What is your approach to further work-up and management of neutropenia in patients with SLE/RA overlap?
For example, a patient with a bone marrow biopsy that shows normocellular bone marrow. Prior management with leflunomide and HCQ with neutropenia attributed to drug effect; however, lack of improvement following medication discontinuation.
Answer from: at Community Practice
This is an interesting situation that comes up in the routine evaluation of patients with rheumatoid arthritis and other autoimmune syndromes. The normocellular bone marrow suggests a peripheral destruction, in general, and raises some concerns for antibodies directed against neutrophils. These are ...
Comments
at Allegheny Health Network Great input, thank you, Dr. @Paul J. DeMarco.
I w...
at NIAMS I attended a grand rounds for the DC Rheumatism So...
at Genesis HealthCare System There was a session at ACR22 by Dr. Thomas Loughra...
Agree with @Paul J. DeMarco.
For the young folk reading this thread (sorry to say we are not young folk, Paul), what we used to call "LGL syndrome" is now called RA-associated T-cell large granular lymphocyte leukemia. It used to sound a lot less scary to our patients when we could say LGL syndrome...
Comments
at Allegheny Health Network Yes, I date back to the early 1990s! Thank you for...
at NIAMS Agree with Dr. @Thomas on this and concede I am no...
at Uniformed Services University of the Health Sciences (USUHS) Thanks for the UpToDate article, @Paul J. DeMarco....
at UC Irvine Great discussion. Many times we try not to treat n...
at Uniformed Services University of the Health Sciences (USUHS) @Zahra Pakbaz: thanks for that additional info. Yo...
at UC Irvine Just clarifying that I am talking about T cell LGL...
Great input, thank you, Dr. @Paul J. DeMarco. I w...
I attended a grand rounds for the DC Rheumatism So...
There was a session at ACR22 by Dr. Thomas Loughra...