Lupus & antiphospholipid syndrome
Immune thrombocytopenia is rare in patients with antiphospholipid syndrome without systemic lupus erythematosus: insights from a series of 351 patients
Authors' conclusion
In patients with APS, the underlying cause of thrombocytopenia can be identified in most cases through careful review of medical records. True ITP is uncommon and appears to be exceptionally rare in patients with APS without concomitant SLE.
Study context
- Population
- Patients with antiphospholipid syndrome (APS) with at least one episode of thrombocytopenia (platelet count <100 x 10ˆ9/L), tertiary referral cohort102 with thrombocytopenia included
- Participants
- 351 patients
- Exposure
- Catastrophic antiphospholipid syndrome (CAPS) vs immune thrombocytopenia (ITP)
- CAPSn = 75reference
- ITPn = 12
- Outcome
- Aetiologies of thrombocytopenia and frequency and characteristics of ITP, including association with SLE
Methodological detailssingle-centre tertiary referral cohort, enriched in severe cases
- Single-centre tertiary referral cohort
- Enriched in severe cases
Main finding
As reported in the abstract
Causes of thrombocytopenia
- Thrombocytopenia among APS patients
- 102 (29.1%)
- CAPS
- n=75, 73.5%
- ITP (including two with both CAPS and ITP)
- n=12, 11.8%
- Other identified causes
- 11 (10.8%)
- Unexplained
- six patients (5.9%)
- Isolated ITP without SLE, share of entire APS cohort
- 0.6%
Observational data: associations, not effects.
Further findings
Associated SLE
P = 0.013
Platelet nadir and severity
- Median platelet nadir (x 10ˆ9/L)
- 34.5
- Severe thrombocytopenia (<20 x 10ˆ9/L)
- 33 (32.4%)
Safety
| Outcome | HR (95% CI) | |
|---|---|---|
| Severe haemorrhagic events, platelet nadir <20vs >100 x 10ˆ9/LGraded increase with severity; not statistically significant | 2.55 (0.94–6.94) | |
| 0.10.31310Hazard ratio (log scale) |
Original publication
Immune thrombocytopenia is rare in patients with antiphospholipid syndrome without systemic lupus erythematosus: insights from a series of 351 patients. Lupus Sci Med. Published 11 August 2026. doi:10.
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