Sarcouncil Journal of Internal Medicine and Public Health

Abstract: Systemic lupus erythematosus (SLE) is an autoimmune disease of chronic nature, having a wide range of hematological manifestations. Thrombocytopenia is a frequent and medically important adverse effect which affects morbidity and the quality of life. This experiment sought to describe the commonness and the severity of thrombocytopenia. It also aimed at determining the prognostic factors that could be linked with severe thrombocytopenia, as well as the patterns through which the various treatments and quality-of-life results could be used within a period of 12 months. A cross-sectional study was carried out on 107 participants who were having SLE. The cohort data on the clinical appearance at presentation and SLE disease activity (SLEDAI) in Thi-Qar-Iraq hospitals in March 2024 - March 2025 was analyzed as the baseline data. Odds ratios were used to determine prognostic factors of severe thrombocytopenia. Rehabilitative interventions and modalities of treatment were recorded. At 6 and 12 months, clinical outcomes such as platelet count, disease activity, bleeding incidents, and hospitalization were measured. Thirty-eight point three percent of the participants had high disease activity (SLEDAI ≥ 20). The predictive value of lupus nephritis (OR 3.12), a SLEDAI score of 20 (OR 2.89), the presence of anti-phospholipid antibodies (OR 2.45), and having a positive direct Coombs test (OR 2.31) were also important prognostic factors of severe thrombocytopenia. The most common treatments were corticosteroids (89.7) and hydroxychloroquine (78.5). The high adherence rates were found in rehabilitative interventions with low-impact aerobic exercise (62.6%) and patient education (55.1%). Mean platelet count (68.3→112.4 x 109/L), bleeding events, SLEDAI scores, and all functional and quality of life parameters, including the SF-36 physical component (+14.4) and pain VAS (−23.6 mm), showed significant improvements at 12 months. SLE patients exhibit thrombocytopenia, which is severe yet prevalent, and correlates well with renal involvement, high disease activity, and anti-specific antigens autoantibodies. The combination of the therapy with pharmacologic therapy and programmed rehabilitation interventions, with a major relief in the hematologic parameters, disease control, and patient-reported functional outcomes and quality of life at 12 months, also became correlated with the multidisciplinary approach to treatment.