期刊
LUPUS
卷 17, 期 8, 页码 739-743出版社
SAGE PUBLICATIONS LTD
DOI: 10.1177/0961203308090990
关键词
anaemia; haemolysis; haemolytic; lupus
类别
资金
- National Center for Research Resources [P20-RR015577]
- University of Oklahoma College of Medicine
- Arthritis National Research Foundation (AHS)
- NIH [AR42460, AI024717, AI31584, AR62277, AR048940, AR0490084, RR020143]
- Kirkland Scholar award
- Alliance for Lupus Research
- US Department of Veterans Affairs (JBH)
- NATIONAL CENTER FOR RESEARCH RESOURCES [P20RR020143, P20RR015577] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES [R01AI024717, R37AI024717, R01AI031584] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES [P30AR053483, P50AR048940, R01AR042460] Funding Source: NIH RePORTER
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.
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