{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T18:22:37Z","timestamp":1787595757859,"version":"build-2736575974"},"reference-count":31,"publisher":"SAGE Publications","issue":"14","license":[{"start":{"date-parts":[[2020,8,24]],"date-time":"2020-08-24T00:00:00Z","timestamp":1598227200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Peking Union Medical College Hospital Fund for Distinguished Young Scholars","award":["JQ201706"],"award-info":[{"award-number":["JQ201706"]}]},{"name":"Chinese National Key Technology R&D Program, Ministry of Science and Technology","award":["2017YFC0907601, 2017YFC0907602"],"award-info":[{"award-number":["2017YFC0907601, 2017YFC0907602"]}]},{"name":"CAMS Innovation Fund for Medical Sciences","award":["2019-I2M-2-008"],"award-info":[{"award-number":["2019-I2M-2-008"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Lupus"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      Thrombotic thrombocytopenia purpura (TTP) associated with systemic lupus erythematous (SLE) (i.e., SLE-TTP) is a rare life-threatening disease often requiring intensive immunosuppressive agents, in addition to high-dose corticosteroids and plasma exchange (PEX). The optimal therapy of rituximab is unclear, but 375\u2009mg\/m\n                      <jats:sup>2<\/jats:sup>\n                      weekly for 4\u2009weeks is the usual practice, adopted from regimens for non-Hodgkin\u2019s lymphoma. We reported two cases of refractory SLE-TTP that showed good efficacy and prognosis with combination of methylprednisolone (MP) pulse, plasma exchange and low-dose rituximab (100\u2009mg weekly for 4\u2009weeks) treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Clinical data and treatment outcomes were reviewed of two patients diagnosed with refractory SLE-TTP at Peking Union Medical College Hospital between July 2017 and July 2018.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Both patients had SLE and presented with microangiopathic anemia and thrombocytopenia. Laboratory assays revealed high anti-nuclear antibody titers, reduced complement 3 and 4 levels, proteinuria, significantly elevated lactate dehydrogenase, schistocytes on peripheral blood smear, low ADAMTS13 activity, and the presence of ADAMTS13 inhibitor. In both patients, platelet counts remained below 50\u2009\u00d7\u200910\n                      <jats:sup>9<\/jats:sup>\n                      \/L after MP pulse and 6 PEXs, confirming the diagnosis of refractory SLE-TTP. Low-dose rituximab (100\u2009mg weekly for 4\u2009weeks) was administered in both cases, resulting in normalization of platelet counts and significant reductions in B-lymphocyte counts. No TTP relapse or SLE flare occurred during 24\u2009months of follow-up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our cases confirmed the efficacy and good follow-up outcomes of low-dose rituximab treatment (100\u2009mg weekly for 4\u2009weeks) for refractory SLE-TTP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0961203320953473","type":"journal-article","created":{"date-parts":[[2020,8,25]],"date-time":"2020-08-25T02:53:53Z","timestamp":1598324033000},"page":"1961-1967","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":17,"title":["Successful treatment of refractory thrombotic thrombocytopenic purpura associated with systemic lupus erythematosus with combination of plasma exchange and low-dose rituximab"],"prefix":"10.1177","volume":"29","author":[{"given":"Wanlu","family":"Ma","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Bai","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences, Beijing, China"},{"name":"National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, China"},{"name":"Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China"},{"name":"Chinese Rheumatism Data Center (CRDC), Chinese SLE Treatment and Research Group (CSTAR)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueyan","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9308-2858","authenticated-orcid":false,"given":"Jiuliang","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences, Beijing, China"},{"name":"National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, China"},{"name":"Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China"},{"name":"Chinese Rheumatism Data Center (CRDC), Chinese SLE Treatment and Research Group (CSTAR)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4252-2889","authenticated-orcid":false,"given":"Mengtao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of 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