YES.

What is a platelet count drop (called thrombocytopenia)?

Platelets are "mini globules" that circulate in the blood and help blood clotting, when they assemble like the bricks of a wall to block bleeding. Lupus can lead to a drop in platelets, called thrombocytopenia. This autoimmune thrombocytopenia is often associated with lupus, and more rarely with other autoimmune diseases. It can also exist on its own, under the name "immunological thrombocytopenic purpura". This sometimes very important thrombocytopenia (less than 10 000 platelets / mm3) can then cause generally benign hemorrhages. These hemorrhages result in small purple spots on the skin, reflecting subcutaneous bleeding (called purpura), but also in other manifestations such as bleeding gums or nose, or more rarely in other organs (digestive or cerebral hemorrhage).

These severe bleeding complications are very rare during lupus.

What causes thrombocytopenia in lupus?

Thrombocytopenia in lupus is usually explained by autoantibodies directed against platelets that have the ability to destroy those platelets.

What should be done in case of thrombocytopenia?

Only significant thrombocytopenia, with a hemorrhagic threat, warrants emergency treatment, most often including cortisone, but also sometimes other drugs such as intravenous immunoglobulins.

It is usually not necessary to transfuse platelets, except when there is a significant hemorrhagic syndrome, threatening the patient's life. In case of marked chronic thrombocytopenia, with episodes of bleeding, it is sometimes necessary to use a biotherapy or an immunosuppressant in addition to cortisone and hydroxychloroquine. In the past when this did not work, removing the spleen (splenectomy) was considered, but today other medical means are usually sufficient. This removal is done by a well-defined surgical operation. It is possible to live a normal life without a spleen because this organ, which can participate in the destruction of platelets, is not essential in adults. This removal of the spleen requires specific vaccination to ensure protection against certain infections, including pulmonary infections (pneumococcal pneumonia), which are more common in people without a spleen. For this, you will be vaccinated (pneumococcal vaccine, meningococcal and Haemophilus vaccine and influenza) and, in case of microbial infection, you will need to be treated very quickly.