Thrombocytopenia in patients with systemic lupus erythematosus (SLE) requires immunosuppressive treatment to restore normal platelet counts and treat concomitant organ involvement in other systems.^1–6 However, relapses are quite common during the course of the disease.⁷

From 1995 to 2004, 38 consecutive patients with SLE with a first episode of thrombocytopenia (platelet count <100 000/μl) were retrospectively assessed. Platelet counts, disease activity (European Consensus Lupus Activity Measurement (ECLAM)),⁸ C3 level, type of treatment and organ involvement were recorded at onset of thrombocytopenia. Relapse was twice defined as a drop in platelet count <100 000/μl after achieving response (increase >150 000). Severe thrombocytopenia (<20 000/μl) was recorded in 34.2% of patients with rare haemorrhagic manifestations. Organ involvement included, in descending order, arthritis (31.6%), renal disease (29%), rash (18.5%), manifestations of the central nervous system (13.2%) and serositis (9%). Low C3 levels …