Abstract
SLE is a multisystem autoimmune disease with significant morbidity and mortality in women of young and child bearing age. The prognosis is still poor in certain ethnic groups like Indians and Hispanics as compared to the western population. Haematological abnormalities are one of the integral criteria for disease classification as specified by the American Rheumatic Association, yet there is a paucity of information regarding their temporal progression and impact on the course of the disease. This prospective study was carried out on forty five patients with SLE in the Department of General Medicine, Govt TD Medical College, Alappuzha with specific emphasis on anaemia and its correlation with the myriad presentations of SLE. The most common haematological abnormality detected in our study was Anaemia, with Iron deficiency Anaemia, Anaemia of Chronic Disease and Auto Immune Hemolytic Anaemia (IHA) being the most common subtypes. Further, Anaemia was significantly associated with Lupus Nephritis but not any other major organ involvement. No significant association was found between anaemia and serum creatinine, but a negative correlation was observed between the two, with higher creatinine values associated with lower haemoglobin levels. Appropriate treatment showed a significant improvement in Haemoglobin levels across all subtypes of anaemia.
References
- Malviya AN, Chandrasekharan AN, Kumar A. Occassional series- lupus round the world: Systemic Lupus erythrematosus in India. Lupus1997; 6: 690-700.
- Cameron SJ, Bank E, Melmerby. Lupus Nephritis. Disease of the month. J Am Soc Nephrology, 1999, 10: 413-422.
- Manzi M, Ramsay-Goldman, Star KV. Epidemiology of systemic lupus Erythrematosis in Rheumatology, 3rd Edition, MC Holdberg, A Silman (eds), Philadelphia; Mosby, 2003:1295-1296.
- Wallace DJ. The clinical presentation of SLE, In Dubois’s Lupus Erythrematosis .4th Chapter 33. Wallace DJ and Hahn BH (eds), Philadelphia, Lea & Febiger 1993:317-321.
- Kumar A. Indian guidelines on the management of SLE. Indian Rheumatology Association 2002, 10:80-96.
- Reichlin M, Harley. Anti-nuclear antibodies: An overview in Dubois Lupus Erythrematosis. 4th Chapter 19. Wallace DJ & Hahn BH (eds), Philadelphia, Lea & Febiger 1993: 356-369.
- Paul BJ, Fassaludeen M, Nanda Kumar. Clinical profile of Systemic lupus Erythrematosis in northern Kerala. J Indian Rheumatol Asso 2003; 11: 94-97.
- Madhavan R, Porkodi R, Ramakrishnan S. Systemic lupus erythrematosis- the Madras experience. J Asso Physician India.1998; 36:473-75.
- Mills JA. Systemic lupus Erythrematosis .NEJM 1994 volume 330:1871-79.
- Budman DR and Steinberg AD. Hematologic aspects of systemic lupus erythromatosis. Current aspects of systemic lupus erythrematosis. Current aspects. Ann Int Med 1997;6: 220-229.
- Voulgarelis M, Kokori SIG, Ioannidis PA. Anaemia in systemic lupus erythromatosis: etiological profile and the role of erythropoietin. Ann Rheum Disease.2000; 59:217-222.
- Miguel EC, Rodrigues Pereira RM, deBraganca Pereira CA. Psychiatric manifestations of systemic lupus erythromatosis: Clinical features, symptoms and signs of central nervous system activity in 43 patients. Medicine 1994; 73: 224-232.
- Donaldo V, Hurrt GM, Bergstrath EJ. Prognostic determinants in lupus nephritis: A long term clinico-pathological Lupus 1995 April, 4(2): 109-15.
- Scofield RR, Gail R, Jennifer A. Thrombocytopenia identifies a severe familial phenotype of systemic lupus erythrematosis. Blood, 1 Feb 2003, vol 101, No.3: pp 992-997.
- Sultan SM, Begum S, Isenberg. Prevalence, patterns of disease and outcome in patients with systemic lupus erythromatosis who develop severe haematological problems. Rheumatology 2003; 42: 230-234.
- Nossent JC and Swaaak AJG. Prevalence and significance of haematological abnormalities in patients with systemic lupus erythrematosis. QJ Med, New Series 80. No 291.1991.July 605-612.
Corresponding Author
Dr Rashmi KP
Assistant Professor of Medicine, Dept of Medicine,
Govt T.D Medical College, Alappuzha
DOI: https://dx.doi.org/10.18535/jmscr/v6i1.127
