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Predictors of severe hemolytic anemia and its impact on major outcomes in systemic lupus erythematosus: Data from a multiethnic Latin American cohort

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dc.contributor.author González, L.A.
dc.contributor.author Alarcón, Graciela S.
dc.contributor.author Harvey, G.B.
dc.contributor.author Quintana, R.
dc.contributor.author Pons-Estel, G.J.
dc.contributor.author Ugarte-Gil, M.F.
dc.contributor.author Vásquez, G.
dc.contributor.author Catoggio, L.J.
dc.contributor.author García, M.A.
dc.contributor.author Borba, E.F.
dc.contributor.author Da Silva, N.A.
dc.contributor.author Tavares Brenol, J.C.
dc.contributor.author Toledano, M.G.
dc.contributor.author Massardo, L.
dc.contributor.author Neira, O.
dc.contributor.author Pascual-Ramos, V.
dc.contributor.author Amigo, M.-C.
dc.contributor.author Barile-Fabris, L.A.
dc.contributor.author De La Torre, I.G.
dc.contributor.author Alfaro-Lozano, J.
dc.contributor.author Segami, M.I.
dc.contributor.author Chacón-Díaz, R.
dc.contributor.author Esteva-Spinetti, M.H.
dc.contributor.author Iglesias-Gamarra, A.
dc.contributor.author Pons-Estel, B.A.
dc.date.accessioned 2023-04-16T04:38:15Z
dc.date.available 2023-04-16T04:38:15Z
dc.date.issued 2023
dc.identifier.uri https://hdl.handle.net/20.500.12866/13398
dc.description.abstract Objective: To determine the predictors of the occurrence of severe autoimmune hemolytic anemia (AIHA) and its impact on damage accrual and mortality in SLE patients. Methods: Factors associated with time to severe AIHA (hemoglobin level ≤7 g/dL) occurring from the onset of SLE symptoms were examined by Cox proportional hazards regressions. The association of severe AIHA with mortality was examined by logistic regression analyses while its impact on damage was by negative binomial regression. Results: Of 1,349 patients, 49 (3.6%) developed severe AIHA over a mean (SD) follow-up time of 5.4 (3.8) years. The median time from the first clinical manifestation to severe AIHA was 111 days (IQR 43–450). By multivariable analysis, male sex (HR 2.26, 95% CI 1.02–4.75, p = 0.044), and higher disease activity at diagnosis (HR 1.04, 95% CI 1.01–1.08, p = 0.025) were associated with a shorter time to severe AIHA occurrence. Of the SLEDAI descriptors, only hematologic (leukopenia and/or thrombocytopenia) showed a certain trend toward significance in the multivariable analysis (HR 2.36, 95% CI 0.91–6.13, p = 0.0772). Severe AIHA contributed neither to damage nor to mortality. Conclusions: Severe AIHA occurs during the early course of SLE. Male sex and higher disease activity at diagnosis emerged as independent predictors of a shorter time to severe AIHA occurrence. Although not statistically significant, hematological abnormalities at SLE diagnosis could predict the occurrence of severe AIHA in a shorter time. Damage and mortality did not seem to be impacted by the occurrence of severe AIHA. © The Author(s) 2023. en_US
dc.language.iso eng
dc.publisher SAGE Publications
dc.relation.ispartofseries Lupus
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject ethnicity en_US
dc.subject autoimmune hemolytic anemia en_US
dc.subject predictors en_US
dc.subject Systemic lupus erythematosus en_US
dc.title Predictors of severe hemolytic anemia and its impact on major outcomes in systemic lupus erythematosus: Data from a multiethnic Latin American cohort en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1177/09612033231163745
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.01.03
dc.relation.issn 0961-2033


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