Asad Ali Khan, Qasim Mahmood, Burhan Ahmed Khan, Nighat Bilal.
Frequency and types of anemia in systemic lupus erythematosus.
Ann Pak Inst Med Sci Jan ;2(4):272-6.

Background: Systemic lupus erythematosus (SLE) is a common autoimmune illness involving multiple organs and systems. Anaemia is present in between 1/2 to 2/3 patients and may be multifactorial; either a result of the disease per se or due to accompanying factors. The various types of anaemia known to complicate SLE are iron deficiency anaemia, anaemia of chronic disease, autoimmune haemolytic anaemia, and other rarer variants. Objective: To determine the frequency of anaemia in a cohort of SLE patients and to determine the various types of anaemia. Materials and Methods: This was a descriptive study conducted at the Department of Medicine and allied departments at Pakistan Institute of Medical Sciences, Islamabad from June 2000 to June 2002. Fifty cases of anaemia from amongst a total of 63 patients of SLE were selected and the underlying aetiology for the anaemia was ascertained. Results: Frequency of anaemia in SLE patients was 79.37%: 47 females and 3 males. Average age was 29.92 years. Identifiable causes of anaemia were iron deficiency anaemia, 44%; anaemia of chronic disease, 34%; autoimmune haemolytic anaemia, 12%; a combination of both iron deficiency anaemia and autoimmune haemolytic anaemia, 6%; tuberculous infiltration of the bone marrow, 2%, and bone marrow suppression induced by cytotoxic immunosuppressive agents, 2%. Of the patients with iron deficiency, 13 (52%) had menorrhagia, 6 (24%) had gastrointestinal blood loss. One patient (4%) was suffering from worm infestation, and for the remaining 5 (20%), the underlying cause could not be found. Conclusions: This study reveals iron deficiency anaemia as the most common, with three quarters of these cases due to correctable pathologies, i.e. menorrhagia and gastrointestinal blood loss. Treatment could subsequently lead to amelioration of symptoms and improvement of morbidity and quality of life.

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