The man behind thrombocytopenia in lupus patients

I thought that the disease control was good, but when I got the examination report, the platelet column lit up red, what can I do! Could it be that lupus is moving again?

Don't scare yourself yet! You are not alone in the red light of platelets!

Thrombocytopenia, which refers to a platelet count <100×10^9/L, is a common hematological manifestation of SLE and an independent risk factor
for poor prognosis.
Epidemiological data show that the probability of thrombocytopenia in SLE patients reaches 20%~40%[1]!

So what causes frequent platelet reduction? This will give you a detailed explanation
.

Causes of thrombocytopenia

1 Autoimmune factor

Increased antiplatelet antibodies are the main pathogenesis
of platelet destruction, resulting in thrombocytopenia in SLE patients.
Antiphospholipid antibodies, on the other hand, can bind to phospholipid-rich platelets and deform them, which are destroyed
.
In addition, studies have shown that thrombocytopenia is more pronounced
in antithrombopoietin antibody positives.
[2]

2 Drugs

In addition to autoimmune factors, drugs are also an important external factor leading to thrombocytopenia in patients, including drugs that inhibit platelet production and drugs that easily cause thrombocytopenia
.

Drugs that inhibit platelet production

Including cyclophosphamide, methotrexate and cyclosporine
.
In the process of disease treatment, SLE patients inevitably use glucocorticoids and immunosuppressants and other drugs, although immunosuppressants can help hormone reduction, but have a myelosuppressive effect, have a direct or indirect toxic effect on megakaryocytes, easy to lead to hematopoietic disorders, suffering from drug-derived thrombocytopenia, but after stopping the drug can often be cured within a week, butterfly friends do not have to worry too much, if this symptom occurs, you can seek help from a doctor in time, do not stop the drug without authorization [2-3
。

Drugs that cause thrombocytopenia in patients

Such drugs have a wide range and have certain antigenicity, including penicillin, cephalosporins, sulfonamides, and other semi-anti-prototype drugs, as well as immune complex drugs
represented by heparin.
There are also autoimmune drugs such as interferon that can change the surface structure of platelets and form platelet autoantibodies that cause platelet damage in patients [2-3].

3 infection

Infection is also one of the important external factors leading to thrombocytopenia, because SLE patients are very prone to bacterial, fungal, and viral infections with the blessing of immune dysfunction and oral immunosuppressants, among which viral infections are the most common, such as HIV virus, cytomegalovirus, rotavirus, etc.
, directly or indirectly damaging the patient's platelets and megakaryocytes, and eventually leading to a decrease in the patient's platelet production [3].

Since thrombocytopenia has become an objective reality, how to treat this disease?

What are the treatments for thrombocytopenia?

1 First-line medication

Studies have shown that hormones (such as prednisone) are 80% effective in the treatment of lupus-associated immune thrombocytopenia, while intravenous immunoglobulin and hormone combined with immunosuppressants can significantly improve lupus activity and serological parameters
in patients with SLE with autoimmune hemolytic anemia.

Therefore, in clinical practice, hormones and intravenous immunoglobulin are generally used in early stage for lupus patients with disease activity and thrombocytopenia to inhibit the production of platelet antibodies and their binding to platelet membranes and avoid platelet destruction
.

2 second-line treatment options

If the patient relapses or the treatment response is suboptimal during hormone reduction, immunosuppressants
such as cyclosporine A, azathioprine, mycophenolate mofetil, and cyclophosphamide can generally be added clinically.
If the patient has high disease activity, immunosuppressants can be added to high-dose hormones to better control lupus disease activity and reduce hormone dose
.
[2,5-7] After lupus patients develop thrombocytopenia, it is important to actively follow the doctor's advice for drug treatment, but is there a simple tip to improve platelet levels in daily life? Of course!

3.
3 liters of platelet dietary therapy

Steamed purslane

Wash purslane, steam on rice, and serve
as a dish with garlic and sesame oil as seasonings.
Portulaca is cool, stops bleeding, and helps to raise platelets
.

Wine stewed pork skin

Take about 150g of pork skin, wash it and add an appropriate amount of sweet rice wine, then add an appropriate amount of water to stew, and then add a little cooking oil to eat after the pork skin is soft, which can reduce blood vessel fragility, activate blood circulation and remove stasis, and raise platelets
.

Stewed turtle meat with red dates

Take 250g of washed turtle meat and 50g of red dates, and simmer them, add a little soy sauce to taste, eat meat and drink soup, which can nourish the yin and strengthen the spleen, and relieve thrombocytopenia
caused by the deficit of spleen and kidneys.
[8-9]