Analysis Of Systemic Lupus Erythematosus With Thrombocytopenia As Initial Symptom

Objective: Systemic lupus erythematosus(SLE), mediated by autoimmunity, is a diffuse connective tissue disease which results in immunity inflammation. The abnormal changes of hematological system are the more common initial symptoms of SLE, especially thrombocytopenia, which is easy to be misdiagnosed as idiopathic thrombocytopenic purpura(ITP)in early stage. This study aims to find out whether could diagnose and treat the patients that have SLE with thrombocytopenia as initial symptom as early as possible and improve the prognosis effectively by their clinical features and laboratory examinations, through contrasting general conditions, laboratory and immunology examination of the patients with SLE and ITP.Methods and objects: To retrospective analysis 35 patients who were diagnosed systemic lupus erythematosus with thrombocytopenia as initial symptom (experiment group) in the rheumatism department of the first hospital of Jilin university during October 1989 until February 2011, through comparative analysising their onset ages distribution, bleeding performance, and laboratory and immunology examinations with those of the 58 patients with ITP (control group) who are selected randomly. By means of SPSS 17.0, independent sample T-tests and chi-square test are conducted to get the statistical analyses of the differences between the groups.Results: SLE with thrombocytopenia as initial symptom often happened in women of reproductive age. The bleeding performance, decrease of platelet counts in peripheral blood and treatment effect after using lucocorticoid 7 days and 14 days are similar to ITP(P>0.05).But the results of ESR(42.44±27.03),C3(0.629±0.344),C4(0.112±0.936),positive rate of ANA(72.7%), ds-DNA(21.8%),nRNP/Sm(13.0%),SSA(39.1%)in the patients with SLE are obvious abnormal to compare with ITP (P<0.05).Conclusion: The patients with SLE often with thrombocytopenia as initial symptom, will display classical symptoms of SLE after several months or years, who are easily misdiagnosised and missed diagnosised. For this reason, clinician should particularly attention these kind of patients and screen them with immunological method and subsequent observation to examine any possibility of SLE, especially the female patients with the abnormal results of ANA, C3, C4, ESR and with the performance of bleeding and anemia. Then we can treat them as early as possible and improve prognosis at last.