Splenectomy in systemic lupus erythematosus and autoimmune hematologic disease: a comparative analysis.
Clin Rheumatol
; 37(4): 943-948, 2018 Apr.
Article
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| MEDLINE
| ID: mdl-29335897
ABSTRACT
The objective of the study is to analyze the efficacy and safety of splenectomy in the management of refractory autoimmune thrombocytopenia (AT)/autoimmune hemolytic anemia (AIHA) associated or not with systemic lupus erythematosus. Thirty-four patients after splenectomy due to severe AT and/or AIHA were divided into group 1 (G1) 18 SLE/APS patients 9 AT/SLE patients, 6 SLE/antiphospholipid syndrome (APS), and 3 primary APS. Group 2 (G2) 16 patients without SLE/APS 2 Fisher-Evans syndrome and 14 AIHA. Surgery approach when (1) platelets ≤ 50,000/ml despite 2 weeks on medical therapy, (2) medically dependent, and (3) medically intolerant or after two hemolytic crises in AIHA patients. Splenectomy response (1) complete (CR) ≥ 150,000 platelets/ml, (2) partial 50,000-149,000/ml, or (3) none ≤ 50,000/ml. CR for AIHA hemoglobin ≥9 g/dl. STATISTICAL ANALYSIS:
descriptive statistics and chi-square test. The mean age was 34.6 years; mean follow-up 28.5 months. Open splenectomy in 15/34 vs laparoscopy in 19/34 (p = NS). CR in 15/34, G1 4/18, G2 11/16, (p = 0.006). Complications in 6/34, 5 from G2 vs 1 from G1 (p = 0.05). Relapse in 7/18 patients in G1 and 3/16 in G2 (p = 0.05). Open and laparoscopic splenectomies in SLE and AT patients are as effective as in those without SLE; however, patients with SLE and APS had more relapses.Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Esplenectomía
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Púrpura Trombocitopénica Idiopática
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Anemia Hemolítica Autoinmune
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Lupus Eritematoso Sistémico
Límite:
Adult
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Female
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Humans
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Male
Idioma:
En
Revista:
Clin Rheumatol
Año:
2018
Tipo del documento:
Article
País de afiliación:
México