Clinical Analysis Of Autoimmune Hemolytic Anemia In Systemic Lupus Erythematosus

Objective:To determine the clinical and serological characteristics of autoimmune hemolytic anemia(AIHI) in systemic lupus erythematosus(SLE) patients.Methods:179newly diagnosed SLE patients of anemia and data integrity were studied who included90cases coomb’s test-negative patients with anemia and89patients Coomb’s test positive, among18cases of patients of AIHI.18cases of patients of hemolytic anemia is group A; Among89patients Coomb’s test positive without AIHI,36patients were chosen by random sampling as control group B; Among90cases coomb’s test negative patients with anemia,36patients were chosen by random sampling as control group C.The patients’demographic data,clinical manifestation,laboratory test results and other examinations were analyzed retrospectively. Student’s t test was used for the comparison of continuous variables,and chi-square test was used for the comparison of proportions.Result:1.89%of patients had autoimmune haemolytic anaemia prior to or at the time of the diagnosis of SLE.2. There was significant heterogeneity in the severity of anaemia between group A and groupB (p<0.01)、group A and groupC (p<0.05). The portortion of severe anemia of group A(33.3%) was higher than groupB(5.6%)、 groupC(5.6%) and mild anemia of group A was lower (16.7%)than groupB (47.2%), groupC(38.9%).3. There was significant difference in coomb’s test the types (IgG+C3type、C3type、IgG type)of antibody between group A and groupB (p<0.05). The portortion of IgG+C3type (61.1%) was highest in group A and C3type was highest (52.8%) in group B.4. The frequencies of rashes、Oral ulcers、alopecia、arthritis and serositis had no statistical significant among three groups.5. The positive rate of anticardiolipin antibody in the group A and groupB was significantly higher than that in the groupC (P<0.05, P<0.01).Anti-dsDNA antibody have no significantly difference among the three groups.6. AIHI in SLE were not associated with renal involvement. Although pairwise comparisons had no statistical significant, central nervous system involvement in groupA was approximately four times of group B and group C.Conclusion:1. The severity of anaemia of AIHI in SLE patients is more severe than the anaemia of other causes.2. The antibody type of coomb’s test were associated with the severity of AIHI,with complex type being more severe than sample type.3. Regardless of Coomb’s test positive in SLE patients with been or not been hemolytic anemia, the positive rate of anticardiolipin antibody was significantly incresed.4. AIHI in SLE were not associated with renal involvement, however, patients with AIHI are prone to develop central nervous system involvement.