This article is more than 5 years old. Information may no longer be current.
History of thrombocytopenia may be linked to diffuse alveolar hemorrhage in patients with SLE
Click Here to Manage Email Alerts
In patients with systemic lupus erythematosus, a history of thrombocytopenia may be predictive of diffuse alveolar hemorrhage, according to recently published research.
Researchers identified 22 patients with systemic lupus erythematosus (SLE) and diffuse alveolar hemorrhage (DAH) from the Michigan Lupus cohort of about 1,000 patients with SLE who met the American College of Rheumatology (ACR) criteria. Patients were aged between 30 and 37 years and were most commonly diagnosed with SLE within 5 years. Sixteen patients were white, two were black and the remaining patients identified as Hispanic, Arab, Asian and the ethnicity of one patients was undetermined. Hemoptysis as a presenting symptom was observed in 27% of the patients.
Variables were identified as potential predictive markers, including sex, ethnicity, the presence of any SLE rash, oral ulcers, alopecia, arthritis, serositis, nephritis, Raynaud’s syndrome, neuropsychological involvement, leucopenia, thrombocytopenia, low complement-3 (C3), low C4, seizures, arterial or venous thrombosis, pregnancy loss, SLE-related antibodies and other factors.
At baseline, hypocomplementemia was seen in 75% and increased anti-dsDNA levels were seen in 56% of the patients with DAH. In 36% of the patients with DAH, nephritis was diagnosed concurrently. The average SLE Disease Activity Index (SLEDAI) score was 11.4 at baseline and all were hospitalized at the time of diagnosis.
Univariate analyses showed that arthritis, any SLE-related rash, positive antinuclear antibody status, thrombocytopenia, leukopenia, low complement and other factors were associated with DAH, but multivariate analysis revealed only thrombocytopenia (OR = 36) and C3 (OR = 19) were associated strongly with the development of DAH.
All patients with DAH survived the episode and were discharged, and DAH recurred in six patients within about 6 months in most cases. – by Shirley Pulawski
Disclosure: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts