Development of systemic lupus erythematosus in patients with immune thrombocytopenic purpura: A systematic meta-analysis

Pamuk, Ömer Nurı; Ali, Saja Mustafa

doi:10.1016/j.autrev.2023.103297

Cited by 14 publications

(15 citation statements)

References 32 publications

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“…SLE development was notably associated with ANA positivity (≥1:160) (OR = 6.638; 95% CI [1.399–31.504]) ( Ahn et al, 2022 ). Several studies also exhibited that ANA positivity was a risk index for SLE in primary ITP patients ( Hazzan et al, 2006 ; Pamuk, Ali & Hasni, 2023 ). However, Wandstrat et al (2006) found that approximately 25% of healthy individuals were positive for ANA using indirect immunofluorescence assays on HEP-2 cells ( Chen, Lin & Chao, 2021 ).…”

Section: Discussionmentioning

confidence: 97%

Incidence and risk factors of systemic lupus erythematosus in patients with primary immune thrombocytopenia: a systematic review and meta-analysis

Zhou,

Shen,

Wang

et al. 2024

PeerJ

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Background Immune disorders and autoantibodies has been noted in both primary immune thrombocytopenia (ITP) and systemic lupus erythematosus (SLE). Whether the two disorders are correlated is unclear. The lack of evidence on the incidence of and risk factors for SLE in primary ITP patients poses a challenge for prediction in clinical practice. Therefore, we conducted this study. Methods The protocol was registered with PROSPERO (CRD42023403665). Web of Science, Cochrane, PubMed, and EMBASE were searched for articles published from inception to 30 September 2023 on patients who were first diagnosed with primary ITP and subsequently developed into SLE. Furthermore, the risk factors were analyzed. Study quality was estimated using the Newcastle-Ottawa Scale. The statistical process was implemented using the R language. Results This systematic review included eight articles. The incidence of SLE during the follow-up after ITP diagnosis was 2.7% (95% CI [1.3–4.4%]), with an incidence of 4.6% (95% CI [1.6–8.6%]) in females and 0 (95% CI [0.00–0.4%]) in males. Older age (OR = 6.31; 95% CI [1.11–34.91]), positive antinuclear antibody (ANA) (OR = 6.64; 95% CI [1.40–31.50]), hypocomplementemia (OR = 8.33; 95% CI [1.62–42.91]), chronic ITP (OR = 24.67; 95% CI [3.14–100.00]), organ bleeding (OR = 13.67; 95% CI [2.44–76.69]), and female (OR = 20.50; 95% CI [4.94–84.90]) were risk factors for subsequent SLE in ITP patients. Conclusion Patients with primary ITP are at higher risk of SLE. Specific follow-up and prevention strategies should be tailored especially for older females with positive ANA, hypocomplementemia, or chronic ITP. In subsequent studies, we need to further investigate the risk factors and try to construct corresponding risk prediction models to develop specific prediction strategies for SLE.

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Section: Discussionmentioning

confidence: 97%

Incidence and risk factors of systemic lupus erythematosus in patients with primary immune thrombocytopenia: a systematic review and meta-analysis

Zhou,

Shen,

Wang

et al. 2024

PeerJ

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“…The neuropsychiatric manifestations differed from the age of SLE onset. Late-onset SLE showed lower frequencies of neuropsychiatric SLE, seizures, and psychosis but a higher prevalence of peripheral neuropathy than early-onset SLE [33]. A study in Korea observed NPSLE in a significant portion (38.3%) of SLE patients with an increased risk of mortality (HR 3.09, 95% CI 1.03~9.21) [34].…”

Section: ) Neuropsychiatric Involvementmentioning

confidence: 99%

Epidemiology of systemic lupus erythematosus in Korea

Han,

Cho,

Sung

2023

J Rheum Dis

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Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by diverse organ system disabilities, predominantly affecting young females. The clinical manifestations of SLE encompass various organs, including the kidney, cardiovascular system, and central nervous system. Young females with SLE experience higher mortality rates than the general population, making it imperative to gain insights into the disease patterns and associated factors. The current review examines the epidemiological studies to analyze the prevalence, incidence, and mortality trends of SLE in Korea and compares them with the findings from other countries. We aim to identify potential similarities, differences, and factors contributing to the burden of SLE in different populations by exploring the comparative epidemiological aspects. The knowledge derived from this comparison would aid in advancing the overall management of SLE in Korea.

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“…49 Apparently, vaccines can trigger immune thrombocytopenia which is a common presentation of SLE and is associated with poor prognosis. 49,69 COVID-19 vaccine, Johnson & Johnson in particular, has been reported to trigger a flare of immune thrombocytopenia in a 59-year-old SLE female patient with previous history of a flare of immune thrombocytopenia occurring after receiving Shingrix vaccine. 70 The mRNA COVID-19 vaccines were also thought to trigger immune thrombocytopenia flares as a significant number of patients, known to have immune thrombocytopenia, had relapses within a year of receiving the second doses of either the BNT162b2 or the mRNA-1273 vaccines.…”

Section: Covid-19 Vaccines and Immune Thrombocytopeniamentioning

confidence: 99%

COVID-19 and SLE: Infection and autoimmunity at its best

Mahroum,

Elsalti,

Ozkan

et al. 2023

Lupus

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If one had any doubts before the pandemic regarding the correlation between infections and autoimmunity, COVID-19 left us fascinated on the strong bond between the two entities. The immune and autoimmune reactions seen in patients infected with SARS-CoV-2 have served as a base for this assumption. Later on, the use of immunosuppressants such as systemic glucocorticoids, among other biological agents, turned this assumption to a fact. This was no different when it comes to the vaccines against COVID-19. Through several postulated mechanisms these vaccines, although generally considered safe, are thought to have the potential to result in autoimmune reactions making them not more innocent than the infection itself. When systemic lupus erythematous (SLE) is viewed as a classical autoimmune multisystemic disorder, the connection with SARS-CoV-2 infection and COVID-19 vaccination is of extreme importance. This is because early reports during the pandemic have shown increased rates of SARS-CoV-2 infection among patients known previously to have SLE and much more interestingly, cases of new-onset SLE after COVID-19 have been documented in the literature. Subsequently vaccines against COVID-19, those mRNA-based and adenovirus-vector based, were reported to induce new SLE cases, trigger immune thrombocytopenia or lupus nephritis, two common presentations of SLE, or exacerbate flares. In our paper, we concluded various aspects of available and recent data regarding SLE and COVID-19 as both an infection and vaccination.

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Development of systemic lupus erythematosus in patients with immune thrombocytopenic purpura: A systematic meta-analysis

Cited by 14 publications

References 32 publications

Incidence and risk factors of systemic lupus erythematosus in patients with primary immune thrombocytopenia: a systematic review and meta-analysis

Incidence and risk factors of systemic lupus erythematosus in patients with primary immune thrombocytopenia: a systematic review and meta-analysis

Epidemiology of systemic lupus erythematosus in Korea

COVID-19 and SLE: Infection and autoimmunity at its best

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