Purpose Anemia is frequent manifestation of SLE. Numerous reasons for anemia are well recognized including chronic disease anemia, iron deficiency anemia, autoimmune hemolytic anemia, anemia due to chronic renal failure, anemia caused by the treatment and others. On the other hand, correlation of anemia severity with SLE disease activity and with particular clinical manifestations is not yet satisfactory examined. The aim of this study is to investigate anemia grade in patients with SLE and propose it as a potential severity and prognostic marker.

Methods 56 patients with a mean age of 33 ± 6.3years and with 7.5 ± 3.2years’ duration of SLE were enrolled in this study. All patients fulfilled with EULAR/ACR 2019 classification criteria and were evaluated with SLEDAI-2K. Anemia was graded as mild(91–110g/l), moderate(71–91g/l) and severe(51–70g/l). Data was analyzed with spss statistical software.

Results Out of all examined patients 85% were females and 15% males. Mean SLEDAI-2K was 11,26±7,2. 68,4% of patients presented with anemia, in particular 27 patients (47,4%) had mild, 7(12,3)– moderate, 4(7,0%)- severe anemia. According to the study lower values of anemia significantly correlate with high SLEDAI-2K(p<0,01) and presence of Lupus nephritis(p<0,042). Diversely, significant association between ESR, CRP and aPL titers and anemia levels was not found. 78,9% of patients with anemia had mucocutaneous manifestations, 57,9%-arthritis, 47,4%-hepatosplenomegaly, 44,7%-pleuritic, 42,1%-pericarditis, 36,8%-lupus nephritis, 28,9%-cerebral vasculitis.

Conclusion Anemia could be used as an additional marker for the evaluation of SLE activity status. In purpose to determine, if specific anemia type is more connected with disease activity, further assessment of hepcidin, ferritin and coombs test is required.