Features associated with hematologic abnormalities and their impact in patients with systemic lupus erythematosus: Data from a multiethnic Latin American cohort |
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| Institution: | 1. School of Medicine, University of Zagreb, Zagreb, Croatia;2. Department of Neurology, Referral Center for Autonomic Nervous System Disorders, University Hospital Center Zagreb, Zagreb, Croatia;3. Faculty of Electrical Engineering, University of Zagreb, Zagreb, Croatia;1. The Third Psychiatric Department, Jining Psychiatric Hospital, Jining, 272051, Shandong Province, People''s Republic of China;2. The Third Psychiatric Department, The Second Affiliated Hospital of Jining Medical University, Jining, 272051, Shandong Province, People''s Republic of China;3. Department of Psychiatry, Mental Diseases Prevention and Treatment Institute of PLA, PLA 91st Central Hospital, Jiaozuo, 454003, Shandong Province, People''s Republic of China;4. Department of Geriatric Psychiatry, Jining Psychiatric Hospital, Jining, 272051, Shandong Province, People''s Republic of China;5. Department of Geriatric Psychiatry, The Second Affiliated Hospital of Jining Medical University, Jining, 272051, Shandong Province, People''s Republic of China;1. Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Japan;2. Center for Bioinformatics and Molecular Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan |
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| Abstract: | ObjectiveTo examine hematological manifestations’ correlates and their impact on damage accrual and mortality in SLE patients from the multiethnic, Latin American, GLADEL cohort.MethodsIn patients with recent SLE diagnosis (≤2 years), the association between follow-up hematological manifestations (per ACR criteria) and socio-demographic and clinical variables was examined by univariable and multivariable logistic regressions; their impact on damage accrual and mortality was examined by Poisson and Cox proportional-hazards regression analyses, respectively.ResultsOf 1437 patients, 948 (66.0%) developed ≥1 hematological manifestation 5.5% hemolytic anemia (AHA), 16.3% thrombocytopenia, and 56.4% lymphopenia] over 4.3 (3.3) follow-up years. Younger age, Mestizo ethnicity, hematologic disorder (at/or before SLE diagnosis), and first damage recorded were associated with hematological manifestations while antimalarials were negatively associated. AHA (at/or before SLE diagnosis), anti-Sm, and anti-RNP antibodies were associated with subsequent AHA occurrence while musculoskeletal involvement was negatively associated. Thrombocytopenia (at/or before SLE diagnosis), AHA, anti-phospholipid antibodies (aPLs), anti-SSA/Ro, anti-SSB/La antibodies, and first damage recorded were associated with later thrombocytopenia occurrence. Lymphopenia (at/or before SLE diagnosis), younger age at diagnosis, Mestizo ethnicity, having medical insurance, and first damage recorded were associated with subsequent lymphopenia occurrence while antimalarials and azathioprine treatment were negatively associated. AHA was associated with damage accrual and mortality after adjusting for variables known to affect these outcomes.ConclusionsMestizo ethnicity and early hematological manifestations are risk factors for their subsequent occurrence while antimalarials have a protective effect. The associations between AHA and aPLs and thrombocytopenia were corroborated. AHA contributes independently to damage accrual and diminished survival. |
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| Keywords: | Systemic lupus erythematosus Hematologic manifestations Autoimmune hemolytic anemia Thrombocytopenia Lymphopenia |
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