When Surgery Becomes Necessary for Lupus Patients

Lupus and Surgery: Splenectomy

More than three-quarters of people with systemic lupus develop antibodies against platelets, the blood cells needed to stop bleeding. Between 8 and 20 percent of these people will experience a decrease in the number of platelets, a condition called thrombocytopenia. If the number of platelets in your blood get too low, excessive bleeding can occur.

“In some cases [of thrombocytopenia] that don’t respond to medication, removal of the spleen may be necessary to correct the problem,” says Dr. Erkan.

Your spleen is an organ that is located just below your ribs on the left side of your body. It is thought that the spleen may be the source of the antiplatelet antibodies that occur in patients with lupus and may play a role in the destruction of platelets that are coated with these antibodies. Surgical removal of the spleen (splenectomy) has been shown to reverse thrombocytopenia in people with lupus.

In a review published in the Annals of Surgery on splenectomies performed on lupus patients with thrombocytopenia, 88 percent responded immediately and 64 percent sustained this response for more than six years. The authors found that splenectomy was a safe and effective treatment for lupus thrombocytopenia that could not otherwise be successfully treated.

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