Department of Rheumatology, American University of Beirut, Beirut, Lebanon.
Department of Medicine & Health Sciences 'V.Tiberio', Universita' del Molise, Campobasso, Italy.
Clin Rheumatol. 2021 May;40(5):1967-1973. doi: 10.1007/s10067-020-05436-2. Epub 2020 Oct 2.
INTRODUCTION/OBJECTIVE: The relationship between autoimmune haemolytic anaemia (AIHA) and antiphospholipid antibodies (aPL) has never been addressed via a meta-analysis in the paediatric age group. We evaluated the link between AIHA and aPL in childhood systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS).
EMBASE and PubMed were screened from inception to May 2020 and Peto's odds ratio for rare events was employed for the between group comparisons.
The meta-analysis included 11 articles for a total of 575 children: the pooled prevalence of AIHA was greater in (1) IgG aCL-positive than IgG aCL-negative children (39.7% vs 20.9%, p = 0.005); (2) in APS-positive than APS-negative SLE children (36.8% vs 13.2%, p = 0.01); and (3) in SLE-related APS than in primary APS children (53% vs 16.2%, p = 0.008).
The pooled prevalence of AIHA is greatest in SLE with aPL/APS, low-moderate in SLE without aPL/APS, and lowest in primary APS. Key Points • Antiphospholipid antibodies strongly relate to autoimmune haemolytic anaemia. • Autoimmune haemolytic anaemia is more common in systemic lupus erythematosus with antiphospholipid antibodies.
简介/目的：自身免疫性溶血性贫血（AIHA）与抗磷脂抗体（aPL）之间的关系从未在儿科人群中通过荟萃分析来解决。我们评估了 AIHA 与儿童系统性红斑狼疮（SLE）和抗磷脂综合征（APS）中 aPL 之间的联系。
从创建到 2020 年 5 月，对 EMBASE 和 PubMed 进行了筛选，并采用 Peto 的罕见事件比值比进行了组间比较。
荟萃分析纳入了 11 篇文章，共 575 名儿童：（1）IgG aCL 阳性患儿比 IgG aCL 阴性患儿的 AIHA 患病率更高（39.7% vs 20.9%，p=0.005）；（2）在 APS 阳性的 SLE 患儿比 APS 阴性的 SLE 患儿中更高（36.8% vs 13.2%，p=0.01）；（3）在与 SLE 相关的 APS 患儿中比在原发性 APS 患儿中更高（53% vs 16.2%，p=0.008）。
AIHA 在伴有 aPL/APS 的 SLE 中患病率最高，在不伴有 aPL/APS 的 SLE 中患病率中等偏低，在原发性 APS 中患病率最低。
关键点 • 抗磷脂抗体与自身免疫性溶血性贫血密切相关。 • 抗磷脂抗体阳性的系统性红斑狼疮患者更易发生自身免疫性溶血性贫血。
