Haemolytic anaemia in a multi-ethnic cohort of lupus patients: a clinical and serological perspective.

Systemic lupus erythematosus is a chronic autoimmune disease that can be associated with a variety of haematological manifestations. We identified 76 patients with haemolytic anaemia in a cohort of 1251 unrelated female lupus patients enrolled in our studies. The presence of the various American College of Rheumatology clinical criteria for lupus and serological specificities were determined in lupus patients with haemolytic anaemia and compared with a group of race-matched control lupus patients without haemolytic anaemia. Clinical data were obtained from medical records, and serological specificities were determined in our clinical immunology laboratory at OMRF. The presence of haemolytic anaemia in lupus patients was associated with a higher frequency of proteinuria (OR = 2.70, P = 0.000031), urinary cellular casts (OR = 2.83, P = 0.000062), seizures (OR = 2.96, P = 0.00024), pericarditis (OR = 2.21, P = 0.0019), pleuritis (OR = 1.72, P = 0.028) and lymphopenia (OR = 1.79, P = 0.015). These findings were independent of the presence of thrombocytopenia, which was approximately five times more common in lupus patients with haemolytic anaemia. Lupus patients with haemolytic anaemia were about 8 years younger than lupus patients without haemolytic anaemia at the time of disease onset (P = 0.000001). In the absence of thrombocytopenia, lupus patients with haemolytic anaemia were approximately two times more likely to have anti-dsDNA antibodies (P = 0.024). The presence of haemolytic anaemia is associated with a subset of lupus characterized by a younger age of disease onset, and a more severe disease with a higher likelihood of renal involvement, seizures, serositis and other cytopenias.

Identification of allergens in a selected group of asthmatics in Lebanon.

Anti-allergen antibodies were searched for by an Enzyme Immunoassay in the sera obtained from 60 patients with a clinical diagnosis of asthma. Allergic rhinitis was also present in 28 patients. The diagnosis of asthma was based on clinical criteria that include history and clinical evidence of airflow obstruction. Ten potential allergens (Bermuda grass, Olive tree, Parietaria, Alternaria, Cat hair dander, Dog hair dander, Mite DPT, Mugwort, Birch tree and Timothy grass) common to the Mediterranean area, were utilized. Twenty-five of 60 specimens were seropositive. Mite DPT was the allergen identified in 16 of the 25 seropositive specimens. Six of the 25 seropositive specimens reacted with more than one allergen. This may be due to the existence of similar antigenic determinant groups in the allergens used. There was no correlation between the occurrence of rhinitis in addition to asthma on one hand and the identified allergen on the other. Sixteen of the 25 seropositive patients were female. This observation is believed to be related to their occupation. Dog hair dander was identified as the allergen in 1 of the 25 seropositive patients. The low figure obtained was expected because keeping house pets is not a common practice in Lebanon. The 35 seronegative patients may belong to the intrinsic asthma group or the causative allergen in each case was not one of the 10 allergens used in this study. These results indicate that the house dust mite appears to be the most common allergen in the Lebanese asthmatic group studied.