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KMID : 0366219830180010059
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Korean Journal of Hematology
1983 Volume.18 No. 1 p.59 ~ p.66
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Bone Marrow in Systemic Lupus Erythematosus
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김소연/S Y Kim
권인순/박선양/최성재/김병국/이문호/조한익/K S Kwon/S Y Park/S J Choi/B K Kim/M H Lee/H I Cho
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Abstract
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To diagnose SLE is very difficult in the early stage of the discase and there are
various abnormalities in hematological aspect.
We compared the findings of peripheral blood smear(PBS) with that of bone
marrow(BM) in 17 patients with SLE who were suspected to have had primary
hematologic disorders at first.
1) Among all the 17 patients with anemia, 4 patients had anemia only, 7 patients had
anemia with leukopenia, 2 patients with thrombocytopenia and 4 patients had
pancytopenia.
2) 3 patients of the 4 patients with anemia alone had elevated reticulocyte and
positive coombs' test who manifested antoimmune hemolytic anemia.
Their red cells were normochromic, normocytic and anisocytotic in PBS with erythroid
hyperplasia in BM.
3) 6 patients of the 7 patients with anemia and leukopenia had decreased serum iron
and total iron binding capacity respectively.
Their BM showed normal cellularity and their findings were compatible with chronic
simple anemia. Only 1 patient of them had tear drop cells in PBS and myelofibrosis in
BM.
4) 2 patients with anemia and thrombocytopenia showed increased Megakaryocyte and
myeloid series in BM.
Case 12 manifested the same as ITP.
Case 13 had 9.8% of reticulocyte and positive Coombs' test, so ITP and autoimmune
hemolytic anemia were considered.
5) All the 4 pancytopenic patients had decreases reticulocyte and no immature cells
with marked decreased cellularity in BM.
17 patients with SLE manifested as hemolytic anemia, ITP, aplastic anemia and
myelofibrosis of primary hematologic disorders at first.
So any time when the clinical picture is suspected as primary hematologic disorders,
SLE should be in differential diagnosis.
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