Dereglările hematologice în lupus eritematos sistemic

Abstract

The occurrence and significance of haematological abnormalities were analysed in 32 prospectively studied patients with systemic lupus erythematosus. Anaemia occurred in 12 patients (36.2%), manifested by changes in the quantity of erythrocytes, hemoglobin, hematocrit. The iron deficiency anaemia was recorded in most patients and consisted of 6 patients (50%). Anaemia of chronic disease was identified in 4 patients (33.3%) and only in individual patients were diagnosed autoimmune hemolytic anaemia and anaemia of chronic renal failure. Leukopenia was found in 47% of patients, lymphopenia – in 20% and thrombocytopenia in 27 % of patients with systemic lupus erythematosus. The most frequent symptoms registred in patients with lupus were arthritis / arthralgia - 84.3%, followed by skin manifestations - malar rash and photosensitivity -78.1%, oral ulcers - 59.3% and renal impairment in 50% of patients. No difference in damage of SLE patients with or without anaemia was marked. Our study marked a strong association between the decrease serum erythropoietin and anaemia of chronic disease. Laboratory examinations were performed for determining anemia of chronic disease in patients with lupus. To determine this type of anemia serum iron, erythropoietin, ferritin were assessed. We came to the conclusion that mild, moderate and severe anaemia were strongly associated with disease activity in SLE. Moderate and severe anemia were associated with the damage accrual. Different stages of anaemia can be used in monitoring disease activity and avoidance of damage accrual in SLE.

Instalarea şi valoarea dereglărilor hematologice au fost analizate la 32 pacienţi cu lupus eritematos sistemic. Anemia a fost stabilită la 12 pacienţi (37.5%), manifestîndu-se prin schimbarea numărului eritrocitelor, hemoglobinei şi nivelului hematocritului. Anemia fierodeficitară a fost înregistrată la 6 (18.7%) pacienţi. Anemia bolii cronice a fost identificată la 4 (12.5%) pacienţi şi numai la 2 (6.2%) pacient a fost depistată anemia pe fondul insuficienţei renale cronice. În studiul efectuat leucopenia a fost depistată la 11 (34.3%) pacienţi, limfopenia la 15 (46.8%) şi trombocitopenia la 4 (12.5%) pacienţi cu lupus eritematos sistemic. 153 Au fost efectuate examinări de laborator pentru constatarea tipului de anemie. Anemia bolii cronice s-a depistat prin nivelul hemoglobinei, hematocritului, fierul seric şi eritropoietina. S-a identificat legătura ABC cu scăderea eritropoietinei în sânge. Anemiile uşoare şi moderate au fost asociate cu activitatea bolii, cele severe - cu indicele lezării organice. Aceste asociaţii sunt depistate atât la debutul lupusului cât şi în evoluţie. Diagnosticul precoce al anemiei, tratamentul adecvat şi monitorizarea activităţii lupice, permite evitarea lezării organice.