Background In Systemic Lupus Erythematous (SLE) patients, various anemia types are found, among others autoimmune hemolytic anemia, iron deficiency anemia (IDA) or anemia of chronic disease. Since Indonesia is located in the thalassemia belt area, thalassemia trait among SLE may exist. Therefore, this study aimed to identify the possibility of thalassemia trait among SLE patients living in Bandung, West Java, Indonesia.
Methods This was an observational study, including complete blood count data of all female SLE patients registered in the Lupus Registry at Dr. Hasan Sadikin General Hospital throughout 2022. Erythrocyte index Shine & Lal (MCV*MCH*MCH/100) was calculated in those with low MCV value (<80 fl) and/or low MCH (<27 pg) to determine whether anemia was due to IDA (>1530) or thalassemia trait (<1530).
Results In total, 298 data of female SLE patients (mean aged 38+10.6 years old) were collected and the mean SLE onset was 29+9.6 years old. Low Hb (<12 mg/dl) was found in 49% (n146) of whom 23.5% were mild, 7% were moderate and 18.5% were severe anemia. Moreover, 26% (n78) had low MCV (microcytic anemia) and/or low MCH (hypochromic anemia). Interestingly, low Shine & Lal index were found in 10.7% these patients, indicating thalassemia trait.
Conclusions About 10% of SLE patients in our study have been considered to carry thalassemia trait, similar to data in the general population in Indonesia. Hb-electrophoresis followed by DNA examination need to be performed to confirm this finding. Since most of SLE patients are female, and they have been mostly diagnosed as SLE in young adult age, thalassemia carrier screening is of great importance for future family planning.
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