Hematological Manifestations among Patients with Rheumatic Diseases

Acta Haematol. 2021;144(4):403-412. doi: 10.1159/000511759. Epub 2020 Nov 20.

Abstract

Background: Rheumatic diseases have many hematological manifestations. Blood dyscrasias and other hematological abnormalities are sometimes the first sign of rheumatic disease. In addition, novel antirheumatic biological agents may cause cytopenias.

Summary: The aim of this review was to discuss cytopenias caused by systemic lupus erythematosus and antirheumatic drugs, Felty's syndrome in rheumatoid arthritis, and autoimmune hemolytic anemia, thrombosis, and thrombotic microangiopathies related to rheumatological conditions such as catastrophic antiphospholipid syndrome and scleroderma renal crisis. Key Message: The differential diagnosis of various hematological disorders should include rheumatic autoimmune diseases among other causes of blood cell and hemostasis abnormalities. It is crucial that hematologists be aware of these presentations so that they are diagnosed and treated in a timely manner.

Keywords: Anemia; Antiphospholipid syndrome; Arthritis; Leukopenia; Rheumatic diseases; Systemic lupus erythematosus; Thrombocytopenia; Thrombosis; Thrombotic microangiopathy; Vasculitis.

Publication types

  • Review

MeSH terms

  • Anemia, Hemolytic / complications
  • Anemia, Hemolytic / drug therapy
  • Anemia, Hemolytic / pathology
  • Antirheumatic Agents / therapeutic use*
  • Felty Syndrome / complications
  • Felty Syndrome / drug therapy
  • Felty Syndrome / pathology
  • Glucocorticoids / therapeutic use
  • Granulocyte Colony-Stimulating Factor / therapeutic use
  • Hematologic Diseases / complications
  • Hematologic Diseases / drug therapy
  • Hematologic Diseases / pathology*
  • Leukopenia / complications
  • Leukopenia / drug therapy
  • Leukopenia / pathology
  • Lupus Erythematosus, Systemic / complications
  • Lupus Erythematosus, Systemic / drug therapy
  • Lupus Erythematosus, Systemic / pathology
  • Protein Kinase Inhibitors / therapeutic use
  • Rheumatic Diseases / complications
  • Rheumatic Diseases / diagnosis
  • Rheumatic Diseases / drug therapy*

Substances

  • Antirheumatic Agents
  • Glucocorticoids
  • Protein Kinase Inhibitors
  • Granulocyte Colony-Stimulating Factor