HAEMATOLOGICAL PESPERCTIVE OF

SYSTEMIC LUPUS ERYTHEMATOSUS

BY:

MERCY ADAH ENEJO

DISSCUSSANT : MR JOHN EGEDIGWE

SEMINAR CORDINATOR: DR. A.J WHYTE

A SEMINAR PRESENTED TO THE DEPARTMENT OF HAEMATOLOGY

UNIVERSITY OF ABUJA TEACHING HOSPITAL GWAGWALADA, ABUJA

MAY, 2024.
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OUTLINE
 INTRODUCTION
 EPIDEMOLOGY
 PATHOPHYSIOLOGY OF SLE
 HAEMATOLOGIC COMPILCATIONS
 SIGNS AND SYMPTOMS OF SLE
 LABORATORY INVESTIGATIONS OF SLE
 CONCLUSION
 RECOMMENDATION
 REFRENCES
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 INTRODUCTION
 Systemic lupus erythematosus {SLE} is the most common type
of lupus. SLE is an autoimmune disease in which the immune
system attacks its own tissues, causing widespread
inflammation and tissue damage in the affected organs.

 The immune system loses the ability to differentiate between

foreign cells and its own cells and tissue.

 Itcan affect the joints, skin, brain ,lungs, kidney and blood
vessels.

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 INTRODUCTION CONT’D
 Lupus is the latin word for wolf. Erythematosus means red
rashes. In 1851, Dr cazenave discovered red raches on a
patients’s face that looked like a wolf bites. He named the rash
Discord Lupus Erythematosus(DLE).

 In 1885, sir William osler recognized that many people with

lupus had a disease involving not only the skin but many other
organs or systems. He named the disease Systemic Lupus
Erythematosus (SLE)

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 EPIDEMOLOGY
 Globally,there are about 3.41 million people with SLE with an
estimated prevalence of 43.37(15.87 to 108.92) per 100000
person

 And over 100,000 cases Diagnosed In nigeria annually

 More than 90% of cases of SLE occur in women, frequently

starting at childbearing age.

(Jingru and Dingyao 2023)

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PATHOPHYSIOLOGY OF SLE

Tissue destruction and complications

Figure 1: Showing SLE pathophysiology

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HAEMATOLOGIC MANIFESTATIONS OF SLE
 ANEMIA- Anemia is a common haematological manifestation in lupus
erythematosus. it can be caused by carious factors, including chronic
disease, iron deficiency or auto immune hemolytic anemia

 LEUKOPENIA- lupus patients may experience a decrease in white

blood cell count, known as leumopenia. this can make the more
susceptible to infections

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 HAEMATOLOGIC MANIFESTATIONS OF SLE CONT.

 THROMBOCYTOPENIA- Thrombocytopenia, is another common

heamatological manifestation in lupus. it can lead to easy brusing and
an increased risk of bleeding.

 COAGULATION ABNORMALITY- Lupus can affect the normal

clotting funtion of the blood leading to an increased risk of thrombosis
or abnormal bleeding.

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 SIGNS AND SYMPTOMS
Painful or swollen joints and muscle pain
Unexplained fever
Rashes, most common in sun exposed areas
Chest pain upon deep breathing
Unusual loss of hair
Raynaud’s phenomenon
Sensitivity to the sun

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Figure 2: (Stella,2022)
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 LABORATORY INVESTIGATIONS

 Antinuclear Antibody Test (ANA)

 Erythrocyte sedimentation rate (ESR)
 Full Blood Count (FBC)

(Pineles et al., 2011)

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Antinuclear Antibody Test (ANA)
(Rotatory bead method)

Principle: Antinuclear antibodies have the property of causing invitro

lysis of the nuclei of neutrophils and subsequent phagocytosis of the
lysed nuclei by other neutrophilis. This is brought about by traumatizing
or causing damage by mechanical means of the cell.

Procedure
 Deliver 10ml of whole blood into universal bottle with glass beads
 Simultaneously shake vigorously to defibrinate
 Incubate at 37o c for 3hours
 Transfers blood into the wintrobe tubes
 Leave for 1hour

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 Antinuclear Antibody Test (ANA)
(Rotatory bead method) CONT.
 Remove serum and make smear from the buffy coat layer or fill into
plain capillary tubes
 Spin at 10,000rpm for 5minutes
 Break at interface and make smear from buffy coat
 Stain with romanowasky stains
 Examine for LE cells
 Express results as positive or negative.

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Figure 2.0. image of lupus Figure 2.1. peripheral blood
cells film showing lupus cells

Figure 2.2. peripheral blood film

showing normal blood cells 06/28/2024 www.askheamatologist.com 14
ERTHROCYTE SEDIMENTATION RATE

ESR results of patients with SLE are elevated due to

the inflammation that occurs.

(Tian,2023).

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 FULL BLOOD COUNT
In patients with SLE, the Full blood count result shows:
Aneamia

Neutropenia

Lymphopenia

Thrombocytopenia

(Dall et al.,2017)

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 CONCLUSION
 Systemic lupus erythromatosus (SLE) is an autoimmine
disease where body attacks its own tissues and organs, its
affects mostly women of childbearing age and it has no known
cause or cure. Heamtological tests for its diagnosis includes
ANA,ESR AND FBC.

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RECOMMENDATION
It is hereby recommended that:

 Further study should be carried out on the diesease, systemic lupus

erythematosis (SLE).

 UATH should incorperate the Antinuclear antibody test (ANA) for the
diagnostic investigation of SLE.

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 REFERENCES
Dall'Era, M., Wofsy, D. (2017). Clinical Manifestations of Systemic Lupus
Erythematosus. Fire textbook of Rheumatology;40(10):11-117
Fitzpatrick, Thomas., Klauss, Wolff., Klaus, Dieter., Johnson, Richard. (2005).
Fizpatric color atlas and synopsis of clinical dermatology .
Jingru, Tian., Dingyao, Zhang. (2023). Global epidemology of systemic lupus
erythromatosus:a comprehensive systemic analysis and modelling study.
Journal of medical science; 82: 351-356
Pineles, D., Valente, A., Warren, B., Peterson, M. G., Lehman, T. J, Moorthy, L. N.
(2011). Worldwide incidence and prevalence of pediatric onset systemic lupus
erythematosus. Lupus; 20(11): 1187-92
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