The Clinical Analysis Of Hematological Abnormality In Systemic Lupus Erythematosus

Systemic lupus erythematosus(SLE) is a kind of immune disease whichinvolves many organs and systems besides hematopoietic system and hasmanyautoantibodies. Its main manifestations show that fever, erythra, defluviumcapillorum, arthrodynia or arthrophlogosis, nephritis, multi-hydrymenitis,hemolytic anemia, leucocytopenia, thrombocytopenia, central nervous systemdamage and so on. One or more item abnormalities may occur in hematologicalsystem in SLE patients. Often these hematological system abnormalities are firstcomplaints. SLE is often hard to identifiy because of short of manifestations oftypical skin, joint, and kidney damages. So there is significance to comprehenddeep the clinical feature of hematological abnormalities associated SLE. Sodoctors can diagnose in time and treat correctly the hematological abnormalitiescorrelated with SLE.Objection To approach the clinical characteristics of hematologicalabnormalities correlated with SLE and offer assistance to doctors, this articlecarried out retrospective analysis of clinical datum of 231 SLE patients withhematological abnormalities from January 2000 to January 2005 in our hospital .Materials and methods The computer records conservancy system havebeen used to retrieve the 231 cases which has been diagnosed as SLE in January2000-January 2005. The patients who had at least twice test blood routine:Hb<110g/L,WBC<4.0×109/L,PLT<100×109/L,and have not received specialtreatment such as radiotherapy and chemotherapy, according which we collected226 cases. Using the method of retrospective analysis for the clinicalcharacteristics including common datum,hemogram abnormal occurrence, the relationsof sex , age and the hematological abnormality in SLE, morphology of bone marrow, andanalysis of therapeutic effect.Result (1) There are 226 cases appear blood anormaly ,which accounts97.8% in 231 cases of SLE. There are male 27 cases ,female 199 cases .The ratio ofmale and female is 1:7.37 .(2)There are all kinds of blood changes ,most of them aretwo series of blood decreased perticularly anemia accompanied with aleucocytosis,than the blood changes often appears pancytopenia . There are no great differencebetween anemia , aleucocytosis and thrombocytopenia.. (3)All the male patients(27/27) occurs blood abnormality,the incidence of which is 100%. There are 199female patients occurs blood abnormality in 204 female patients ,the incidence ofwhich is 97.6%(199/204).Although the incidence of blood abnormality of femaleis lower than the male ,there are no significant difference between them.(p=0.42).(4)The 33 cases of the 35 patients in children group have suffered from bloodabnormality,the incidence of that is 94.3%;And the 186 cases of the 189 patientsin young and middle age group have suffered from blood abnormality,theincidence of that is 98.4%;the 7 cases in old-age group have all suffered fromblood abnormality,the incidence of that is 100%;there is no significant defferencein the incidence of the three groups(p=0.28).(5) 154 cases' karyocyte(95.2%) haveactive and obviously active cellular proliferation in marrow, and 8 cases' have lowcellular proliferation in marrow(4.8%). The ratio of granulocyte and erythrocyte ismostly normal. 11 cases decrease. The ratio and morphous of each stage ofgranulocyte and erythrocyte are normal. 109 cases have megalokaryocytosis. 32cases have normal megalokaryocyte. 21 cases have low hypoplasiamegakaryocytic. (6) 226 patients were treated with glucocorticoid, and 52 patientswith severity condition among them were treated with gamma globulin and/orimmune depressant. Single drug and multi-drug therapy both are effective to theSLE patients with hematological abnormality except the patients have moreseverity conditions .Conclusion (1) There are all kinds of abnormal appearances inhematological system in SLE. The main manifestation is hypocytosis in twoarrays. (2) Sex and age have nothing to do with the hematological abnormality inSLE. (3)The SLE patients' bone marrow have few changes. The granulocytesand erythrocytesare mostly normal and megacaryocytes have obvious changes. (4)Glucocorticoid is first choice drug for hematological abnormalities in SLE.Gamma globulin and immune depressant can be added to increase the therapeuticeffect when the patients's condition are severity. (5) The effect of reduction ofWBC and PLT are better than the effect of reduction of HGB. (6) The patients'hematological changes with severe SLE treated with therapeutic alliance can get thesame effect as the patients' hematological changes with slight SLE treated withsingle drug.In short, the hematological abnormalities associated with SLE are morecomplicated. These abnormalities are the first syndrome in some patients. Toyounger women, especially who have fever, joint damage, skin lesion, SLE shouldbe considered. Correlated antibodies should be examined in time so that doctorscan make prompt diagnosis and correct treatment the hematological damage.