SYSTEMIC SCLERODERMIA AND INTERSTITIC LUNG DISEASE: HEMATOLOGICAL PICTURE
Summary. Aim. To analyze the features of hematological picture in patients with systemic sclerosis (SSc) and people with SSc-associated interstitial lung disease (SSc-ILD). Materials and methods. Our study had a retrospective design. We reviewed the medical records of 52 patients with a diagnosis of SSc, which was verified according to the 2013 ACR/EULAR classification criteria and national guidelines. The study also included a control group of 30 healthy individuals. Hematological disorders were determined on the basis of changes in general blood count indices. Anemia was established at a hemoglobin level of less than 110 g/l. Hematological indices such as neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR) were calculated. Statistical analysis of the data was performed using the Statistical Package for the Social Sciences version 26.0. Results. It was found that 36.5% (19 out of 52) of patients in the research group had changes in hematological parameters. Among these patients, the following structure of hematological pathology was revealed: 28.8% (15 out of 52) had anemia of various degrees of severity, 21.2% (11 out of 52) had lymphopenia, 11.5% (6 out of 52) had leukopenia, and only 2 patients had lymphocytosis. During the analysis of the association between the features of the course of SSc and the severity of hematological disorders, it was established that most of the considered indicators showed a direct correlation. The risk of a decrease in hemoglobin level less than 110 g/L was almost twice as high among patients with SSc-ILD [OR 1.96 (1.54–2.47)], p=0.034. Also, a low absolute number of lymphocytes less than or equal to 1.9·109/l and an increase in the NLR index also showed a similar trend with the values of the odds ratio, respectively [OR 2.10 (1.34–3.14)], p=0.022 and [OR 2.43 (0.95–3.57)], p=0.015. Conclusion. Patients with systemic sclerosis demonstrate the presence of anemia and lymphopenia more often than the control group. Individuals with systemic sclerosis and pulmonary involvement are characterized by more pronounced hematological disorders compared to the general cohort of patients with systemic sclerosis.
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