Lu Wentian, Zhong Ying, Zhang Yi, Liu Zhichun, Xue Leixi
Department of Rheumatology and Immunology, The Second Affiliated Hospital of Soochow University, Sanxiang Road No. 1055, Suzhou, 215004, Jiangsu, China.
Rheumatol Ther. 2021 Sep;8(3):1177-1188. doi: 10.1007/s40744-021-00336-6. Epub 2021 Jun 20.
The characteristics of leukopenia in patients with systemic lupus erythematosus (SLE) in different studies are different, which may be related to region, race, and sample size. Moreover, the extent of leukocyte count decline remains to be studied. This study aimed to analyze the clinical characteristics of leukopenia in patients with SLE of Han ethnicity in China.
A single-center, retrospective, cross-sectional study was conducted in Chinese Han patients with SLE from June 2013 to August 2020.
A total of 125 patients with SLE were included in the study, and 104 age- and sex-matched healthy controls were recruited. The prevalence of leukopenia, neutropenia, and lymphopenia was 40.0, 20.8, and 55.2%, respectively. The median leukocyte count in the leukopenia group was 2.80 × 10/l, the median neutrophil count in the neutropenia group was 1.40 × 10/l, and the median lymphocyte count in the lymphopenia group was 0.60 × 10/l, which was 47.06, 40.58, and 30.00% of the median of the healthy control group, respectively. The lymphocyte count of SLE patients without lymphopenia was also lower than that of healthy controls, and the lymphocyte count was negatively correlated with the SLE disease activity index 2000 score in all patients with SLE. Independent risk factors for neutropenia include decreased platelet count and lymphocyte count, as well as the presentation of cylindruria. For lymphopenia, the independent risk factors were positivity for anti-dsDNA antibody and Coombs' test, decreased platelet count, and cylindruria.
In Han Chinese patients with SLE, leukopenia, neutropenia, and lymphopenia are common clinical manifestations, and the degree of reduction in blood cell count was also remarkable. Lymphopenia is associated with disease severity in patients with SLE. The correlation between Coombs' test results and lymphopenia deserves further study.
不同研究中系统性红斑狼疮(SLE)患者白细胞减少的特征有所不同,这可能与地区、种族和样本量有关。此外,白细胞计数下降的程度仍有待研究。本研究旨在分析中国汉族SLE患者白细胞减少的临床特征。
对2013年6月至2020年8月期间的中国汉族SLE患者进行了一项单中心、回顾性横断面研究。
本研究共纳入125例SLE患者,并招募了104例年龄和性别匹配的健康对照。白细胞减少、中性粒细胞减少和淋巴细胞减少的患病率分别为40.0%、20.8%和55.2%。白细胞减少组的白细胞计数中位数为2.80×10⁹/L,中性粒细胞减少组的中性粒细胞计数中位数为1.40×10⁹/L,淋巴细胞减少组的淋巴细胞计数中位数为0.60×10⁹/L,分别为健康对照组中位数的47.06%、40.58%和30.00%。无淋巴细胞减少的SLE患者的淋巴细胞计数也低于健康对照组,且所有SLE患者的淋巴细胞计数与SLE疾病活动指数2000评分呈负相关。中性粒细胞减少的独立危险因素包括血小板计数和淋巴细胞计数降低以及出现管型尿。对于淋巴细胞减少,独立危险因素为抗双链DNA抗体和库姆斯试验阳性、血小板计数降低和管型尿。
在汉族SLE患者中,白细胞减少、中性粒细胞减少和淋巴细胞减少是常见的临床表现,血细胞计数下降程度也较为显著。淋巴细胞减少与SLE患者的疾病严重程度相关。库姆斯试验结果与淋巴细胞减少之间的相关性值得进一步研究。