DOI QR코드

DOI QR Code

The Management of Lupus Thrombocytopenia in Poly Trauma Patient

  • Ye, Jin Bong (Department of Trauma Surgery, Chungbuk National University Hospital) ;
  • Sul, Young Hoon (Department of Trauma Surgery, Chungbuk National University Hospital) ;
  • Go, Seung Je (Department of Trauma Surgery, Chungbuk National University Hospital) ;
  • Choi, Jung Hee (Department of Anesthesiology and Pain Medicine, Chungbuk National University Hospital) ;
  • Kim, Joong Suck (Department of Trauma Surgery, Cheju Halla General Hospital)
  • Received : 2017.04.21
  • Accepted : 2017.04.24
  • Published : 2017.06.30

Abstract

Lupus thrombocytopenia is a common clinical manifestation in systemic lupus erythematosus (SLE). It may present to clinicians with considerable therapeutic difficulties. We experienced a 40-year-old poly trauma patient with lupus thrombocytopenia who had been treated with immunosuppressive drugs for SLE. She was treated for refractory thrombocytopenia with platelet transfusion, corticosteroid and Intravenous immunoglobulin (IVIG). Fourteen days after admission, her platelet count started to increase, $101{\times}103/ul$ at 16 days after admission. Trauma patients may carry various underlying diseases and thus trauma surgeons should always be aware and ready for peculiar situations.

Keywords

References

  1. Ward MM, Pyun E, Studenski S. Mortality risks associated with specific clinical manifestations of systemic lupus erythematosus. Arch Intern Med 1996; 156: 1337-44. https://doi.org/10.1001/archinte.1996.00440110109015
  2. Cervera R, Khamashta MA, Font J, Sebastiani GD, Gil A, Lavilla P, et al. Morbidity and mortality in systemic lupus erythematosus during a 5-year period. A multicenter prospective study of 1,000 patients. European Working Party on Systemic Lupus Erythematosus. Medicine (Baltimore) 1999; 78: 167-75. https://doi.org/10.1097/00005792-199905000-00003
  3. Mok CC, Lee KW, Ho CT, Lau CS, Wong RW. A prospective study of survival and prognostic indicators of systemic lupus erythematosus in a southern Chinese population. Rheumatology (Oxford) 2000; 39: 399-406. https://doi.org/10.1093/rheumatology/39.4.399
  4. Ioannou Y, Isenberg DA. Current concepts for the management of systemic lupus erythematosus in adults: a therapeutic challenge. Postgrad Med J 2002; 78: 599-606. https://doi.org/10.1136/pmj.78.924.599
  5. Lurie DP, Kahaleh MB. Pulse corticosteroid therapy for refractory thrombocytopenia in systemic lupus, erythematosus. J Rheumatol 1982; 9: 311-4.
  6. Abu-Shakra M, Shoenfeld Y. Azathioprine therapy for patients with systemic lupus erythematosus. Lupus 2001; 10: 152-3. https://doi.org/10.1191/096120301676669495
  7. Griffiths B, Emery P. The treatment of lupus with cyclosporin A. Lupus 2001; 10: 165-70. https://doi.org/10.1191/096120301672970034
  8. You YN, Tefferi A, Nagorney DM. Outcome of splenectomy for thrombocytopenia associated with systemic lupus erythematosus. Ann Surg 2004; 240: 286-92. https://doi.org/10.1097/01.sla.0000133182.92780.9c
  9. Maier WP, Gordon DS, Howard RF, Saleh MN, Miller SB, Lieberman JD, Woodlee PM. Intravenous immunoglobulin therapy in systemic lupus erythematosus-associated thrombocytopenia. Arthritis Rheum 1990; 33: 1233-9.
  10. Insiripong S, Chanchairujira T, Bumpenboon T. Danazol for thrombocytopenia in pregnancy with underlying systemic lupus erythematosus. J Med Assoc Thai 1996; 79: 330-2.
  11. Boumpas DT, Barez S, Klippel JH, Balow JE. Intermittent cyclophosphamide for the treatment of autoimmune thrombocytopenia in systemic lupus erythematosus. Ann Intern Med 1990; 112: 674-7. https://doi.org/10.7326/0003-4819-112-9-674
  12. Hepburn AL, Narat S, Mason JC. The management of peripheral blood cytopenias in systemic lupus erythematosus. Rheumatology (Oxford) 2010; 49: 2243-54. https://doi.org/10.1093/rheumatology/keq269