SYSTEMIC LUPUS ERYTHEMATOSUS AFTER "IDIOPATHIC" THROMBOCYTOPENIC PURPURA: A REVIEW.

Abstract

Thrombocytopenia occurs in 30% of cases of systemic lupus erythematosus (S.L.E.), while 7-8% develop overt thrombocytopenic purpura. Occasional cases have been reported with thrombocytopenic purpura as the presenting manifestation and idiopathic thrombocytopenic purpura (I.T.P.) the initial diagnosis. This study indicates that this is a fairly frequent occurrence. In the post-July, 1949 series of 51 splenectomized cases of I.T.P., there were 8 "definite," 2 "probable," and 6 "possible" cases of S.L.E. In the pre-July, 1949 series of 27 cases, despite limited follow-up, 4 "definite" and 2 "possible" cases of S.L.E. were diagnosed. All cases suggestive of S.L.E. were female. Failure of response, or relapse of purpura, after splenectomy (35.7%) was similar in frequency to I.T.P. in general. In 2 cases splenectomy appeared to cause exacerbation of S.L.E. It is too early to evaluate cases of I.T.P. treated with prednisone (our current routine therapy). Every case of I.T.P. is a "possible" case of S.L.E. and prolonged follow-up is indicated.