Haematological abnormalities in systemic lupus erythematosus.

TLDR

The study aimed to assess the frequency and patterns of hematological abnormalities in SLE patients at diagnosis and follow‑up and their association with organ involvement. A retrospective cohort of 624 SLE patients (90.7 % female, mean age 34.3 yr) from 1982‑2008 at King Khalid University Hospital was analyzed, recording demographics, hematologic parameters, disease manifestations, organ involvement, and clinical complications, with multivariate analysis used to assess associations. Hematologic abnormalities were present in 82.7 % of patients at diagnosis, most commonly anemia (63 %) followed by lymphopenia (40.3 %), leukopenia (30 %), thrombocytopenia (10.9 %) and AIHA (4.6 %); after a mean 9.3‑year follow‑up, 67 % still had abnormalities, with anemia (51.7 %) and lymphopenia (33.1 %) remaining most frequent, and specific abnormalities (leukopenia, anemia, AIHA, elevated IgG, low C3) were significantly associated with distinct organ manifestations, underscoring the high prevalence and clinical relevance of hematologic involvement in SLE.

Abstract

This study was conducted to evaluate the frequency and pattern of haematological abnormalities (HA) in SLE patients at the time of diagnosis and last follow-up, and their relationship with organ involvement.This retrospective study included patients who were diagnosed and treated for SLE from 1982 to 2008 at King Khalid University hospital, Riyadh. Demographic and haematological parameters at diagnosis and the last follow-up, disease manifestations, organ involvement and clinical hematological complications were recorded. Association of HA with organ involvement was explored by multivariate analysis.A total of 624 patients (90.7% females, mean age 34.3±11.9 years) were studied. HA were present in 516 (82.7 %) patients at the time of diagnosis. Anemia was the most frequent HA in 63.0% patients followed by lymphopenia in 40.3%, leukopenia in 30.0%, thrombocytopenia in 10.9% and autoimmune hemolytic anemia (AIHA) in 4.6% patients. Deep vein thrombosis and pulmonary embolism were diagnosed in 7.4% and 2.6% patients respectively. After a mean follow-up of 9.3±5.3 years, 329/491 (67%) patients still had some HA present. Anemia remained the most common abnormality (51.7% patients) followed by lymphopenia in 33.1%, and thrombocytopenia in 4.8% patients. Leucopenia was associated with oral ulcers (p=0.021) and alopecia (p=0.031), anemia with renal disease (p=0.017), AIHA with neurological involvement (p=0.003), elevated IgG with malar rash (p=0.027), and low C3 with serositis (p=0.026).HA are very common at the time of diagnosis and during follow-up in SLE, and some of these abnormalities are associated with organ damage. This information may help in better management planning of SLE patients.