Prevalence of Hematological Disorders in Autoimmune Diseases in Beni-Suef Governorate. A Single Center Study

Abstract

Background: Autoimmune diseases such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), systemic sclerosis (SSc), and vasculitis are often associated with hematologic abnormalities that may reflect disease activity and prognosis.

Objective: To assess the prevalence and types of hematologic disorders in patients with autoimmune diseases and explore their correlation with disease activity.

Methods: This cross-sectional analytical study included 420 patients diagnosed with SLE (n=201), RA (n=180), SSc (n=20), and vasculitis (n=19), recruited from Beni-Suef University Hospital. Patients underwent clinical assessment, complete blood count, inflammatory and immunological markers, and disease activity scoring (SLEDAI, DAS28, and others). Hematologic findings were compared across groups and correlated with disease activity.

Results: the most common haematological disorders in SLE group 201 patients were anemia, 178 patients have anemia mostly ACD followed by thrombocytopenia 41(20%). In RA group, 180 patients, the most prevalent hematological disorder was anemia, 112(62%) cases, most them ACD 85(47%) followed by leuckopenia 14(7.7%). In systemic sclerosis patients (20) cases were 15 patients with anemia 9 of them anemia of chronic illness, 5 iron deficiency anemia. In vasculitic group, there were 19 patients were 10 without anemia and 9 with anemia mostly anemia of chronic illness, regarding leuckocytic count was 3 leuckocytosis and 3 leuckopenia. Regarding disease activity, In SLE group, there was a statistically higher level of RDW, and lower mean of MPV among cases with sever SLEIDAI score with p-value 0.04. In RA cases, there was a statistically significant higher level of neutrophils, Neutrophil/Lymphocyte, and NHL levels among cases with severe degrees of DAS with p-value <0.05. Cases of SSc with lung fibrosis and PAH show statistically significant lower mean of HB and higher level of neutrophil, and NHL levels with p-value <0.05.

Conclusion: Anemia was the most common hematological disorders between all study groups mostly anemia of chronic illness. higher percentage of iron deficiency anemia in SSc cases. MPV, RDW may be useful in prediction of systemic lupus activity. neutrophil, Neutrophil/Lymphocyte, and NHL levels may be used for prediction of RA activity. lower mean of HB and higher level of neutrophil, and NHL levels may be used for prediction of lung fibrosis in systemic sclerosis.