Hematological presentation in systemic lupus erythematosus and its relationship with disease activity

Abnormalities of hematological system are very common in systemic lupus erythematosus (SLE). The aim of the study is to evaluate hematological findings in patients with SLE at the time of referral and their relationship with disease activity and organ involvement. The study was carried consecutive 115 patients, including 20 males and 85 females. Most of the cases had anemia at the time of presentation due to various etiologies. Anemia of chronic disease was seen in 46% and it was the most common encountered picture. The rate of hemolytic anemia was 28%, and Coombs' positivity rate was 22% among our patients. Leukopenia ( < 4.0 x 10(9)/l), neutropenia ( < 1.8 x 10(9)/l), and lymphopenia ( < 1.5 x 10(9)/l) rates were 57, 20, and 82%, respectively. Thrombocytopenia was seen in 40% for < 150 x 10(9)/l, 26% for < 100 x 10(9)/l, and 8% for < 50 x 10(9)/l. Of our patients, 10% had antiphospholipid syndrome (APS) at the time of diagnosis. Increased fibrinogen levels were observed in 35% without relating to disease activity. The rates of C3 and C4 hypocomplementemia were 86 and 64%, respectively, and both are closely correlated with the disease activity. Moreover, C3 hypocomplementemia was more prominent in cases with renal or serosal involvement. Leukopenia and hyperfibrinogenemia were more common in patients with skin/mucosal involvements. C3 hypocomplementemia, APS and elevated IgG levels were more common in our patients with renal involvement. SLE should be kept in mind while evaluating patients with mentioned hematological findings, especially in those with accompanying organ involvements.