Splenectomy increases the subsequent risk of systemic lupus erythematosus

Rheumatol Int. 2016 Feb;36(2):271-6. doi: 10.1007/s00296-015-3388-9. Epub 2015 Nov 2.

Abstract

Splenectomy may be necessary to treat systemic lupus erythematosus (SLE) patients with thrombocytopenia; however, whether performing a splenectomy on patients without SLE increases the subsequent risk of SLE remains unknown. Therefore, this study was conducted to determine the association between splenectomy and SLE. We conducted a cohort study by using data from the Taiwan National Health Institute Research Database to identify 10,298 patients with received a splenectomy between 2000 and 2006 and 41,192 participants without received a splenectomy who were selected by frequency matched based on sex, age, and the index year. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95 % confidence intervals (CIs) of developing SLE associated with splenectomy compared with patients who did not receive a splenectomy. During the study period, the overall incidence density rate of SLE was higher in the splenectomy cohort than in the non-splenectomy cohort (adjusted HR 10.55; 95 % CI 50.55-20.05). The incidence density rates of SLE in women and men who received a splenectomy were higher than those of patients who did not receive a splenectomy. Non-traumatic splenectomy increases the subsequent risk of SLE. The risk of SLE should be considered before performing a splenectomy, particularly in women and younger patients.

Keywords: Non-traumatic; Splenectomy; Systemic lupus erythematosus.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Distribution
  • Chi-Square Distribution
  • Databases, Factual
  • Female
  • Humans
  • Incidence
  • Kaplan-Meier Estimate
  • Lupus Erythematosus, Systemic / diagnosis
  • Lupus Erythematosus, Systemic / epidemiology*
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Risk Assessment
  • Risk Factors
  • Sex Distribution
  • Splenectomy / adverse effects*
  • Taiwan / epidemiology
  • Time Factors
  • Young Adult