Pattern of Hematological Manifestations in Patients with Systemic Lupus Erythematosus Attending in a Tertiary Care Hospital (original) (raw)
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International journal of research publications, 2022
Systemic Lupus Erythematosus (SLE) is an autoimmune illness with a broad range of clinical manifestations, one of which is hematological manifestations that cause high morbidity and mortality if there is a delay in diagnosis. This research was conducted to analyze the pattern of hematological manifestations of SLE patients. This research was a descriptive retrospective study. A total of 106 patients with systemic lupus erythematosus met the inclusion criteria. Patients were dominated by a female (94.34%) and the age group of 18-27 years old (46.23%). The average hemoglobin level of the sample was 8.16 g/dl with anemia in 99 patients (93.4%), which was morphologically dominated by normochromic normocytic anemia in 61 patients (57.55%). The mean platelet count of the sample was 192.77 x and thrombocytopenia was found in 26 patients (24.53%). The mean lymphocyte count of the sample was 1.03 x and lymphopenia was found in 26 patients (79.25%). The mean leukocyte count in the sample was 7.53 x and leukopenia was found in 22 patients (20.75%). This study concludes that SLE patients are dominated by females aged 18-27 years old and the most frequent hematological abnormalities are anemia (morphologically dominated by normochromic normocytic anemia), thrombocytopenia, lymphopenia, and leukopenia.
Hematology, 2007
Abnormalities of hematological system are very common in systemic lupus erythematosus (SLE). The aim of the study is to evaluate hematological findings in patients with SLE at the time of referral and their relationship with disease activity and organ involvement. The study was carried consecutive 115 patients, including 20 males and 85 females. Most of the cases had anemia at the time of presentation due to various etiologies. Anemia of chronic disease was seen in 46% and it was the most common encountered picture. The rate of hemolytic anemia was 28%, and Coombs' positivity rate was 22% among our patients. Leukopenia (,4.0 £ 10 9 /l), neutropenia (, 1.8 £ 10 9 /l), and lymphopenia (, 1.5 £ 10 9 /l) rates were 57, 20, and 82%, respectively. Thrombocytopenia was seen in 40% for , 150 £ 10 9 /l, 26% for ,100 £ 10 9 /l, and 8% for , 50 £ 10 9 /l. Of our patients, 10% had antiphospholipid syndrome (APS) at the time of diagnosis. Increased fibrinogen levels were observed in 35% without relating to disease activity. The rates of C3 and C4 hypocomplementemia were 86 and 64%, respectively, and both are closely correlated with the disease activity. Moreover, C3 hypocomplementemia was more prominent in cases with renal or serosal involvement. Leukopenia and hyperfibrinogenemia were more common in patients with skin/mucosal involvements. C3 hypocomplementemia, APS and elevated IgG levels were more common in our patients with renal involvement. SLE should be kept in mind while evaluating patients with mentioned hematological findings, especially in those with accompanying organ involvements.
Pattern of Anaemia in Systemic Lupus Erythemetosus (Sle) Patients
Journal of Chittagong Medical College Teachers' Association
Background: Anaemia of Chronic Disease (ACD) is the most common form of anaemia in patients with Systemic Lupus Erythemetosus (SLE) Autoimmune Hemolytic Anaemia (AIHA), Iron Deficiency Anemia (IDA) drug-induced myelotoxicity, and anaemia due to chronic renal failure are also often detected. Distinctly different therapeutic approaches are required for the multiple causes of anaemia in these patients. However, the pattern of anaemia among the SLE patient of this geographical area is less studied. Aim of this study was to investigate the pattern of anaemia in patients with SLE. Materials and methods: This study was carried out on the patients who had been admitted in the Departments of Medicine, Nephrology and also from outpatient Department of Chittagong Medical College Hospital (CMCH) Chittagong. SLE patients were selected consecutively as per inclusion and exclusion criteria. Detailed history and physical examinations were performed in every patient. Necessary investigations were ca...
Frequency of anaemia in patients with systemic lupus erythematosus at tertiary care hospitals
JPMA. The Journal of the Pakistan Medical Association, 2010
To analyze the frequency and causes of anaemia in systemic lupus erythematosus (SLE) patients attending in department of medicine at tertiary care hospitals. This retrospective, descriptive and analytical study was planned to analyze the frequency and causes of anaemia in SLE patients attending the department of medicine at (MMC) and (LUMHS) hospitals during the period of Jan 2006 to Nov 2008. The criteria used in this study were from the American College of Rheumatology. Investigations recorded were blood complete picture, absolute values, peripheral smear, and reticulocyte count in all patients of anaemia. These investigations were necessary to analyse the cases of anaemia in SLE. All investigations were not done in all cases. Patients with hypochromic microcytic anaemia were advised to have serum iron and ferritin levels, seven patients with macrocytic anaemia were advised to have direct and indirect coomb's test, LFTs, serum LDH, serum B12 and folate levels. Patients with no...
A Practical Perspective of the Hematologic Manifestations of Systemic Lupus Erythematosus
Cureus, 2022
Systemic lupus erythematosus (SLE) is a chronic inflammatory disease with an unknown etiology that can affect any organ or system of the human body. Hematological, renal, or central nervous system manifestations in these patients result in great morbidity because high doses of glucocorticoids, cytotoxic medications, or biological drugs are required to control these manifestations. It is noteworthy that hematological involvement predominates during the first years of the disease and tends to last over time, with the premise that it may be the initial manifestation of the disease. Clear examples of this are the cases of hemolytic anemia and immune thrombocytopenia that can be initially classified as idiopathic or primary to be later classified as secondary when associated with infections, medications, neoplasms, or autoimmune diseases. The spectrum of hematologic manifestations in SLE is very broad, including lymphopenia, anemia, thrombocytopenia, or pancytopenia. In some cases, lymphadenopathy and splenomegaly are also identified. The vast majority of these manifestations denote high disease activity. However, many of these alterations have a multifactorial cause that must be taken into account to adopt a more complete therapeutic approach. The objective of this review is to characterize in detail the hematological manifestations of SLE to offer clinicians a practical vision of its diagnosis and treatment.
Haematological abnormalities in systemic lupus erythematosus
2014
OBJECTIVES 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. PATIENTS AND METHODS 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. RESULTS 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 thr...
Hematological disorders in patients with systemic lupus erythematosus
The Open Rheumatology Journal, 2013
This article is a review of different management strategies for the hematological manifestations of systemic lupus erythematosus (SLE), the strategies include immunosuppressive drugs, some noval therapies and B-cell depletion for refractory thrombocytopenia in patients with SLE and in antiphospholipid antibody syndrome associated with SLE. The researcher questions the validity of the current classic treatment modes and the article explores the relationships between SLE hematological manifestations and the level of morbidity and mortality burden and focuses on the pathophysiology, diagnostic approaches and management strategies of these manifestations. The researcher focuses on hematological abnormalities because they are the commonest among most manifestations in SLE seen in Anemia, leucopenias and thrombocytopenia. They commonly result from an immune mediated bone marrow failure, excessive peripheral cells destruction or certain drugs and infections. There is also an association between antiphospholipid antibody syndrome (APS) and SLE referred to as secondary APS or SLE-APS. Furthermore, it was recently found that mycophenolatemofetil acts as corticosteroids and as cyclophosphamide sparing agent. Although there is no specific therapy for cytopenias in SLE, corticosteroids remain the mainstay in the treatment of these patients along with less used other conventional treatment options such as azathioprine, cyclophosphamide and human normal immunoglobulin. There are other novel therapies such as thrombopoietin receptor agonists in thrombocytopenia and the use of autologous hematopoitic stem cells transplantation in refractory SLE-APS that are under review. Some of these therapies include thrombopoietin receptor agonists in thrombocytopenia and the use of autologous hematopoitic stem cells transplantation in refractory SLE-APS. The study concludes that treatment of hematological abnormalities is challenging because the treatment itself can cause undue complications sometimes such as granulocytosis due to infection or the use of high doses of steroids and may occur during acute exacerbations of SLE. It is important to take these factors into consideration for disease therapy and management.