Prevalence of the American College of Rheumatology hematological classification criteria and associations with serological and clinical variables in 460 systemic lupus erythematosus patients

Abstract

ObjectiveTo study systemic lupus erythematosus in a Brazilian population using the American College of Rheumatology hematological classification criteria and report associations of the disease with serological and clinical profiles.MethodsThis is a retrospective study of 460 systemic lupus erythematosus patients followed in a single rheumatologic center during the last 10 years. Hematological manifestations considered for this study were hemolysis, leukopenia, lymphocytopenia and thrombocytopenia.ResultsThe cumulative prevalences of leukopenia, thrombocytopenia, lymphocytopenia and hemolytic anemia were 29.8%, 21.08%, 17.7% and 8.4%, respectively. A higher percentage of patients with hemolysis had anticardiolipin IgM (p-value = 0.002). Those with leukopenia had more lymphopenia (p-value = 0.02), psychosis (p-value = 0.01), thrombocytopenia (p-value <0.0001) and anti-double stranded DNA antibodies (p-value = 0.03). Patients with lymphopenia had more leukopenia (OR = 1.8; 95% CI = 1.01–3.29) and lupus anticoagulant antibodies (OR = 2.2; 95% CI = 1.16–4.39) and those with thrombocytopenia had more leukopenia (OR = 3.1; 95% CI = 1.82–5.44) and antiphospholipid syndrome (OR = 3.1; 95% CI = 1.28–7.87).ConclusionThe most common hematological finding was leukopenia and the least common was hemolysis. Associations of low platelet count and hemolysis were found with antiphospholipid syndrome and anticardiolipin IgM positivity, respectively. Leukopenia and lymphocytopenia are correlated and leukopenia is more common in systemic lupus erythematosus patients with psychosis, thrombocytopenia and anti-double stranded DNA.

Detailed features of hematological involvement and medication-induced cytopenia in systemic lupus erythematosus patients: single center results of 221 patients

“…Leukopenia may also be a predictor for being anti-ds-DNA positive, a component of the SLE diagnostic criteria (4). Similarly, our patients with cytopenia at diagnosis were significantly found to be positive for anti-ds-DNA more frequently.…”

Effect of ethnicity on clinical presentation and risk of antiphospholipid syndrome in Roma and Caucasian patients with systemic lupus erythematosus: a multicenter cross‐sectional study

“…Differences in the prevalence of APS associated with SLE by race have been reported (Table ), ranging from 2.9% in Iban patients from East Malaysia to 27.8% in Indian patients . We found a prevalence of APS in Caucasians (13.3%) similar to that reported in a prospective study that showed that 13.8% of Spanish SLE patients had concurrent APS, while we detected a lower prevalence of APS in Roma patients (28.8%) compared to that previously published (36%) .…”

“…90%, P = 0.03). Prevalence of APS associated with lupus varies according to race (Table ). It has been reported that APS prevalence in Chinese SLE patients is lower than in the Caucasian population .…”

The Clinical Characteristics of Leukopenia in Patients with Systemic Lupus Erythematosus of Han Ethnicity in China: A Cross-Sectional Study

“…Leukopenia was positively associated with anti-dsDNA antibody, anti-ribosomal P protein antibody, neutropenia, lymphopenia, and thrombocytopenia in the present study, and patients with leukopenia developed decreased neutrophil counts, lymphocyte counts, platelet counts, and complement C3 levels. In another study, SLE patients with leukopenia also had an increased incidence of lymphopenia, thrombocytopenia, hemolytic anemia, anti-dsDNA antibody positivity, lupus anticoagulant and psychosis [ 15 ]. Recent research showed that leukopenia was associated with anti-dsDNA antibody positivity, low complement and ESR ≥ 25 mm/H [ 16 ].…”