Hematologic Manifestations

Abnormal blood conditions are common in people with SLE. Problems include anemia, thrombocytopenia, and other clotting disorders.

Anemia, which is common in SLE people, reflects insufficient bone marrow activity, shortened Red Blood Count (RBC) life span, or poor iron uptake. Aspirin, NSAIDs, and prednisone can cause stomach bleeding and exacerbate the condition. There is no specific therapy for this type of anemia. Immune-mediated anemia (or hemolytic anemia), which is due to antibodies directed at RBCs, is treated with corticosteroids.

Thrombocytopenia may occur and may respond to low-dose corticosteroids. Mild forms may not need to be treated, but a severe form requires high-dose corticosteroid or cytotoxic drugs. The major clinical features of Antiphospholipid Anitbodies (APLs) and APL syndrome are venous thrombosis, and thrombocytopenia with a history of positive anticardiolipin antibody (ACL) tests.

Abnormal laboratory tests may include a false-positive VDRL test for syphilis. Fluorescent treponemal antibody absorption (FTA-ABS) and microhemagglutination-Treponema pallidum (MHA-TP) tests, which are more specific tests for syphilis, are almost always negative if the person does not have syphilis. An elevated erythrocyte sedimentation rate (ESR) is a common finding in active SLE, but it does not always mirror disease activity.