REVIEW

Anaemia in systemic lupus erythematosus: from pathophysiology to clinical assessment

S Giannouli, M Voulgarelis, P D Ziakas, A G Tzioufas

Department of Pathophysiology, Medical School, National University of Athens, Greece

Correspondence to:
Dr M Voulgarelis
Department of Pathophysiology, Medical School, National University of Athens, M. Asias 75, Goudi, 11527 Athens, Greece; mvoulgar{at}med.uoa.gr

Haematological abnormalities are common in systemic lupus erythematosus. Anaemia is found in about 50% of patients, with anaemia of chronic disease being the most common form. Impaired erythropoietin response and presence of antibodies against erythropoietin may contribute to the pathogenesis of this type of anaemia. Patients with autoimmune haemolytic anaemia usually belong to a distinct category, which is associated with anticardiolipin antibodies, thrombosis, thrombocytopenia, and renal disease, often in the context of secondary antiphospholipid syndrome. Autoantibodies, T lymphocytes, and deregulation of the cytokine network can affect bone marrow erythropoiesis, leading to anaemia.

Abbreviations: ACD, anaemia of chronic disease; aCL, anticardiolipin antibodies; AHA, autoimmune haemolytic anaemia; APS, antiphospholipid syndrome; BM, bone marrow; EPO, erythropoietin; IDA, iron deficiency anaemia; IFN, interferon; PRCA, pure red cell aplasia; rHuEPO, recombinant human erythropoietin; SLE, systemic lupus erythematosus; TNF, tumour necrosis factor

Keywords: systemic lupus erythematosus; anaemia; pathogenesis; diagnostic approach

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