Thrombocytopenia in Lupus

In lupus, thrombocytopenia is generally due to antibodies that form against platelets and destroy them.  This destruction can occur in the blood or in the spleen, an organ in the left upper part of the abdomen.  Sometimes the spleen enlarges in patients with immune thrombocytopenia.  So if the antibodies damage the platelets and the bone marrow cannot make new platelets fast enough, the platelet count drops.  Sometimes a bone marrow aspiration is done.  This can be momentarily painful, but it assesses the blood-making cells.  Blood cells such as white blood cells, red blood cells, and platelets are made in the marrow of long bones.  If there are plenty of precursors to platelets (called megakaryocytes), then the destruction of platelets must be occurring outside the bone marrow and in the blood, spleen, etc.  This is immune thrombocytopenia such as in lupus in which sufficient platelets are made, but there is an overactive response at destroying them. Read more.

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