COOMBS TEST POSITIVITY AND ITS ASSOCIATION WITH ANTI-CARDIOLIPIN ANTIBODIES AND DIFFERENT CLINICAL MANIFESTATIONS IN PAEDIATRIC SLE PATIENTS

*Dr. Maria Kibtiar, Dr. Mohammad Imnul Islam AND Dr. Shahana Akhter Rahman

ABSTRACT

Background: Anemia is a well-known hematological abnormality in paediatric SLE patients (pSLE).The etiology of anemia in pSLE is multifactorial, including iron deficiency anemia, anemia of chronic disease and autoimmune hemolytic anemia (AHA). Coombs positive hemolytic anemia has specific clinical and serological characteristics compared to the others. Aims: To assess the coombs test frequency in pSLE patients and its association with anti-cardiolipin (aCL) antibodies and different clinical manifestations. Method: This was a cross-sectional study. Sixty five newly diagnosed pSLE patients who fulfilled the American College of Rheumatology 1997 revised classification criteria and attended in the department of paediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU) during the study period were included. Detailed history, examination, laboratory investigations including direct and indirect coombs test and aCL antibodies were done at diagnosis. Results: The mean age of the pSLE patients was 11.77 years and the female to male ratio was 6:1. Constitutional symptoms (92.3%) followed by mucocutaneous (87.7%), hematological (87.7%), renal (52.3%), musculoskeletal (50.8%) and neurological (23%) manifestations were the predominant manifestations in this cohort. Coombs test was positive in 52.3% of pSLE patients. Coombs test had significant positive association with aCL antibodies but no significant association was found between coombs test positivity and different clinical manifestations. Conclusion: Hematological manifestations were very common in pSLE patients. A Significant association of positive coombs test with aCL antibodies was observed in this study.

Keywords: Anticardiolipin (aCL) antibodies, Coombs test, paediatric SLE (pSLE).