Age

18–65

Sex

ALL

Healthy volunteers

Not accepted

Age ≥ 18 and \< 65 years
1. Meet 2012 SLICC or 2019 EULAR/ACR criteria for systemic lupus erythematosus
2. Meet ITP diagnostic criteria: platelet count ≤ 30×10\^9/L, or ≤ 50×10\^9/L with bleeding tendency
3. At least two CBC tests showing thrombocytopenia
4. Bone marrow smear showing megakaryocyte maturation disorder
5. Willing to sign informed consent form

1. Other causes of thrombocytopenia
2. Refractory SLE-ITP (no partial response after 3 months of high-dose steroids or immunosuppressants)
3. Use of rituximab within 6 months
4. Severe organ involvement (e.g., proteinuria \> 1g/24h, CNS involvement, cardiac/GI involvement)
5. Other autoimmune diseases (except Sjögren's syndrome)
6. Malignancy
7. Active infections (HIV, HBV, HCV, syphilis)
8. Severe liver or kidney dysfunction
9. Splenomegaly
10. Pregnancy or breastfeeding
11. Contraindications to study drugs
12. Unhealed major wounds or incisions
13. Judged unsuitable by investigator

Sirolimus in Patients With Systemic Lupus Erythematosus-Associated Immune Thrombocytopenia