Mira Merashli1, Alessia Arcaro2, Maria Graf3, Fabrizio Gentile2, Paul R J Ames4,5. 1. Department of Rheumatology, American University of Beirut, Beirut, Lebanon. 2. Department of Medicine & Health Sciences 'V.Tiberio', Universita' del Molise, Campobasso, Italy. 3. Department of Laboratory and Transfusion Medicine, Federico II University Hospital, Naples, Italy. 4. Immune Response & Vascular Disease Unit, Nova University, Lisbon, Portugal. paxmes@aol.com. 5. Dumfries and Galloway Royal Infirmary, Dumfries, UK. paxmes@aol.com.
Abstract
INTRODUCTION/ OBJECTIVE: The relationship between autoimmune haemolytic anaemia (AIHA) and antiphospholipid antibodies (aPL) has never been addressed via a meta-analysis in the paediatric age group. We evaluated the link between AIHA and aPL in childhood systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS). METHODS: EMBASE and PubMed were screened from inception to May 2020 and Peto's odds ratio for rare events was employed for the between group comparisons. RESULTS: The meta-analysis included 11 articles for a total of 575 children: the pooled prevalence of AIHA was greater in (1) IgG aCL-positive than IgG aCL-negative children (39.7% vs 20.9%, p = 0.005); (2) in APS-positive than APS-negative SLE children (36.8% vs 13.2%, p = 0.01); and (3) in SLE-related APS than in primary APS children (53% vs 16.2%, p = 0.008). CONCLUSIONS: The pooled prevalence of AIHA is greatest in SLE with aPL/APS, low-moderate in SLE without aPL/APS, and lowest in primary APS. Key Points • Antiphospholipid antibodies strongly relate to autoimmune haemolytic anaemia. • Autoimmune haemolytic anaemia is more common in systemic lupus erythematosus with antiphospholipid antibodies.
INTRODUCTION/ OBJECTIVE: The relationship between autoimmune haemolytic anaemia (AIHA) and antiphospholipid antibodies (aPL) has never been addressed via a meta-analysis in the paediatric age group. We evaluated the link between AIHA and aPL in childhood systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS). METHODS: EMBASE and PubMed were screened from inception to May 2020 and Peto's odds ratio for rare events was employed for the between group comparisons. RESULTS: The meta-analysis included 11 articles for a total of 575 children: the pooled prevalence of AIHA was greater in (1) IgG aCL-positive than IgG aCL-negative children (39.7% vs 20.9%, p = 0.005); (2) in APS-positive than APS-negative SLEchildren (36.8% vs 13.2%, p = 0.01); and (3) in SLE-related APS than in primary APSchildren (53% vs 16.2%, p = 0.008). CONCLUSIONS: The pooled prevalence of AIHA is greatest in SLE with aPL/APS, low-moderate in SLE without aPL/APS, and lowest in primary APS. Key Points • Antiphospholipid antibodies strongly relate to autoimmune haemolytic anaemia. • Autoimmune haemolytic anaemia is more common in systemic lupus erythematosus with antiphospholipid antibodies.