AB0449 CLINICAL CHARACTERISTICS AND RISK FACTORS OF SYSTEMIC SCLEROSIS WITH HEMATOLOGIC SYSTEM DAMAGES
Authors: J. Zheng, Z. R. Dong, Y. P. Tang, Y. Q. Huang, Q. B. Zhang, F. Dai, Y. F. Qing
Journal: Annals of the Rheumatic Diseases (2021)

Background: SSc characterized by varying degrees of fibrosis of the skin and internal organs, clinicians pay more attention to skin and viscera conditions, tend to ignore hematologic system damage. Studies have shown that rheumatic disease such as SLE, RA, pSS often accompanied with hematologic system damages, and hematologic system damages is multiple organ involvement and risk factor of poor prognosis [1-2] . Objectives: To investigate the the clinical features, laboratory characteristics and risk factors of Systemic Sclerosis (SSc) patient with hematologic system damages. Methods: The clinical data of 180 patients were collected from January 2010 to April 2020, at the Affiliated Hospital of North Sichuan Medical College. The demographic information, laboratory tests, and clinical symptoms were analyzed retrospectively. Results: Among 180 SSc patients, 70(38.9%) cases were complicated with hematologic system damages. 51(72.9%) cases had anemia, 24 cases (34.3%) had leukopenia, 24 cases (34.3%) had thrombocytopenia, and 22 cases had hematologic system damages associated with more than two cell line involvement. Clinical symptoms: arthritis was significantly higher in the hematologic system damages group than patient without (P&lt;0.05), however, there was no significantly difference in gender, age, disease course, respiratory symptoms, gastrointestinal symptoms, Raynaud’s phenomenon, interstitial lung disease and pulmonary hypertension (all P&gt;0.05). Laboratory tests: ESR and hsCRP were increased in the hematologic system damages group, while the albumin decreased (all P&lt;0.05). The positive rates of resistance to anti-dsDNA antibody and anti-ribosomal P protein antibody was higher in the hematologic system damages group (all P&lt;0.05). Prognosis: During follow-up, leukopenia was more likely to recover, while the thrombocytopenia was more difficult to recover. Logistics regression analysis showed that positive of anti-ribosomal P protein antibody maght be a risk factor for SSc complicated with hematologic system damages [OR = 3.930(P&lt;0.05)] (Table 1). Conclusion: SSc complicated with hematologic system damages is common, and patients with hematologic system damages have more serious clinical symptoms, some of whom have difficulty in recovey. Anti-ribosomal P protein antibody may be a risk factor of SSc hematologic system damages. Table 1. Bivariate logistics regression analysis on risk factors associated with hematologic damages in SSc. Factor B SE Wald OR (95% CI ) P value arthritis 0.654 0.347 3.543 1.922(0.973-3.797) 0.060 ESR -0.081 0.487 0.028 0.922(0.355-2.393) 0.868 hsCRP -0.007 0.492 0.000 0.993(0.379-2.607) 0.989 anti-dsDNA 0.868 0.673 1.664 2.393(0.637-8.916) 0.197 anti-Rib-P 1.369 0.636 4.633 3.930(1.130-13.666) 0.031 References: [1]González-Naranjo L A, Betancur O M, Alarcón G S, et al. Features associated with hematologic abnormalities and their impact in patients with systemic lupus erythematosus: Data from a multiethnic Latin American cohort[J]. Seminars in Arthritis and Rheumatism, 2016,45(6):675-683.DOI:10.1016/j.semarthrit.2015.11.003. [2]Skare T, Damin R, Hofius R. Prevalence of the American College of Rheumatology hematological classification criteria and associations with serological and clinical variables in 460 systemic lupus erythematosus patients[J]. Revista Brasileira de Hematologia e Hemoterapia, 2015,37(2):115-119.DOI:10.1016/j.bjhh.2015.01.006 Disclosure of Interests: None declared.