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SAT0211 Hematological abnormalities in 624 patients with systemic lupus erythematosus and their relationship with organ involvement
  1. A. Alarfaj,
  2. A. Aleem,
  3. N. Khan
  1. Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia

Abstract

Background Hematological abnormalities are common in SLE [1-4].

Objectives To find out the hematological abnormalities and their relationship in a large cohort of Saudi SLE patients.

Methods SLE Patients (fulfilling ACR criteria)attending KKUH clinics, Riyadh,between 1980-2006 were studied. Demographic, hematological, and clinical manifestations were collected.

Results A total of 624 patients, 566 (90.7%) females, were diagnosed to have SLE with a mean age of 34.3±11.9 (range 8-71) years, and mean duration of SLE of 9.3±5.3 (range 0.3-30) years. Of these patients, 516 (82.7%) had hematological abnormalities at the time of diagnosis (Table 1). Anemia (Hb <12 gm/dL), occurred in 63% patients. leucopenia (WBC <4 ×109/L) in 30%, lymphopenia (>1.5×109/L) in 40.3%, thrombocytopenia (platelets <100×109/L) in 10.9% and autoimmune hemolytic anemia (AIHA) in 4.6% patients. C3 and C4 hypocomplimentemia was seen in 45.4% and 42.2% patients respectively. Deep venous thrombosis (DVT) developed in 46 (7.4%) patients, pulmonary embolism in 16 (2.6%) and antiphospholipid syndrome was diagnosed in 257 (41.2%) patients.

Twelve patients developed TTP, 3 patients had Evans syndrome and 3 Budd-Chiari syndrome. In multivariate analysis leucopenia was associated with oral ulcers and alopecia, anemia with renal disease, AIHA with neurological involvement, elevated IgG with malar rash and low C3 with serositis (for all p<0.05).

Table 1. Multivariate analysis of association between hematological abnormalities and organ involvement in SLE patients

Conclusions Among hematological manifestations of SLE, Anemia was the most common, followed by lymphopenia,leucopenia and thrombocytopenia.Patients with leucopenia were more likely to develop oral ulcers and alopecia, anemia predicted renal disease and AIHA was associated with neurological involvement.

  1. Fernández M, Alarcόn GS, Calvo-Alén J, et al (2007) LUMINA Study Group. A multiethnic, multicenter cohort of patients with systemic lupus erythematosus (SLE) as a model for the study of ethnic disparities in SLE. Arthritis Rheum 57:576-584

  2. Al Arfaj AS, Khalil N (2009) Lupus18:465-473

  3. Sultan SM, Begum S, Isenberg DA (2003) Prevalence, patterns of disease and outcome in patients with systemic lupus erythematosus who develop severe haematological problems. Rheumatology (Oxford) 42:230-234

  4. Tan EM, Cohen AS, Fries JF, et al (1982) The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 25:1271-1277

Disclosure of Interest None Declared

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