Abstract
Background: Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease in which hematological manifestations such as anemia, leukopenia, and thrombocytopenia are very common and carry significant prognostic implications. However, there has been limited research on this issue in Vietnam.
Aims: This study was conducted to: 1) Determine the prevalence of hematological manifestations, and 2) Identify the association between certain risk factors (age, anti ds-DNA, complement C3, C4) and hematological manifestations in SLE patients.
Methods and Materials: A cross-sectional study was performed on 159 SLE patients diagnosed according to the SLICC criteria at Cho Ray Hospital from September to December 2024. Hematological manifestations (anemia, autoimmune hemolytic anemia, leukopenia, thrombocytopenia) were defined by specific criteria. Statistical analysis was used to assess associations.
Results: The overall prevalence of hematological manifestations was 32.1% (51/159 patients). The specific manifestations encountered were: autoimmune hemolytic anemia (18.9%), lymphocytecytopenia (11.3%), neutropenia (4.4%), and thrombocytopenia (5%). Younger age was significantly associated with autoimmune hemolytic anemia, lymphocytecytopenia, and overall hematological manifestations. Elevated anti ds-DNA (≥ 25 U/mL) was associated with lymphocytecytopenia and overall hematological manifestations. Low complement C3 and C4 levels were associated with autoimmune hemolytic anemia, lymphocytecytopenia, neutropenia (C4 only), and overall hematological manifestations. No significant association was found between these factors and thrombocytopenia.
Conclusion: Hematological manifestations are common in SLE patients, with the most frequent types being autoimmune hemolytic anemia and lymphocytecytopenia. Factors such as younger age, elevated anti ds-DNA, and low complement C3 and C4 levels are associated with the occurrence of these manifestations. Therefore, screening for hematological abnormalities is necessary in all SLE patients, especially younger individuals, for timely intervention and management.
| Published | 2026-09-28 | |
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| Issue | Vol. 16 No. 5 (2026) | |
| Section | Original Articles | |
| DOI | 10.34071/jmp.2026.5.762 | |
| Keywords | Systemic Lupus Erythematosus, hematological manifestations lupus ban đỏ hệ thống, tổn thương huyết học |
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright (c) 2026 Hue Journal of Medicine and Pharmacy
Santacruz JC, Mantilla MJ, Rueda I, Pulido S, Rodriguez-Salas G, Londono J. A Practical Perspective of the Hematologic Manifestations of Systemic Lupus Erythematosus. Cureus. 2022;14(3):e22938.
Jeffries M, Hamadeh F, Aberle T, Glenn S, Kamen DL, Kelly JA, et al. Haemolytic anaemia in a multi-ethnic cohort of lupus patients: a clinical and serological perspective. Lupus. 2008;17(8):739-43.
Uzun GS. OP 16 CHARACTERISTICS OF HEMATOLOGICAL MANIFESTATIONS IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: SINGLE CENTER EXPERIENCE. Hematology, Transfusion and Cell Therapy. 2025;47:103931.
Kokori SI, Ioannidis JP, Voulgarelis M, Tzioufas AG, Moutsopoulos HM. Autoimmune hemolytic anemia in patients with systemic lupus erythematosus. Am J Med. 2000;108(3):198-204.
Mirzayan MJ, Schmidt RE, Witte T. Prognostic parameters for flare in systemic lupus erythematosus. Rheumatology (Oxford). 2000;39(12):1316-9.
Li C, Mu R, Lu XY, He J, Jia RL, Li ZG. Antilymphocyte antibodies in systemic lupus erythematosus: association with disease activity and lymphopenia. J Immunol Res. 2014;2014:672126.
Fernandez-Cladera Y, Garcia-Gonzalez M, Hernandez-Diaz M, Gomez-Bernal F, Quevedo-Abeledo JC, Gonzalez-Rivero AF, et al. Relationship of Hematological Profiles with the Serum Complement System in Patients with Systemic Lupus Erythematosus. Biomedicines. 2024;12(5).
Keeling DM, Isenberg DA. Haematological manifestations of systemic lupus erythematosus. Blood Rev. 1993;7(4):199-207.
Fayyaz A, Igoe A, Kurien BT, Danda D, James JA, Stafford HA, Scofield RH. Haematological manifestations of lupus. Lupus Sci Med. 2015;2(1):e000078.
Mok CC, Lee KW, Ho CT, Lau CS, Wong RW. A prospective study of survival and prognostic indicators of systemic lupus erythematosus in a southern Chinese population. Rheumatology (Oxford). 2000;39(4):399-406.
Morgan M, Downs K, Chesterman CN, Biggs JC. Clinical analysis of 125 patients with the lupus anticoagulant. Aust N Z J Med. 1993;23(2):151-6.
Doumeth SA, Kort J, Pamuk ON. Blood-dominant disease in late-and-early-onset lupus: A systematic review and meta-analysis. Autoimmun Rev. 2024;23(11):103652.
Vương Tuyết Mai, Trịnh Thị Thuý, Dung ĐTK. Khảo sát một số chỉ số huyết học ở bệnh nhân viêm thận lupus điều trị nội trú. Y Học TP Hồ Chí Minh. 2016;Phụ bản Tập 20(1):413-9.
Skare T, Damin R, Hofius R. Prevalence of the American College of Rheumatology hematological classification criteria and associations with serological and clinical variables in 460 systemic lupus erythematosus patients. Rev Bras Hematol Hemoter. 2015;37(2):115-9.
Bashal F. Hematological disorders in patients with systemic lupus erythematosus. Open Rheumatol J. 2013;7:87-95.
Vananuvat P, Suwannalai P, Sungkanuparph S, Limsuwan T, Ngamjanyaporn P, Janwityanujit S. Primary prophylaxis for Pneumocystis jirovecii pneumonia in patients with connective tissue diseases. Semin Arthritis Rheum. 2011;41(3):497-502.
Yang Z, Wu Y, Huang S, Bao J, Xu L, Fan Y. Risk factors associated with thrombocytopenia in systemic lupus erythematosus: A systematic review and meta-analysis. Autoimmun Rev. 2025;24(2):103721.
Petri M, Orbai AM, Alarcon GS, Gordon C, Merrill JT, Fortin PR, et al. Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum. 2012;64(8):2677-86.
Hill QA, Hill A, Berentsen S. Defining autoimmune hemolytic anemia: a systematic review of the terminology used for diagnosis and treatment. Blood Advances. 2019;3(12):1897-906.
Abuagela M, Elalem N, Elyounsi N, Elarbi W, Almahmoudi R, Gaumati S. Hematological Disorders of Systemic Lupus Erythematosus: A Cross-Sectional Study. Khalij Libya Journal of Dental and Medical Research. 2025;9(1):97-102.
AA JV, A G, MA V. Systemic Lupus Erythematosus. 2023 cập nhật ngày 04-08-2023 [cited 18-09-2025]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, [cited 18-09-2025]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK535405/.
Noguchi M, Iwamori M, Hirano T, Kobayashi S, Hashimoto H, Hirose S, Nagai Y. Autoantibodies to T and B cell lines detected in serum samples from patients with systemic lupus erythematosus with lymphopenia and hypocomplementaemia. Ann Rheum Dis. 1992;51(6):713-6.