Autoimmune disease and sickle cell anaemia: ‘Intersecting pathways and differential diagnosis’

Abstract

Sickle cell disease (SCD) is an inherited disorder, which occurs due to a single gene mutation. It has multisystemic manifestations, affecting millions of people worldwide. The effect of SCD on joints and musculature can overlap with clinical features of autoimmune disease (AD). It is therefore difficult for clinical haematologists and physicians treating SCD patients to discriminate between these two conditions clinically. A delay in diagnosis leads to untreated symptoms and treatment differs considerably. An accurate knowledge of clinical findings and laboratory results of AD and SCD can help physicians avoid this. In the review that follows, we examine the existing literature on SCD and AD, and describe the features that may distinguish SCD and autoimmune disease such as systemic lupus erythematosus and rheumatoid arthritis. We aim to guide clinical haematologists and physicians towards a more rapid diagnosis of AD in sickle cell anaemia patients, by correct interpretation of the clinical assessment and commonly available diagnostics.

Coexistence of Sickle Cell Thalassaemia with Overlapping Syndrome: A Case Report of Systemic Lupus Erythematosus and Autoimmune Hepatitis

“…19 This drug suppresses the production of autoantibodies, potentially concealing early autoimmune disease. 20 As a matter of fact, corticosteroids are an appealing treatment for severe SCD complication, because they are inexpensive, readily available, and exhibit strong anti-inflammatory effects. 21 In this particular situation, a decision was made to refrain from using full-dose steroids, despite their known anti-inflammatory properties.…”

Sickle cell and autoimmune disease: a double whammy

“…Piccin et al have published a useful algorithm for trying to discriminate between sickle cell and autoimmune conditions, and summarized possible implications for treatment. 10 Future directions may include research into disease modifiers that interact at the crossroads between vaso-occlusion, hemolysis and progression of autoimmune disease; from this perspective hemopexin would be an interesting target. From a clinical perspective, the data presented calls for building up more joint expertise between hematologist and rheumatologist.…”

A Retrospective Analysis of the Association of Neutrophil–Lymphocyte Ratio (NLR) with Anemia in the Saudi Population

“…The most prevalent cause of anemia is iron deficiency (IDA), followed by anemia of chronic disease (ACD) [ 7 ]. ACD, also named anemia of inflammation, is seen in kidney disease, congestive heart failure, cancer, and autoimmune disorders [ 7 ] with concurrent elevated inflammatory markers [ 8 ]. Additionally, there was a link between inflammatory status and erythropoietin therapy resistance in anemic patients with chronic kidney disease [ 9 ].…”