Please use this identifier to cite or link to this item:
https://hdl.handle.net/11499/57904
Title: | Severe haematological involvement in children with systemic lupus erythematosus and clinical associations | Authors: | Kisaoglu, Hakan Sener, Seher Demirbas, Kaan Can Demir Yigit, Yasemin Garipcin, Pinar Coskun, Serkan Kacmaz, Hatice Melisa |
Keywords: | children damage flare haematological involvement systemic lupus erythematosus treatment Macrophage Activation Syndrome Disease Onset Prevalence Juvenile Cohort Damage Thrombocytopenia Validation Management |
Publisher: | Oxford Univ Press | Abstract: | Objectives: To investigate the severe haematological involvement in children with SLE and assess its clinical associations, treatments, outcome and damage accrual. Methods: The medical charts of children with SLE in whom haematological involvement was observed were reviewed. Severe haematological indices were defined as autoimmune haemolytic anaemia with a haemoglobin concentration <8 g/dl, thrombocyte count <30 000/mu L and neutrophil count <500/L. Results: Among the 224 patients included, 102 (45.5%) displayed severe indices, predominantly at the initial involvement, and most frequently as severe anaemia in 54 (24.1%) and severe thrombocytopenia in 45 (20.1%). Disease activity did not differ according to the presence of severe disease indices. In addition, the presence of severe indices at initial involvement did not affect the damage accrual. However, a higher rate of damage (51.1% vs 29.9%, P = 0.002) and steroid-induced damage (28.9% vs 8.2%, P < 0.001) was evident in patients with flares of the haematological system. Regression analysis revealed that rituximab treatment during the initial episode (OR: 4.5, P = 0.006) and the presence of anticardiolipin antibodies (OR: 2.3, P = 0.014) significantly increases the odds for haematological system flare. However, severe indices at initial involvement did not increase the odds of a haematological flare. Conclusion: Severe haematological indices at onset are common but not related with disease outcomes. Prevention of flares is important to improve outcomes, and a more rigorous maintenance strategy would benefit most to children who display haematological indices refractory to conventional immunosuppressants and those with anti-cardiolipin antibodies. | URI: | https://doi.org/10.1093/rheumatology/keae414 https://hdl.handle.net/11499/57904 |
ISSN: | 1462-0324 1462-0332 |
Appears in Collections: | PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection WoS İndeksli Yayınlar Koleksiyonu / WoS Indexed Publications Collection |
Show full item record
CORE Recommender
Items in GCRIS Repository are protected by copyright, with all rights reserved, unless otherwise indicated.