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Male sex and disease activityat diagnosis are predictors of severe hemolytic anemia in patientswith systemic lupus erythematosus: data from a multiethnic latin american cohort

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dc.contributor.author Gonzalez, LA
dc.contributor.author Alarcon, Graciela S.
dc.contributor.author Harvey, GB
dc.contributor.author Quintana, R
dc.contributor.author Pons-Estel, GJ
dc.contributor.author Ugarte-Gil, MF
dc.contributor.author Vasquez, G
dc.contributor.author Catoggio, LJ
dc.contributor.author Garcia, MA
dc.contributor.author Borba, EF
dc.contributor.author GLADEL Grp Latino Amer
dc.date.accessioned 2023-10-09T17:09:19Z
dc.date.available 2023-10-09T17:09:19Z
dc.date.issued 2023
dc.identifier.uri https://hdl.handle.net/20.500.12866/14233
dc.description.abstract Background: Systemic lupus erythematosus (SLE) is an important cause of secondary warm-antibody autoimmune hemolytic anemia (AIHA). The prevalence of AIHA has been estimated to range from 5% to 30%, but severe AIHA is comparatively less frequent in SLE patients. The severity of AIHA has rarely been studied in SLE patients;1–3 we thus have examined the predictors of severe AIHA using the extensive database of a large Latin American inception cohort. Methods: In patients with a recent diagnosis of SLE (≤ 2 years), factors associated with the occurrence of severe AIHA (hemoglobin level <7 g/dl) were examined by Cox proportional univariable and multivariable hazards regression analyses. Results: Of 1,349 patients, 103 (7.6%) developed AIHA over 5.4 (3.8) years. Of them, 49 (47.6%) patients were classified as having severe AIHA (Mestizos 44.9%, Caucasians 40.8%, and African-Latin American 14.3%). The median time from the first clinical SLE manifestation to the occurrence of severe AIHA was 3.7 months (IQR 1.4–15). In the univariable analyses, male sex and disease activity at diagnosis were associated with a shorter time to severe AIHA occurrence while malar rash and photosensitivity were associated with a longer time. By multivariable analysis and after adjusting for age at SLE diagnosis, gender, and ethnicity, male sex, and higher disease activity at diagnosis remained associated with a shorter time to the occurrence of severe AIHA. The results are shown in the Table below. Conclusions: Severe AIHA occurred in 3.6% of our cohort and it is an early manifestation of lupus. In Latin American patients with SLE, male sex represents more than a two-fold higher risk of experiencing severe AIHA at a faster pace. A higher level of disease activity at SLE diagnosis is also an independent predictor of the occurrence of severe AIHA in a shorter time. en_US
dc.language.iso eng
dc.publisher BMJ Group
dc.relation.ispartofseries Lupus Science and Medicine
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Male sex en_US
dc.subject Disease activity en_US
dc.subject Diagnosis en_US
dc.subject Hemolytic anemia en_US
dc.subject Patients en_US
dc.subject Systemic lupus erythematosus en_US
dc.subject Multiethnic Latin American cohort en_US
dc.title Male sex and disease activityat diagnosis are predictors of severe hemolytic anemia in patientswith 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/10.1136/lupus-2023-KCR.170
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.01.03
dc.relation.issn 2053-8790


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