Hematological involvement in pediatric systemic lupus erythematosus: A multi-center study

Area of Science:

• Pediatric Rheumatology
• Hematology
• Immunology

Background:

• Systemic Lupus Erythematosus (SLE) can manifest with diverse hematological abnormalities.
• Understanding these manifestations is crucial for managing pediatric SLE patients.

Purpose of the Study:

• To characterize hematological involvement in pediatric SLE patients.
• To identify associations between hematological findings and clinical/immunological markers.

Main Methods:

• Retrospective multi-center study analyzing medical records of pediatric SLE patients (2000-2020).
• Inclusion criteria: Systemic Lupus International Collaborating Clinics (SLICC) criteria.
• Evaluation of hematological abnormalities and their correlation with disease characteristics.

Main Results:

• 118 out of 215 pediatric SLE patients had hematological manifestations.
• Anemia was the most common abnormality (74.5%), particularly autoimmune hemolytic anemia.
• Hematological involvement was associated with renal disease, low C3 levels, and positive antiphospholipid antibodies (aPLs), including anti-cardiolipin, anti-β2 GP1, and lupus anticoagulant.
• Multivariate analysis revealed aPLs (OR: 4.021) and high SLEDAI scores (OR: 1.136) as independent predictors of hematological involvement.

Conclusions:

• Hematological abnormalities are frequent in pediatric SLE.
• Positive antiphospholipid antibodies and high SLE disease activity scores are significantly associated with hematological involvement in this population.