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Pediatric Hematology/Oncology • Internal Medicine • Rheumatology • Hematology • Pediatric Hematology • Systemic lupus erythematosus • Benign Hematology
What is your approach to using medications that can cause bone marrow suppression in SLE patients who have persistent leukopenia?
Answer from: at Community Practice
I agree with @Don’s approach. It helps to look for anti-neutrophil/granulocyte and anti-lymphocytes antibodies in some cases (some but not all labs offer this). The older method for testing this is to provide a 10-20 day trial of steroid with taper to see if the WBC count improves. Doses of pr...
Answer from: at Academic Institution
Generally, people are afraid of pushing Imuran, MTX, etc., if a patient with lupus has leukopenia. However, more often than not, the leukopenia is from the underlying autoimmune disorder, not from the drugs. Unless the WBC is extremely low, say 1,000 or so, I usually continue the DMARD. What matters...
Comments
at Arthritis Clinic of Central Texas
Thank you all for the comments. Circling back to u...
Thank you all for the comments. Circling back to u...
at Uniformed Services University of the Health Sciences (USUHS)
@Hassan Alissa: I feel very fortunate practicing i...
@Hassan Alissa: I feel very fortunate practicing i...
at Arthritis Clinic of Central Texas
Thank you for your reply!!
Thank you for your reply!!
at Austin Regional Clinic
What is your lower threshold for absolute lymphocy...
What is your lower threshold for absolute lymphocy...
at Duke University Medical Center
Agree with you, Dr. @Gonzalez. People, especially ...
Agree with you, Dr. @Gonzalez. People, especially ...
I do this with WBC 3000 and even upper 2000's, but...
@Hassan Alissa: I used to be very nervous about it...
Very helpful! Have you seen improvement in platele...
@Jinan Al-Naqeeb: I have not used belimumab (BEL) ...