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218 Risk factors associated with the occurrence of autoimmune hemolytic anaemiaanemia in systemic lupus erythematosus
  1. A Kurniawan1,
  2. NPH Lugito1,
  3. S Sumantri1,
  4. AS Soetjipto2,
  5. V Kusnaidi2,
  6. D Hadi2 and
  7. LM Rouly2
  1. 1University of Pelita Harapan, Internal medicine, Tangerang, Indonesia
  2. 2University of Pelita Harapan, School of Medicine, Tangerang, Indonesia

Abstract

Background and aims Almost all systemic lupus erythematosus (SLE) patients develop haematological abnormalities during their disease course. Autoimmune hemolytic anaemia (AIHA) was reported in 5%–14% of SLE patients which is usually mediated by warm-type IgG anti-erythrocyte antibodies. There is still paucity data about risk factors associated with the occurrence of AIHA in SLE patients. The aim of this study is to know risk factors associated with the occurrence of AIHA in SLE patients.

Methods This study was a retrospective cohort single centre study from 2013–2015 from our general hospital, Karawaci, Tangerang, Banten, Indonesia. The criteria of SLE patients were using American College of Rheumatology (ACR) criteria. The data were from our medical records database. The criteria of AIHA were based on American Society Haematology (ASH) criteria. Clinical data and risk factors of AIHA patients were reviewed and analysed. Anti-nuclear antibody (ANA) and anti-dsDNA were detected using indirect immunofluorescence test (IFA-Bio-Rad, USA).

Results Fifty-seven patients were included, of whom 93% were female with a median age of 36 (12-72) year old. AIHA patient found in 57.9% of the patients with positive IgG antibody to erythrocyte. ANA was positive in 84.2% and anti-dsDNA was positive 75.4%. Positive ANA, OR 1.91 (0.45–8.02); positive anti-dsDNA 2.25 (0.66–7.76); decreased complement3 (C3) 0.77 (0.23–2.51); decreased C4 0.67 (0.21–2.16); decreased albumin level 0.82 (0.23–2.92); thrombocytopenia 3.19 (1.01–10.05), leucopenia 0.95 (0.30–3.0) did not significantly related to AIHA.

Conclusions The proportion of AIHA in SLE patients 57.9%. Positive ANA, anti-dsDNA, decreased C3, C4, hypoalbuminemia, thrombocytopenia, and leucopenia were not statistically significant.

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