Anemia in Colombian patients with systemic lupus erythematosus

Abstract

Introduction: systemic Lupus Erythematosus (SLE) is an autoimmune disease with multi-organ involvement. Anemia is common in SLE, presenting up to 50% of patients and is associated with activity of the disease. The objective of the study was to discriminate the different causes of anemia in patients with SLE and the associated variables with its presentation in a cohort of patients in Bucaramanga, Colombia. Methods: a cross-sectional study of 114 patients that met the classification criteria of SLE determined by the Systemic Lupus International Collaborating Clinics (SLICC) criteria. Descriptive analysis was performed. Quantitative variables were used: means and standard deviations (SDs) were used for those with normal distribution, and median and interquartile ranges were used for those who did not. Bivariate analysis using logistic regression with OR measurement, p-value, and confidence intervals was performed. Results: the most frequent cause of anemia was anemia of chronic disease/inflammation (60.53 %), followed by iron deficiency anemia (28.95%), autoimmune hemolytic anemia (24.56%) and megaloblastic anemia (2.53%). An association with a significant difference was found between anemia of chronic disease/inflammation and the presence of pericardial disease (OR 2.11, p=0.045). Iron deficiency anemia showed association with increase in the mortality rate (OR 2.66, p= 0.04), while the use of cyclophosphamide and azathioprine showed a decrease in the probability of presenting iron deficiency anemia (OR 0.14, p=0.045; OR 0.32, p= 0.048, respectively). Regarding the subjects with hemolytic anemia, a decrease was found a decrease in the probability of having it in the patients using azathioprine (OR 0.25, p=0.042). Conclusion: this is the first Colombian study that evaluates anemia in patients with SLE. The most frequent anemia was anemia of chronic disease/inflammation. The prevalence of megaloblastic anemia in patients with SLE was determined for the first time. Likewise, the increase in the probability of mortality in patients with iron deficiency anemia was reported, which should be considered in clinical practice.