Thrombocytopenia Is an Independent Risk Factor for the Prognosis of Thrombotic Microangiopathy in Chinese Patients With Systemic Lupus Erythematosus

Thrombocytopenia Is an Independent Risk Factor for the Prognosis of Thrombotic Microangiopathy in Chinese Patients With Systemic Lupus Erythematosus

Objectives: This study aims to describe clinical characteristics and outcome of thrombotic microangiopathy (TMA) in Chinese patients with systemic lupus erythematosus (SLE), and investigate the risk factors.Methods: We conducted a retrospective single-center cohort and enrolled patients of TMA assoc...

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Autores principales: Fan Yang, Junwei Tian, Linyi Peng, Li Zhang, Jia Liu, Xinping Tian, Wen Zhang, Mengtao Li, Yan Zhao, Fengchun Zhang, Xiaofeng Zeng, Li Wang, Xiaomei Leng
Formato: article
Lenguaje:EN
Publicado: Frontiers Media S.A. 2021
Materias:
systemic lupus erythematosus
thrombotic microangiopathy
clinical characteristics
thrombocytopenia
risk factor
Medicine (General)
R5-920
Acceso en línea:https://doaj.org/article/a9907d5b6115406bb09744ebafcdcfd8
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spelling oai:doaj.org-article:a9907d5b6115406bb09744ebafcdcfd82021-11-08T06:43:59ZThrombocytopenia Is an Independent Risk Factor for the Prognosis of Thrombotic Microangiopathy in Chinese Patients With Systemic Lupus Erythematosus2296-858X10.3389/fmed.2021.772607https://doaj.org/article/a9907d5b6115406bb09744ebafcdcfd82021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fmed.2021.772607/fullhttps://doaj.org/toc/2296-858XObjectives: This study aims to describe clinical characteristics and outcome of thrombotic microangiopathy (TMA) in Chinese patients with systemic lupus erythematosus (SLE), and investigate the risk factors.Methods: We conducted a retrospective single-center cohort and enrolled patients of TMA associated with SLE between January 2015 and December 2018. Demographic characteristics, clinical features, laboratory profiles, therapeutic strategies, and outcomes were collected. The risk factors of TMA in patients with SLE for mortality using multivariate analysis were estimated.Results: A total of 119 patients with a diagnosis of TMA were enrolled within the study period in our center, and SLE was found in 72 (60.5%) patients. The mean age was 29.2 ± 10.1 and 65 (92.3%) were women. Only 15 patients were found with definite causes, the other 57 cases remained with unclear reasons. Sixty-two patients got improved, while 10 patients died after treatment (mortality rate: 13.9%). Compared with the survival group, the deceased group had a higher prevalence of neuropsychiatric manifestations, infection with two or more sites, increased levels of C-reaction protein (CRP) and D-Dimer, and decreased platelet count. Multivariate analysis showed that the decrease of platelet count is the independent risk factor for in-hospital mortality for TMA in patients with SLE. The receiver operating characteristic (ROC) curve analysis displayed that a cutoff value of <18 × 109/L for platelet count could significantly increase the risk of death.Conclusions: Thrombotic microangiopathy often occurs in patients with active SLE with high mortality (13.9%), and thrombocytopenia, especially when the platelet count is lower than 18 × 109/L, is the risk factor for death.Fan YangJunwei TianLinyi PengLi ZhangJia LiuXinping TianWen ZhangMengtao LiYan ZhaoFengchun ZhangXiaofeng ZengLi WangXiaomei LengFrontiers Media S.A.articlesystemic lupus erythematosusthrombotic microangiopathyclinical characteristicsthrombocytopeniarisk factorMedicine (General)R5-920ENFrontiers in Medicine, Vol 8 (2021)
institution DOAJ
collection DOAJ
language EN
topic systemic lupus erythematosus
thrombotic microangiopathy
clinical characteristics
thrombocytopenia
risk factor
Medicine (General)
R5-920
spellingShingle systemic lupus erythematosus
thrombotic microangiopathy
clinical characteristics
thrombocytopenia
risk factor
Medicine (General)
R5-920
Fan Yang
Junwei Tian
Linyi Peng
Li Zhang
Jia Liu
Xinping Tian
Wen Zhang
Mengtao Li
Yan Zhao
Fengchun Zhang
Xiaofeng Zeng
Li Wang
Xiaomei Leng
Thrombocytopenia Is an Independent Risk Factor for the Prognosis of Thrombotic Microangiopathy in Chinese Patients With Systemic Lupus Erythematosus
description Objectives: This study aims to describe clinical characteristics and outcome of thrombotic microangiopathy (TMA) in Chinese patients with systemic lupus erythematosus (SLE), and investigate the risk factors.Methods: We conducted a retrospective single-center cohort and enrolled patients of TMA associated with SLE between January 2015 and December 2018. Demographic characteristics, clinical features, laboratory profiles, therapeutic strategies, and outcomes were collected. The risk factors of TMA in patients with SLE for mortality using multivariate analysis were estimated.Results: A total of 119 patients with a diagnosis of TMA were enrolled within the study period in our center, and SLE was found in 72 (60.5%) patients. The mean age was 29.2 ± 10.1 and 65 (92.3%) were women. Only 15 patients were found with definite causes, the other 57 cases remained with unclear reasons. Sixty-two patients got improved, while 10 patients died after treatment (mortality rate: 13.9%). Compared with the survival group, the deceased group had a higher prevalence of neuropsychiatric manifestations, infection with two or more sites, increased levels of C-reaction protein (CRP) and D-Dimer, and decreased platelet count. Multivariate analysis showed that the decrease of platelet count is the independent risk factor for in-hospital mortality for TMA in patients with SLE. The receiver operating characteristic (ROC) curve analysis displayed that a cutoff value of <18 × 109/L for platelet count could significantly increase the risk of death.Conclusions: Thrombotic microangiopathy often occurs in patients with active SLE with high mortality (13.9%), and thrombocytopenia, especially when the platelet count is lower than 18 × 109/L, is the risk factor for death.
format article
author Fan Yang
Junwei Tian
Linyi Peng
Li Zhang
Jia Liu
Xinping Tian
Wen Zhang
Mengtao Li
Yan Zhao
Fengchun Zhang
Xiaofeng Zeng
Li Wang
Xiaomei Leng
author_facet Fan Yang
Junwei Tian
Linyi Peng
Li Zhang
Jia Liu
Xinping Tian
Wen Zhang
Mengtao Li
Yan Zhao
Fengchun Zhang
Xiaofeng Zeng
Li Wang
Xiaomei Leng
author_sort Fan Yang
title Thrombocytopenia Is an Independent Risk Factor for the Prognosis of Thrombotic Microangiopathy in Chinese Patients With Systemic Lupus Erythematosus
title_short Thrombocytopenia Is an Independent Risk Factor for the Prognosis of Thrombotic Microangiopathy in Chinese Patients With Systemic Lupus Erythematosus
title_full Thrombocytopenia Is an Independent Risk Factor for the Prognosis of Thrombotic Microangiopathy in Chinese Patients With Systemic Lupus Erythematosus
title_fullStr Thrombocytopenia Is an Independent Risk Factor for the Prognosis of Thrombotic Microangiopathy in Chinese Patients With Systemic Lupus Erythematosus
title_full_unstemmed Thrombocytopenia Is an Independent Risk Factor for the Prognosis of Thrombotic Microangiopathy in Chinese Patients With Systemic Lupus Erythematosus
title_sort thrombocytopenia is an independent risk factor for the prognosis of thrombotic microangiopathy in chinese patients with systemic lupus erythematosus
publisher Frontiers Media S.A.
publishDate 2021
url https://doaj.org/article/a9907d5b6115406bb09744ebafcdcfd8
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