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Aplastic Crisis as Primary Manifestation of Systemic Lupus Erythematosus

By Philipp Baumann, Andreas Völkl, Michael Bäuerle, Ralf Schmidmaier and Fuat S. Oduncu

Abstract

Aplastic crisis is an unusual feature of systemic lupus erythematosus (SLE). We report the case of a 54-year-old woman presenting with both (extravascular) Coombs-positive hemolytic anemia and laboratory findings of bone marrow hyporegeneration with concomitant severe neutropenia. A bone marrow biopsy confirmed aplastic crisis. Diagnostic work-up revealed soaring titers of autoantibodies (anti-nuclear, anti-double-stranded DNA, anti-cardiolipin-IgM, and anti-beta 2-glykoprotein-IgM antibodies), indicating a connective tissue disease as the most plausible reason for bone marrow insufficiency. As the criteria for SLE were fulfilled, we initiated an immunosuppressive therapy by steroids, which led to a rapid complete hematologic and clinical remission in our patient. In this case, we could report on one of the rare cases of SLE-induced aplastic crisis showing that this condition can be entirely reversed by immunosuppressive treatment and that SLE-induced aplastic crisis yields a good prognosis. In conclusion, in a case of aplastic crisis, physicians should be aware that SLE can be a rare cause that is accessible to specific treatment.

Topics: Medizin, ddc:610
Publisher: Ludwig-Maximilians-Universität München
Year: 2011
DOI identifier: 10.1159/000331069
OAI identifier: oai:epub.ub.uni-muenchen.de:16419
Provided by: Open Access LMU

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