BONE-MARROW FINDINGS IN SYSTEMIC LUPUS-ERYTHEMATOSUS PATIENTS WITH PERIPHERAL CYTOPENIAS

We studied 21 bone marrow specimens from 21 patients with systemic lup us erythematosus (SLE) and peripheral cytopenias: anaemia (Hb <10 g/dl ), and/or leucopenia (white blood cell count <4 x 10(9)/l), and/or thr ombocytopenia (platelets < 150 x 10(9)/l). None of the patients had us ed immunosuppressive drugs in the 2 months before the study, and 11 (5 2.4%) had never used these drugs. The global and specific series cellu larity, degree of fibrosis and necrosis were evaluated by bone marrow trephine; morphological abnormalities and iron stores were evaluated b y cytological smears. The most important abnormalities viewed in bone marrow biopsies were: global hypocellularity (47.6%), increased reticu lin proliferation (76.2%) with myelofibrosis in one patient, and necro sis (19.0%). The marrow aspirates were difficult to obtain in four pat ients, who showed an increased reticulin proliferation on histological analysis. Plasmocytosis was present in 26.7% of cases and in one ther e was a serum monoclonal component (IgG kappa). Iron stores were norma l or increased in 26.7% of specimens and decreased or absent in 73.3%. The most frequent peripheral abnormality was leucopenia in 90.4% (19/ 21) and granulocytic hypoplasia was observed in 47.3% (9/19) of these patients. We conclude that the bone marrow may be a target organ in SL E with cytopenias.