Butt Nauman Ismat, Ghoauri Muhammad Sohail Ajmal, Waris Barak, Javed Muhammad Umair, Sabeh Dure, Qaisar Fahad
Internal Medicine/Rheumatology, Azra Naheed Medical College, Superior University, Lahore, PAK.
Neurology, Bahawal Victoria Hospital, Quaid-e-Azam Medical College, Bahawalpur, PAK.
Cureus. 2024 Nov 6;16(11):e73112. doi: 10.7759/cureus.73112. eCollection 2024 Nov.
Background and objective This study aims to investigate thrombocytosis and thrombocytopenia in treatment-naïve rheumatoid arthritis (RA) patients, addressing the lack of data on their prevalence and clinical significance. By focusing on untreated patients, this study seeks to clarify the disease's natural course without confounding factors from prior therapies. The research is particularly important in the Pakistani context, where regional variations in RA presentation are underexplored. Findings are expected to enhance understanding of these hematological changes, ultimately guiding improved clinical management strategies for RA. Methods The present retrospective data-based study was conducted at the Department of Medicine & Allied Health Sciences, Azra Naheed Medical College, Superior University, Lahore, Pakistan. The 2010 American College of Rheumatology (ACR) diagnostic criteria were used to define RA. Thrombocytosis was defined as a platelet count greater than 400×10/L. Thrombocytopenia was defined as a platelet count less than 150×10/L. The Disease Activity Score in 28 joints (DAS-28 score) was used to categorize the disease severity of RA. Retrospective data were collected from the medical records of 165 patients with RA. Records from January 2023 to December 2023 were included. The assessment included demographic information, rheumatoid factor status, anti-CCP antibody status, disease severity measured by the DAS-28 score, and complete blood count (CBC) results, such as hemoglobin, white blood cell (WBC) count, and platelet count. Data entry and analysis were conducted using IBM SPSS Statistics software, version 23 (IBM Corp., Armonk, NY). Results The mean age of the patients was 42.5±13.6 years, with 25 (15.2%) male and 140 (84.8%) female patients. The RA factor (RAF) was positive in 128 (77.6%) and the anti-CCP antibody in 102 (61.8%). The mean DAS-28 score was 4.5±1.4, with 113 (68.5%) patients having mild-to-moderate disease and 52 (31.5%) patients having severe disease. Mean hemoglobin, WBC, and platelet counts were 12.0±1.4 g/dl, 9.0±2.7 ×10/L, and 352.6±110.4 ×10/L, respectively. Thrombocytosis was seen in 52 (31.5%) patients, while thrombocytopenia was seen in 11 (6.7%). Conclusion Thrombocytosis was seen in almost one-third of RA patients, having a significant association with age, the RAF factor positivity, and anti-CCP antibody negativity but not with gender and disease severity. Thrombocytopenia was relatively uncommon.
背景与目的 本研究旨在调查初治类风湿关节炎（RA）患者的血小板增多症和血小板减少症，以填补其患病率及临床意义方面的数据空白。通过聚焦未治疗患者，本研究旨在阐明疾病的自然病程，避免既往治疗产生的混杂因素影响。在巴基斯坦，类风湿关节炎的表现存在地区差异，但相关研究较少，因此本研究尤为重要。研究结果有望增进对这些血液学变化的理解，最终为类风湿关节炎的临床管理策略改进提供指导。方法 本研究是一项基于回顾性数据的研究，在巴基斯坦拉合尔优越大学阿兹拉·纳希德医学院医学与联合健康科学系开展。采用2010年美国风湿病学会（ACR）诊断标准来定义类风湿关节炎。血小板增多症定义为血小板计数大于400×10⁹/L。血小板减少症定义为血小板计数小于150×10⁹/L。采用28个关节的疾病活动评分（DAS-28评分）对类风湿关节炎的疾病严重程度进行分类。从165例类风湿关节炎患者的病历中收集回顾性数据。纳入2023年1月至2023年12月的记录。评估内容包括人口统计学信息、类风湿因子状态、抗环瓜氨酸肽（anti-CCP）抗体状态、用DAS-28评分衡量的疾病严重程度以及全血细胞计数（CBC）结果，如血红蛋白、白细胞（WBC）计数和血小板计数。使用IBM SPSS Statistics软件23版（IBM公司，纽约州阿蒙克）进行数据录入和分析。结果 患者的平均年龄为42.5±13.6岁，其中男性25例（15.2%），女性140例（84.8%）。类风湿因子（RAF）阳性者128例（77.6%），抗CCP抗体阳性者102例（61.8%）。平均DAS-28评分为4.5±1.4，其中113例（68.5%）患者病情为轻至中度，52例（31.5%）患者病情严重。血红蛋白、白细胞和血小板的平均计数分别为12.0±1.4 g/dl、9.0±2.7×10⁹/L和352.6±110.4×10⁹/L。52例（31.5%）患者出现血小板增多症，11例（6.7%）患者出现血小板减少症。结论 近三分之一的类风湿关节炎患者出现血小板增多症，其与年龄、RAF因子阳性及抗CCP抗体阴性显著相关，但与性别和疾病严重程度无关。血小板减少症相对少见。
