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Thrombocytopenia in lupus: baseline C3 as an independent risk factor for relapse
  1. P D Ziakas,
  2. L S Poulou,
  3. S Giannouli,
  4. A G Tzioufas,
  5. M Voulgarelis
  1. Department of Pathophysiology, University of Athens Medical School, Athens, Greece
  1. Correspondence to:
    Dr M Voulgarelis
    Department of Pathophysiology, University of Athens Medical School, 75 M Asias Street, 11527 Athens, Greece; mvoulgar{at}med.uoa.gr

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Thrombocytopenia in patients with systemic lupus erythematosus (SLE) requires immunosuppressive treatment to restore normal platelet counts and treat concomitant organ involvement in other systems.1–6 However, relapses are quite common during the course of the disease.7

From 1995 to 2004, 38 consecutive patients with SLE with a first episode of thrombocytopenia (platelet count <100 000/μl) were retrospectively assessed. Platelet counts, disease activity (European Consensus Lupus Activity Measurement (ECLAM)),8 C3 level, type of treatment and organ involvement were recorded at onset of thrombocytopenia. Relapse was twice defined as a drop in platelet count <100 000/μl after achieving response (increase >150 000). Severe thrombocytopenia (<20 000/μl) was recorded in 34.2% of patients with rare haemorrhagic manifestations. Organ involvement included, in descending order, arthritis (31.6%), renal disease (29%), rash (18.5%), manifestations of the central nervous system (13.2%) and serositis (9%). Low C3 levels …

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