Association between Lymphopenia and Clinical Manifestations, Anti-dsDNA, and Disease Activity in Children with Systemic Lupus Erythematosus
Sunday, March 4, 2018
South Hall A2 (Convention Center)
Gartika Sapartini, Reni Ghrahani, Budi Setiabudiawan
RATIONALE: Lymphopenia, one of the hematologic criteria in diagnosing systemic lupus erythematosus (SLE), can also be used as a parameter to assess disease activity in SLE. In Indonesia, SLE disease monitoring is based on anti-dsDNA level, which is expensive and only available in several health centers. Lymphocyte count could be used as an inexpensive alternative to monitor SLE disease activity. We hypothesized that there would be an association between lymphopenia and clinical manifestations, anti-dsDNA, and disease activity in SLE children.

METHODS: This was a retrospective cross-sectional study on newly diagnosed SLE patients, aged 0-18 years, who visited Hasan Sadikin General Hospital, during the period of January 2009 – March 2017. Data collected were clinical manifestations, lymphocyte count, anti-dsDNA, and MEX-SLEDAI scores. Statistical analysis was performed using Chi-squared test and Student’s t-test.

RESULTS: There were 103 subjects participated in this study, 58 (56.3%) lymphopenia and 45 (43.7%) non-lymphopenia subjects. Most subjects were 12-18 years old, with a female-to-male ratio of 16:1. Compared to non-lymphopenia group, the most frequently seen clinical manifestations in the lymphopenia group were nephritis (72.4% vs. 13.3%), hypertension (24.1% vs. 6.7%), and leucopenia (36.2% vs. 6.7%), which were statistically different (p<0.05). Neuropsychiatric SLE was found only in the lymphopenia group. Negative correlation was found between lymphocyte count and anti-dsDNA level (r=-0.24), p<0.05. The median score of MEX-SLEDAI was higher in lymphopenia compared to non-lymphopenia group (13 vs. 7), p<0.05.

CONCLUSIONS: There is an association between lymphopenia and clinical manifestations (nephritis, hypertension, neuropsychiatric, leucopenia), anti-dsDNA level, and disease activity in SLE children.