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
Ekinci, Rabia Miray Kisla
Ozturk, Kubra
Koker, Oya
Ucak, Kubra
Tuncez, Serife
Kilbas, Gulsah
Karacayir, Nihal
Baykal, Gulcan Ozomay
Taskin, Sema Nur
Bozkaya, Burcu
Baba, Ozge
Demir, Selcan
Basaran, Ozge
Sahin, Sezgin
Baglan, Esra
Sahin, Nihal
Gungorer, Vildan
Kisaarslan, Aysenur Pac
Sozeri, Betul
Yuksel, Selcuk
Bakkaloglu, Sevcan
Balat, Ayse
Gurgoze, Metin Kaya
Kasapcopur, Ozgur
Ozen, Seza
Kalyoncu, Mukaddes
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
Tıp Fakültesi Koleksiyonu
WoS İndeksli Yayınlar Koleksiyonu / WoS Indexed Publications Collection

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