Anaemia in systemic lupus erythematosus: from pathophysiology to clinical assessment

• Published in: Annals of the Rheumatic Diseases Vol. 65; no. 2; pp. 144 - 148
• Main Authors: Giannouli, S, Voulgarelis, M, Ziakas, P D, Tzioufas, A G
• Format: Journal Article Book Review
• Language: English
• Published: London BMJ Publishing Group Ltd and European League Against Rheumatism 01.02.2006; BMJ; BMJ Publishing Group LTD; BMJ Group
• Subjects: ACD; aCL; AHA; anaemia; anaemia of chronic disease; Anemia, Hemolytic, Autoimmune - drug therapy; Anemia, Hemolytic, Autoimmune - etiology; Anemia, Hemolytic, Autoimmune - immunology; Anemias. Hemoglobinopathies; anticardiolipin antibodies; Anticoagulants; Antigens; antiphospholipid syndrome; APS; Autoantibodies - immunology; autoimmune haemolytic anaemia; Biological and medical sciences; bone marrow; Chronic illnesses; diagnostic approach; Diseases of red blood cells; Diseases of the osteoarticular system; EPO; erythropoietin; Erythropoietin - immunology; Erythropoietin - therapeutic use; Hematologic and hematopoietic diseases; Hematology; Hematopoiesis; Humans; IDA; IFN; Immunoglobulins; interferon; iron deficiency anaemia; Lupus; Lupus Erythematosus, Systemic - drug therapy; Lupus Erythematosus, Systemic - immunology; Medical sciences; Pathogenesis; Plasma; PRCA; Proteins; pure red cell aplasia; recombinant human erythropoietin; Recombinant Proteins; Review; rHuEPO; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; SLE; systemic lupus erythematosus; T-Lymphocytes - immunology; TNFα; tumour necrosis factor α; Connective tissue disease; Skin disease; Systemic lupus erythematosus; Pathophysiology; Anemia; Systemic disease; Rheumatology; Autoimmune disease; Hemopathy
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/ard.2005.041673

Haematological abnormalities are common in systemic lupus erythematosus. Anaemia is found in about 50% of patients, with anaemia of chronic disease being the most common form. Impaired erythropoietin response and presence of antibodies against erythropoietin may contribute to the pathogenesis of this type of anaemia. Patients with autoimmune haemolytic anaemia usually belong to a distinct category, which is associated with anticardiolipin antibodies, thrombosis, thrombocytopenia, and renal disease, often in the context of secondary antiphospholipid syndrome. Autoantibodies, T lymphocytes, and deregulation of the cytokine network can affect bone marrow erythropoiesis, leading to anaemia.