medication
Initial treatments include corticosteroids such as prednisolone or methylprednisolone, or intravenous antibodies commonly known as immuno-gamma globulin. Subsequent treatments may include a combination of several drugs, such as hydroxychloroquine, Danazole, or azathioprine, which may reduce immune system response and increase platelet count. When platelet levels return to a safe level, doctors generally recommend stopping treatment.
2. Surgery
Sometimes people with chronic or severe thrombocytopenia should undergo spleen removal surgery, but this procedure does not apply to everyone.Living without spleen can cause other complications, such as becoming more susceptible to infection. For this reason, lupus patients with thrombocytopenia should consider all options and side effects before starting treatment.After spleen resection, people should closely monitor their health and monitor for signs of infection, such as fever.
3. Other treatments
If surgery and medication do not help improve thrombocytopenia, doctors can prescribe thrombopoietin receptor agonists such as eltrombofag or romeflostim. They help increase platelet production. In rare cases, thrombocytopenia can cause severe bleeding, which may require hospitalization and donor platelet concentrate transfusion. The transfusion process injects donor platelets into the patient's bloodstream. People with thrombocytopenia should avoid several common drugs that may increase their risk of bleeding, such as aspirin, ibuprofen, and other nonsteroidal anti-inflammatory drugs.