Systemic lupus erythematosus (SLE) is a chronic inflammatory disease with an unknown etiology that can affect any organ or system of the human body. Hematological, renal, or central nervous system manifestations in these patients result in great morbidity because high doses of glucocorticoids, cytotoxic medications, or biological drugs are required to control these manifestations. It is noteworthy that hematological involvement predominates during the first years of the disease and tends to last over time, with the premise that it may be the initial manifestation of the disease. Clear examples of this are the cases of hemolytic anemia and immune thrombocytopenia that can be initially classified as idiopathic or primary to be later classified as secondary when associated with infections, medications, neoplasms, or autoimmune diseases. The spectrum of hematologic manifestations in SLE is very broad, including lymphopenia, anemia, thrombocytopenia, or pancytopenia. In some cases, lymphadenopathy and splenomegaly are also identified. The vast majority of these manifestations denote high disease activity. However, many of these alterations have a multifactorial cause that must be taken into account to adopt a more complete therapeutic approach. The objective of this review is to characterize in detail the hematological manifestations of SLE to offer clinicians a practical vision of its diagnosis and treatment.

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BackgroundSpondyloarthritis groups several diseases with similar clinical, biochemical, and imaging characteristics. These similarities have allowed this disease to be classified since 2009 as both axial or peripheral. The Latin American population with spondyloarthritis presents differential characteristics that do not allow it to be adequately classified by the current ASAS criteria, and because there are few latin cohorts of patients with spondyloarthritis, it is necessary to continue with the construction of said cohorts to improve the knowledge of the disease in our region, improving our participation in the construction of more inclusive criteria.ObjectivesTo describe the clinical, biochemical, and imaging characteristics of Colombian patients diagnosed with spondyloarthritis at a reference institution in Bogotá DC.MethodsPatients with a diagnosis of spondyloarthritis were chosen according to the assessment carried out by four expert rheumatologists at a reference institution in Bogotá DC, Colombia, between 2002 and 2015. They underwent a survey that included clinical, biochemical, and imaging characteristics and were followed up in a rheumatology clinic.Results473 patients were recruited between 2002 and 2015, with 65.1% men, 83.7% being of mixed race, a mean age of onset of the disease of 29.5 years, and a median delay in the diagnosis of the disease of 24 months.According to the ASAS classification, there were 189 axial patients and 223 peripheral patients; there were no differences between the age of onset of symptoms, sex, race, or duration of the first symptom between both groups. The axial patients had the longest delay in diagnosis (P = 0.03); more low back pain and less arthritis as initial symptoms (P 0.001); a higher frequency of insidious onset of arthritis (P 0.001); greater pain in the spine, stiffness, and inflammatory characteristics of pain (P 0.001). Patients with axSpA presented with more enthesitis (P = 0.03), less arthritis (P = 0.02), limited chest expansion (P = 0.03), and sacroiliitis on physical examination (P = 0.001).Patients with pSpA have a lower frequency of HLA-B27 (P 0.001) but a higher frequency of other HLA alleles (P = 0.01), such as HLA-B15 (P = 0.001), with a higher ESR (P = 0.03).ConclusionColombian patients with SpA are predominantly young men, with pSpA being the most frequent. AxSpA patients present a longer delay in diagnosis, more low back pain and less arthritis as initial symptoms, greater pain and stiffness of the spine compared to patients with pSpA spondyloarthritis, but the latter present more of the HLA-B15 allele, a higher frequency of previous infection and higher ESR than patients with axSpA.Reference[1]Rudwaleit M, van der Heijde D, Landewe R, Listing J, Akkoc N, Brandt J, et al. The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis [Internet]. 2009 Jun 1;68(6):777–83.Acknowledgements:NIL.Disclosure of InterestsNone Declared.