Chinese SLE Treatment and Research group (CSTAR) registry: Clinical significance of thrombocytopenia in Chinese patients with systemic lupus erythematosus
Autoři:
N. Jiang aff001; M. Li aff001; M. Zhang aff002; J. Xu aff003; L. Jiang aff004; L. Gong aff005; F. Wu aff006; J. Gu aff007; J. Zhao aff001; Y. Xiang aff001; Z. Wang aff001; Y. Zhao aff001; X. Zeng aff001;
Působiště autorů:
Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
aff001; Department of Rheumatology, Jiangsu Provincial People's Hospital, Nanjing, Jiangsu, China
aff002; Department of Rheumatology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
aff003; Department of Rheumatology, Zhongshan Hospital Affiliated to Fudan University, Shanghai, China
aff004; Department of Rheumatology, the General Hospital of Tianjin Medical University, Tianjin, China
aff005; Department of Rheumatology, Capital Institute of Pediatrics, Beijing, China
aff006; Department of Rheumatology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
aff007
Vyšlo v časopise:
PLoS ONE 14(11)
Kategorie:
Research Article
prolekare.web.journal.doi_sk:
https://doi.org/10.1371/journal.pone.0225516
Souhrn
Objectives
To investigate the prevalence, clinical characteristics, and prognosis of thrombocytopenia (TP) in Chinese patients with systemic lupus erythematosus (SLE).
Methods
The study was conducted based on the Chinese SLE Treatment and Research group (CSTAR) registry. Thrombocytopenia was defined as the platelet count<100,000/mm3 at enrollment. Severe thrombocytopenia was defined as the platelet count<50,000/mm3. The prevalence of SLE-related TP, the associations of thrombocytopenia with demographic data, organ involvements, laboratory findings, disease activity, damage, and mortality were investigated.
Results
Of 2104 patients with SLE, 342 patients (16.3%) were diagnosed with thrombocytopenia. The prevalence of neuropsychiatric SLE, vasculitis, myositis, nephritis, mucocutaneous lesions, pleuritis, fever, leukocytopenia and hypocomplementemia were significantly higher in patients with thrombocytopenia (p<0.05). SLE disease activity index (SLEDAI) was significantly higher in patients with thrombocytopenia (p<0.05). Multivariate analysis showed that leukocytopenia (OR = 2.644), lupus nephritis (OR = 1.539), hypocomplementemia (OR = 1.497) and elevated SLEDAI (OR = 1.318) were independently associated with thrombocytopenia (p<0.05). Long disease duration (OR = 1.006) was an independent risk factor of severe thrombocytopenia, while anti-rRNP (OR = 0.208) was an independent protective factor of severe thrombocytopenia (p<0.05). Long disease duration was an independent risk factor of mortality in patients with thrombocytopenia (RR = 1.006). The 6-year survival of patients with thrombocytopenia was significantly lower than patients without thrombocytopenia (88.2% vs. 95.5%).
Conclusions
Thrombocytopenia was a common manifestation of SLE and was associated with leukocytopenia, nephritis and severe disease activity. Severe thrombocytopenia tended to occur in long-term and relatively inactive SLE. Patients with SLE-related thrombocytopenia has a decreased long-term survival rate. Long disease duration was an independent risk factor of mortality in patients with thrombocytopenia.
Klíčová slova:
Medical risk factors – Prognosis – Chinese people – Platelets – Nephritis – Thrombocytopenia
Zdroje
1. Li M, Zhang W, Leng X, Li Z, Ye Z, Li C, et al. Chinese SLE Treatment and Research group (CSTAR) registry: I. Major clinical characteristics of Chinese patients with systemic lupus erythematosus. Lupus. 2013; 22(11): 1192–1199. doi: 10.1177/0961203313499086 23963101
2. Fayyaz A, Igoe A, Kurien BT, Danda D, James JA, Stafford HA, et al. Haematological manifestations of lupus. Lupus Sci Med. 2015; 2(1): e000078. doi: 10.1136/lupus-2014-000078 25861458
3. Keeling DM, Isenberg DA. Haematological manifestations of systemic lupus erythematosus. Blood Rev. 1993; 7(4): 199–207. doi: 10.1016/0268-960x(93)90006-p 8130682
4. Cervera R, Khamashta MA, Font J, Sebastiani GD, Gil A, Lavilla P, et al. Morbidity and mortality in systemic lupus erythematosus during a 10-year period: a comparison of early and late manifestations in a cohort of 1,000 patients. Medicine (Baltimore). 2003; 82(5): 299–308.
5. González-Naranjo LA, Betancur OM, Alarcón GS, Ugarte-Gil MF, Jaramillo-Arroyave D, Wojdyla D, et al. Features associated with hematologic abnormalities and their impact in patients with systemic lupus erythematosus: Data from a multiethnic Latin American cohort. Semin Arthritis Rheum. 2016; 45(6): 675–683. doi: 10.1016/j.semarthrit.2015.11.003 26698222
6. Fernández M, Alarcón GS, Apte M, Andrade RM, Vilá LM, Reveille JD, et al. Systemic lupus erythematosus in a multiethnic US cohort: XLIII. The significance of thrombocytopenia as a prognostic factor. Arthritis Rheum. 2007; 56(2): 614–621. doi: 10.1002/art.22376 17265496
7. Patel N, Mody GM. Acute presentation of thrombocytopaenia in systemic lupus erythematosus is associated with a high mortality in South Africa. Lupus. 2014; 23(2): 204–212. doi: 10.1177/0961203313512009 24213307
8. Jung JH, Soh MS, Ahn YH, Um YJ, Jung JY, Suh CH, et al. Thrombocytopenia in Systemic Lupus Erythematosus: Clinical Manifestations, Treatment, and Prognosis in 230 Patients. Medicine (Baltimore) 2016; 95(6): e2818.
9. Li M, Wang Q, Zhao J, Li Z, Ye Z, Li C, et al. Chinese SLE Treatment and Research group (CSTAR) registry: II. Prevalence and risk factors of pulmonary arterial hypertension in Chinese patients with systemic lupus erythematosus. Lupus. 2014; 23(10): 1085–1091. doi: 10.1177/0961203314527366 24651670
10. Zhao J, Bai W, Zhu P, Zhang X, Liu S, Wu L, et al. Chinese SLE Treatment and Research group (CSTAR) registry VII: prevalence and clinical significance of serositis in Chinese patients with systemic lupus erythematosus. Lupus. 2016; 25(6): 652–657. doi: 10.1177/0961203315625460 26762471
11. Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1997; 40(9): 1725.
12. Gladman DD, Ibañez D, Urowitz MB. Systemic lupus erythematosus disease activity index 2000. J Rheumatol. 2002; 29(2): 288–291. 11838846
13. Gladman DD, Goldsmith CH, Urowitz MB, Bacon P, Fortin P, Ginzler E, et al. The Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Damage Index for systemic lupus erythematosus international comparison. J Rheumatol 2000; 27: 373–376. 10685799
14. Alger M, Alarcon-Segovia D, Rivero SJ. Hemolytic anemia and thrombocytopenic purpura: two related subsets of systemic lupus erythematosus. J Rheumatol. 1977; 4:.351–357. 564405
15. Harris EN, Asherson RA, Gharavi AE, Morgan SH, Derue G, Hughes GR. Thrombocytopenia in SLE and related autoimmune disorders: association with anticardiolipin antibody. Br J Haematol. 1985; 59:227–230. doi: 10.1111/j.1365-2141.1985.tb02988.x 3970855
16. Sultan SM, Begum S, Isenberg DA. Prevalence, patterns of disease and outcome in patients with systemic lupus erythematosus who develop severe haematological problems. Rheumatology (Oxford). 2003; 42: 230–234.
17. To CH, Petri M. Is antibody clustering predictive of clinical subsets and damage in systemic lupus erythematosus? Arthritis Rheum. 2005; 52: 4003–4010. doi: 10.1002/art.21414 16320348
Článok vyšiel v časopise
PLOS One
2019 Číslo 11
- Metamizol jako analgetikum první volby: kdy, pro koho, jak a proč?
- Nejasný stín na plicích – kazuistika
- Masturbační chování žen v ČR − dotazníková studie
- Úspěšná resuscitativní thorakotomie v přednemocniční neodkladné péči
- Dlouhodobá recidiva a komplikace spojené s elektivní operací břišní kýly
Najčítanejšie v tomto čísle
- A daily diary study on maladaptive daydreaming, mind wandering, and sleep disturbances: Examining within-person and between-persons relations
- A 3’ UTR SNP rs885863, a cis-eQTL for the circadian gene VIPR2 and lincRNA 689, is associated with opioid addiction
- A substitution mutation in a conserved domain of mammalian acetate-dependent acetyl CoA synthetase 2 results in destabilized protein and impaired HIF-2 signaling
- Molecular validation of clinical Pantoea isolates identified by MALDI-TOF