Abstract: We report a case of systemic lupus erythematosus patient with progressive cytopenia, fever, fatigue, and nasal mucosal bleeding. Methylprednisolone was gradually increased from the standard dose to 500 mg/d (combined with gamma globulin). The patient's condition improved, but neuropsychiatric symptoms and other adverse reactions occurred. Two days later, the patient's condition recurred with a small amount of bleeding from the nasal mucosa. The patient was improved after the addition of rituximab, and his condition was stable after two and a half years follow up.

Key words: systemic lupus erythematosus, blood crisis, rituximab treatment