Hematologic Manifestations of Systemic Lupus Erythematosus in a Tertiary Care Centre

Abstract

Background: Systemic lupus erythematosus (SLE) can present with hematologic manifestations alone or with features of systemic involvement. Diagnosis may be delayed or missed at presentation time, especially in those with hematologic abnormalities as the initial manifestation, with low index of clinical suspicion or inadequate follow-up. Aim And Objectives: To study the prevalence and the type of hematologic manifestations in SLE from pathologist's perspective. Setting And Design: Retrospective observational study. Material And Methods: Study was done in 63 SLE patients in a tertiary care hospital in Secunderabad for duration of one and half years, from January 2018 to June 2019. Hematological parameters of the same were retrieved. Results :It was observed that anemia was the most common hematologic nding with iron deciency anemia (IDA) being the commonest cause followed by hemolytic anemia. Leucopenia with predominant lymphopenia was the most common WBC abnormality and thrombocytopenia was seen in majority of the patients. Bi and pancytopenia was also observed. Raised erythrocyte sedimentation rate (ESR) was a common nding. Deranged coagulation prole was seen due to secondary anti-phospholipid antibody (APLA) syndrome, hemolysis and sepsis on anticoagulant. Bone marrow studies showed varied ndings including hypocellularity, dyspoiesis in the erythroid, myeloid and megakaryocytic series and abnormal localisation of immature precursors (ALIP) aggregates. Conclusion: This study was conducted to estimate the proportion of patients with hematological abnormalities as the manifestation of SLE and to study the nature of hematological problems, so that the empirical treatment can be started.