Clinical Characteristic Of Primary Sj(?)gren's Syndrome Associated With Thrombocytopenia

The blood system is frequently involved in primary sjogren's syndrome(pSS).Some patients are refractory cases and their prognosis is poor.No identifying characteristics was found at the early stage of disease until now.We retrospectively analyzed the clinical data of pSS patients with thrombocytopenia in our inpatient,and summarized their clinical characteristics recently.The aim is to identify refractory cases at the early stage and improve their prognosis.Objective:To evaluate the disease condition and prognosis of pSS patients with thrombocytopenia by retrospective analysis.Methods:351 pSS patients were collected from the Second Hospital of Hebei Medical University from October 2016 to December 2019.They were divided into two groups according to the platelet count,group A was pSS patients with normal platelet count(PLT)?100×10~9/L(n=261)and group B was consisted of pSS patients with thrombocytopenia(PLT<100×10~9/L,n=90).Then the clinical features and the lab data were compared between two groups.Furthermore,we categorized the patients of group B into group C including 76non-refractory thrombocytopenia patients(n=76)and group D consisting of14 refractory thrombocytopenia patients(n=14)according to different treating effect.We also compared the relevant data between group C and group D for analyzing the risk factors of refractory thrombocytopenia.Results:Female was dominant in group A and group B.(96.9%vs97.8%).The average age of patients in group B was older than that in group A[54.0(49.0,63.3)y vs 51.0(41.5,61.0)y](P=0.023),the purpura and splenomegaly appeared more frequently in group B than that in group A(P<0.05).Some features,including the level of white blood cell(WBC)?hemoglobin(Hb)?potassium and calcium concentration,were lower patients than those in group A(P<0.05).While others in group B were higher than those in group A(P<0.05),such as the serum levels of urea nitrogen(UREA)?Alanine aminotransferase(ALT)?direct bilirubin(DBIL)?total bilirubin(TBIL)and glutamyl transpeptidase(GGT).As for the immunological marker,the numerical number of rheumatic factor(RF)?complement 3(C3)?complement 4(C4)and the rate of positive anti-SSA-60KD antibody?anti-SSA-52KD in group B were lower than those in group A(P<0.05).The level of PLT in group D patients was lower than that in group C(P<0.05),but the rate of positive Coomb‘s test in group D was higher than that in group C(P<0.05).Conclusions:pSS patients with thrombocytopenia were more elder and often with purpura,splenomegaly.Hypocomplementemia and the lower positive of anti-SSA antibody were also more common.The patients with positive Coombs'test maybe occur ref-ractory thrombocytopenia.