The role of megakaryocyte proliferation and differentiation in systemic lupus erythematosus patients with thrombocytopenia

Objective　To investigate the function of megakaryocytic cells in systemic lupus erythematosus(SLE)patients with thrombocytopenia. Methods　Standard hematological tests，bone marrow examinations and immunological tests were carried out to scan thrombocytopenia in a total of 176 consecutive SLE patients，the clinical and laboratory data were compared between SLE patients with or without thrombocytopenia，and bone marrow examinations for analysis of megakaryocytic function in SLE patients with thrombocytopenia were compared with that in 32 SLE patients without thrombocytopenia. Results　Thrombocytopenia was identified in 64 SLE patients(36.4%)，among whom，48(75%)with mild thrombocytopenia and 16(25%)with severe thrombocytopenia. In comparison with patients without thrombocytopenia，SLE patients with thrombocytopenia had higher incidence of serositis，more sever renal damage，lower serum C3 levels(P<0.05)，and higher disease activity scores(P<0.05). The total numbers of megakaryocytes was decreased in SLE patients with thrombocytopenia in comparision with that in SLE patients without thrombocytopenia(P=0.001)，especially the platelete-forming megakaryocyte. Whereas，the numbers of promegakaryocytes was markedly increased in SLE patients with thrombocytopenia(P=0.019). Conclusions　Thrombocytopenia in SLE is more likely developed in patients with active and severe disease. Impaired function in megakaryocytic proliferation and differentiation may contribute to the thrombocytopenia occurred in SLE patients.