Bone marrow necrosis in systemic lupus erythematous patient
DOI:
https://doi.org/10.5327/Z1984-4840201625947Keywords:
lupus erythematous, systemic, pancytopenia, necrosis, bone marrowAbstract
The hematological manifestations of systemic lupus erythematous (SLE) are causes of morbidity and increased risk of mortality. Young patient, female, with SLE and antiphospholipid syndrome (APS) had severe pancytopenia after urinary tract infection. A biopsy of the bone marrow (BM) showed necrosis and fibrosis. The most common pathophysiological mechanism for pancytopenia is the production of peripheral antibodies. However, pancytopenia with BM aplasia or necrosis is rare. BM necrosis is more common with neoplastic diseases, severe infections or sickle cell anemia but is also reported for patients with SLE. It is seen more rarely in patients with primary APS. Changes in the BM microcirculation lead to ischemia and subsequent necrosis. The main complications are pancytopenia and embolism. BM necrosis has been appointed in few clinical studies as a possible cause for pancytopenia in SLE patients. Among the findings, BM necrosis was present in 19% of the patients. BM necrosis is a relatively rare and poor prognosis entity.Downloads
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