The case of a young woman with systemic lupus erythematosus (SLE) is reported in whom thrombocytopenia was a major feature of her disease. She was given three courses of ‘pulse’ intravenous methyl prednisolone (IVMP) on separate occasions as treatment for profound thrombo-cytopenia. A diminishing response in platelet count was obtained following each course. She received a further course of IVMP for treatment of a nephritis, with a moderate platelet response: this may have been related in part to concomitant oral cyclophosphamide.IVMP may be an effective treatment for SLE-associated thrombocytopenia but repeated courses may result in a reduced platelet response.