HEMATOLOGICAL PROFILE OF SYSTEMIC LUPUS

ERYTHEMATOSUS AT SMCH : A HOSPITAL BASED STUDY

DR. AKHIL AGRAWAL , DR DIPANKAR DEB , DR BIJUSH DIFOESA , DR ARUP SARMA
DEPT OF MEDICINE , SILCHAR MEDICAL COLEGE & HOSPITAL

HAEMATOLOGICAL PROFILE
INTRODUCTION

•Systemic lupus erythematous (SLE) is a multisystem autoimmune disorder affecting 80

predominantly females of child bearing age group.

• The expression of SLE is influenced by the combined effect of genetic,

environmental, demographic and geographical factors.

• Hematological abnormalities are common presentations in SLE that may be missed

if index of suspicion is low. 25
25
•This study was conducted to assess the prevalence of patients with hematological
10
abnormalities in SLE in Barak Valley.
ANEMIA LEUCOPENIA NEUTROPHILIA THROMBOCYTOPENIA

OBJECTIVES
1.To estimate the proportion of patients with hematological abnormalities as the
manifestation of SLE

2.To study the nature of hematological presentation

DISCUSSION
METHODS AND STUDY POPULATION
This study shows that hematological abnormalities are extremely common in
our SLE population, next only to arthritis and arthralgia.
The study was conducted at Department of Medicine , Silchar Medical College &
Hospital from September 2016 to August 2017 .
The etiology of anemia in SLE is usually heterogeneous and may result from
immune and non immune mechanisms.
The occurrence and significance of hematological abnormalities were analyzed in
20 prospectively studied patients with SLE who satisfied SLICC 2012 criteria
Anemia was seen in 80% cases , commonly anemia of chronic Disease (ACD)
All patients gave written informed consent.
,iron deficiency anemia(IDA), autoimmune hemolytic anemia (AIHA). ACD in
our population may have been due to chronic inflammation and renal disease
while IDA may have been due to menorrhagia as most of our participants were
RESULTS young females in the reproductive age group, gastrointestinal bleeding due to
the frequent use of NSAIDS and steroids, nutritional and possibly due to
hookworm infestations.
BASELINE CHARACTERISTIC OF STUDY FREQUENCY PERECENTAGE
POPULATION Leucopenia may be secondary to Immune destruction of antibody coated WBC,
SEX FEMALE 19 95% active disease and steroid therapy. Thrombocytopenia was most of the time
MALE 01 05%
mild and benign and not associated with any overt bleeding
AGE DISTRIBUTION <20YRS 03 15%
20-40 YRS 16 80% Hematological manifestations are common since blood and blood vessels
>40 YRS 01 05% together contain more diverse number of antigens than any other organ in the
body and in SLE auto antibodies are known to develop against any antigen or
CLINICAL PROFILE OF PATIENTS
tissue.

The findings in our study was similar to other studies as done by Agrawal et
100
90 al(3) in Central India , Sasidharan et al(1) in kerala and Njoroge et al (4) in
85 Africa.
80

CONCLUSION
35
Hematological manifestation is the second most common presenting
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manifestation of SLE in people of Barak valley, India. The study concludes that
ARTHRITIS HEMATOLOGICAL ORAL ULCERS ALOPECIA ANA ANTI-DSDNA
treatment of hematological abnormalities is challenging because the treatment
itself can cause undue complication such as Leucopenia due the use of high
Hematological abnormalities were present in 85% cases. doses of steroids or granulocytosis due to infections .

Anemia was the most common finding and detected in 80% of total cases of
which anemia of chronic disease in 75% and 12.5% each in IDA and AIHA
were observed .
Leucopenia was found in 25% patients and neutrophilia in 10%.
Thrombocytopenia was seen 25% cases
It is important to take these factors into consideration for disease therapy and
management.
BIBLIOGRAPHY
1. HematologicalManifestations of SLE at Initial Presentation: P. K. Sasidharan, M.Bindya, KG.Sajeeth Kumar. ISRN Hematology doi:10.5402/2012/961872
2. Fayyaz A, Igoe A, Kurien BT, et al. Haematological manifestations of lupus. Lupus Science & Medicine 2015;2:e000078. doi:10.1136/lupus-2014-000078
3. Agrawal SR, Tiewsoh I, Rajput A, Jain A. study of clinical andimmunological profile of systemic lupus erythematosus patients from central rural India. printed by
Indian J Allergy Asthma Immunol 2013;27:33-7.
4. Njoroge JW1, Oyoo GO1, Kitonyi G2, Barasa A2, Odhiambo A1 Afr J Rheumatol 2016; 4(2): 57-62
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