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EVALUATION OF HAEMATOLOGICAL PARAMETERS CHANGES AND D-DIMER VALUES AMONG SUDANESE SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS IN KHARTOUM STATE
Akasha A. S.*, Sharaf Eldeen R. I., Afaq A. and Khadija A.
Background: Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with multisystem inclusion and is related with significant morbidity and mortality. Hematologic manifestation abnormalities are common in systemic lupus erythematosus (SLE), both at the time of diagnosis and all through the illness. The major hematologic appearances of SLE incorporate anemia, leukopenia, thrombocytopenia, and increased ability for thrombosis. This study was conducted to evaluate the hematological parameters (CBC) changes of SLE and to investigate the clinical significance of D-dimer values in systemic lupus erythematosus (SLE) patients in predicting thrombosis among Sudanese patients in Khartoum state. Methodology: Cross sectional case-control study done during the period of May 2020 to August 2021 in Alrayan Specilaized Center and Omdurman military hospital in Khartoum state to evaluate the haematological and coagulation changes among Sudanese patients with systemic lupus erythromatosus. Sixty (60) SLE Patients and 40 apparently healthy individual as control), their age ranged from (15-55) years. Results: In systemic lupus erythematosus (SLE) there are significant differences in the mean of RBCs, WBCs, neutrophil, Lymphocyte, platelets count, and D-dimer between the SLE patients group and normal control group (P-value 0.003, <0.001, 0.009, <0 .0 01, <0 .0 01, and 0.001) respectively. This might reflects the effect of SLE on many haematological and coagulation parameters. Out of 60 patients affected by systemic lupus erythromatosus anemia was detected in 24 patients (40%) , leukopenia in 23 patients (38.3%) , lymphopenia in 12 patient (20%), neutropenia in 28 patients (47%), and thrombocytopenia in 13 patients (21.7%). Systemic lupus erythematosus patients had significantly higher D-dimer levels (6.32±5.12), when compared with the control group (0.25±0.04) (P = 0.001). In systemic lupus erythematosus patients, 28 patients (46.7%) out of 60 showed negative D-dimer results (? 0.5 ?g/ml) with no thrombosis seen, 11 patients (18.3%) out of 60 showed higher levels of D-dimer (0.5 – 3.0 ?g/ml) with thrombosis seen in 4%, 21 patients (35%) out of 60 showed higher levels of D-dimer (> 3.0 ?g/ml) with thrombosis seen in 25%. Conclusions: The major haematological abnormalities in patients with systemic lupus erythromatosus (SLE) include anemia, leukopenia, and thrombocytopenia, or pancytopenia. This study concluded that the red blood cells (RBCs), white blood cells (WBCs), neutrophils, lymphocytes and platelets were lower in systemic lupus erythromatosus (SLE) when compared with the normal control. D-dimer level in patients with systemic lupus erythematosus (SLE) could be an effective sign in indication of the disease. The level of D-dimer elevates in patients with active disease. D-dimer levels had increased in all patients with thrombosis.[Full Text Article]