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2008 ; 17
(8
): 739-43
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Haemolytic anaemia in a multi-ethnic cohort of lupus patients: a clinical and
serological perspective
#MMPMID18625652
Jeffries M
; Hamadeh F
; Aberle T
; Glenn S
; Kamen DL
; Kelly JA
; Reichlin M
; Harley JB
; Sawalha AH
Lupus
2008[Aug]; 17
(8
): 739-43
PMID18625652
show ga
Systemic lupus erythematosus is a chronic autoimmune disease that can be
associated with a variety of haematological manifestations. We identified 76
patients with haemolytic anaemia in a cohort of 1251 unrelated female lupus
patients enrolled in our studies. The presence of the various American College of
Rheumatology clinical criteria for lupus and serological specificities were
determined in lupus patients with haemolytic anaemia and compared with a group of
race-matched control lupus patients without haemolytic anaemia. Clinical data
were obtained from medical records, and serological specificities were determined
in our clinical immunology laboratory at OMRF. The presence of haemolytic anaemia
in lupus patients was associated with a higher frequency of proteinuria (OR =
2.70, P = 0.000031), urinary cellular casts (OR = 2.83, P = 0.000062), seizures
(OR = 2.96, P = 0.00024), pericarditis (OR = 2.21, P = 0.0019), pleuritis (OR =
1.72, P = 0.028) and lymphopenia (OR = 1.79, P = 0.015). These findings were
independent of the presence of thrombocytopenia, which was approximately five
times more common in lupus patients with haemolytic anaemia. Lupus patients with
haemolytic anaemia were about 8 years younger than lupus patients without
haemolytic anaemia at the time of disease onset (P = 0.000001). In the absence of
thrombocytopenia, lupus patients with haemolytic anaemia were approximately two
times more likely to have anti-dsDNA antibodies (P = 0.024). The presence of
haemolytic anaemia is associated with a subset of lupus characterized by a
younger age of disease onset, and a more severe disease with a higher likelihood
of renal involvement, seizures, serositis and other cytopenias.