Management for haematological features of SLE

For people with SLE, minor reductions in blood cell counts do not necessarily require treatment; however, if cytopenia is progressive or severe, refer patients to a specialist (eg rheumatologist, haematologist).

Note: If cytopenia associated with SLE is progressive or severe, refer the patient urgently to a rheumatologist or haematologist.

For modest reductions in blood cell counts, management may include oral corticosteroids or other immunomodulatory drugs such asazathioprine, mycophenolate, rituximab or cyclophosphamide, in addition to hydroxychloroquine. Profound or progressive cytopenia may require high-dose systemic corticosteroid therapy (pulse intravenous methylprednisolone or high-dose oral corticosteroids), or intravenous immunoglobulin (IVIg), rituximab or plasma exchange.