Highlights on Medicine and Medical Science Vol. 9 | 2021
Hematological Involvement in Pediatric Systemic Lupus Erythematosus
Abstract
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with multisystemic involvement with a variable clinical course. Hematological involvement is frequent and both morbidity and mortality, as well as the increased risk of infection and decreased survival rates have been significantly related with such compromise. The objective of this study was to describe the hematologic alterations in pediatric patients with SLE at the time of diagnosis. \nMethods. A retrospective descriptive study of patients with SLE controlled in the Immunorheumatology outpatients centre of Exequiel Gonzalez Cortes Children´s Hospital, Santiago, Chile was conducted. Thirty-three clinical files were reviewed, and demographic and clinical data were obtained. \nResults. Thirty patients met the inclusion criteria, 22 females, mean age 11.6 years (range 5 to 14). The prevalence of hematological compromise was 60% (n = 18). The most frequent hematological alteration was lymphopenia in 14 patients, followed by autoimmune hemolytic anemia (HA) in 11, leukopenia in 10, and thrombocytopenia in 3 patients. The association between different hematological alterations showed lymphopenia with leukopenia in 50% of the patients (n = 9) and HA with lymphopenia in 8 patients. The most frequent extra-hematological manifestations in patients with hematological alterations was skin involvement in 26/30 patients, followed by kidney involvement in 25, articular in 22, and serositis in 17. \nConclusions. Hematological involvement in this series of pediatric SLE was frequent and this is included in traditional and current diagnostic criteria. In a group of patients, it can be the first manifestation, and this requires a differential diagnosis and careful monitoring. In other cases, it may be a manifestation of severe SLE that requires vigorous treatment.