Predictors of severe hemolytic anemia and its impact on major outcomes in systemic lupus erythematosus: Data from a multiethnic Latin American cohort

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0
Tipo de produção
article
Data de publicação
2023
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
SAGE PUBLICATIONS LTD
Autores
GONZALEZ, Luis Alonso
ALARCON, Graciela S.
HARVEY, Guillermina B.
QUINTANA, Rosana
PONS-ESTEL, Guillermo J.
UGARTE-GIL, Manuel F.
VASQUEZ, Gloria
CATOGGIO, Luis J.
GARCIA, Mercedes A.
Citação
LUPUS, v.32, n.5, p.658-667, 2023
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Objective To determine the predictors of the occurrence of severe autoimmune hemolytic anemia (AIHA) and its impact on damage accrual and mortality in SLE patients. Methods Factors associated with time to severe AIHA (hemoglobin level <= 7 g/dL) occurring from the onset of SLE symptoms were examined by Cox proportional hazards regressions. The association of severe AIHA with mortality was examined by logistic regression analyses while its impact on damage was by negative binomial regression. Results Of 1,349 patients, 49 (3.6%) developed severe AIHA over a mean (SD) follow-up time of 5.4 (3.8) years. The median time from the first clinical manifestation to severe AIHA was 111 days (IQR 43-450). By multivariable analysis, male sex (HR 2.26, 95% CI 1.02-4.75, p = 0.044), and higher disease activity at diagnosis (HR 1.04, 95% CI 1.01-1.08, p = 0.025) were associated with a shorter time to severe AIHA occurrence. Of the SLEDAI descriptors, only hematologic (leukopenia and/or thrombocytopenia) showed a certain trend toward significance in the multivariable analysis (HR 2.36, 95% CI 0.91-6.13, p = 0.0772). Severe AIHA contributed neither to damage nor to mortality. Conclusions Severe AIHA occurs during the early course of SLE. Male sex and higher disease activity at diagnosis emerged as independent predictors of a shorter time to severe AIHA occurrence. Although not statistically significant, hematological abnormalities at SLE diagnosis could predict the occurrence of severe AIHA in a shorter time. Damage and mortality did not seem to be impacted by the occurrence of severe AIHA.
Palavras-chave
Systemic lupus erythematosus, autoimmune hemolytic anemia, predictors, ethnicity
URI
https://observatorio.fm.usp.br/handle/OPI/53803
Referências
  1. Alarcon GS, 2007, ANN RHEUM DIS, V66, P1168, DOI 10.1136/ard.2006.068676
  2. Alarcon GS, 2004, RHEUMATOLOGY, V43, P202, DOI 10.1093/rheumatology/keg481
  3. Artim-Esen B, 2019, LUPUS, V28, P1480, DOI 10.1177/0961203319877245
  4. Beyan E, 2007, HEMATOLOGY, V12, P257, DOI 10.1080/10245330701214145
  5. BOMBARDIER C, 1992, ARTHRITIS RHEUM, V35, P630, DOI 10.1002/art.1780350606
  6. Bruce IN, 2015, ANN RHEUM DIS, V74, P1706, DOI 10.1136/annrheumdis-2013-205171
  7. Duran S, 2008, ARTHRIT RHEUM-ARTHR, V59, P1332, DOI 10.1002/art.24020
  8. Fayyaz A, 2015, LUPUS SCI MED, V2, DOI 10.1136/lupus-2014-000078
  9. Fietta R, 2009, CLIN EXP RHEUMATOL, V27, P140
  10. Garcia MA, 2005, LUPUS, V14, P938, DOI 10.1191/0961203305lu2245oa
  11. Geaffar M., 1956, COURRIER 6, V6, P445, DOI 10.2307/2172077
  12. Gladman D, 1996, ARTHRITIS RHEUM, V39, P363, DOI 10.1002/art.1780390303
  13. Gladman DD, 2003, J RHEUMATOL, V30, P1955
  14. Gonzalez-Naranjo LA, 2016, SEMIN ARTHRITIS RHEU, V45, P675, DOI 10.1016/j.semarthrit.2015.11.003
  15. Gormezano NWS, 2017, LUPUS, V26, P426, DOI 10.1177/0961203316676379
  16. Hsu CY, 2018, RHEUMATOLOGY, V57, P1743, DOI 10.1093/rheumatology/key167
  17. Jacobsen S, 1998, CLIN RHEUMATOL, V17, P478, DOI 10.1007/BF01451283
  18. Jeffries M, 2008, LUPUS, V17, P739, DOI 10.1177/0961203308090990
  19. Jorge A, 2021, ARTHRIT CARE RES, V73, P1219, DOI 10.1002/acr.24255
  20. Kasitanon N, 2006, MEDICINE, V85, P147, DOI 10.1097/01.md.0000224709.70133.f7
  21. Kokori SIG, 2000, AM J MED, V108, P198, DOI 10.1016/S0002-9343(99)00413-1
  22. LAVALLE C, 1983, CLIN RHEUMATOL, V2, P227, DOI 10.1007/BF02041395
  23. Miranda-Hernandez D, 2017, LUPUS, V26, P640, DOI 10.1177/0961203316672926
  24. Mo HY, 2021, ANN RHEUM DIS, V80, P403, DOI 10.1136/annrheumdis-2020-218886
  25. Molina JF, 1996, MEDICINE, V75, P124, DOI 10.1097/00005792-199605000-00002
  26. Moysidou GS, 2023, LUPUS, V32, P225, DOI 10.1177/09612033221144425
  27. Petri M., 1998, SEMIN CUTAN MED SURG, V7, P84
  28. Petri M, 2012, ARTHRITIS RHEUM-US, V64, P4021, DOI 10.1002/art.34672
  29. Pons-Estel BA, 2004, MEDICINE, V83, P1, DOI 10.1097/01.md.0000104742.42401.e2
  30. Santacruz JC, 2022, CUREUS J MED SCIENCE, V14, DOI 10.7759/cureus.22938
  31. Shinjo SK, 2010, ARTHRITIS RHEUM-US, V62, P855, DOI 10.1002/art.27300
  32. Sultan SM, 2003, RHEUMATOLOGY, V42, P230, DOI 10.1093/rheumatology/keg069
  33. TAN EM, 1982, ARTHRITIS RHEUM, V25, P1271, DOI 10.1002/art.1780251101
  34. Tan LM, 2021, INT J MED SCI, V18, P2624, DOI 10.7150/ijms.48997
  35. Tan TC, 2012, J RHEUMATOL, V39, P759, DOI 10.3899/jrheum.111061
  36. Voulgarelis M, 2000, ANN RHEUM DIS, V59, P217, DOI 10.1136/ard.59.3.217

Coleções
Artigos e Materiais de Revistas Científicas - FM/MCM
Artigos e Materiais de Revistas Científicas - LIM/17