Systemic lupus erythematosus related thrombotic microangiopathy: A retrospective study based on Chinese SLE Treatment and Research Group (CSTAR) registry

作者：Yupei Zhang, Nan Jiang, Zhen Chen, Xinwang Duan, Xiaofei Shi, Hongbin Li, Zhenyu Jiang, Yuhua Wang, Yanhong Wang, Jiuliang Zhao, Qian Wang, Xinping Tian, Mengtao Li, Xiaofeng Zeng · 发表于：Chinese Medical Journal · 年份：2024 · DOI：10.1097/cm9.0000000000003388 · 被引用次数：9 · 研究领域：Complement system in diseases、Renal Diseases and Glomerulopathies、Dialysis and Renal Disease Management

To the Editor: Thrombotic microangiopathy (TMA) is an uncommon hematological involvement in systemic lupus erythematosus (SLE) patients with an estimated incidence of 0.5–1%, including but not limited to thrombotic thrombocytopenic purpura (TTP), hemolytic uremic syndrome (HUS), and other secondary conditions. SLE-TMA has a rapid onset and poor prognosis, manifesting as microvascular thrombosis, thrombocytopenia, and microangiopathic hemolytic anemia.[1] Based on the Chinese SLE Treatment and Research Group (CSTAR) registry, we aimed to summarize clinical characteristics and explore prognostic risk factors in SLE-TMA patients through a retrospective multicenter study. This study was approved by the institutional review board of Peking Union Medical College Hospital (JS-2038) and informed consent was acquired. Between March 2012 and April 2022, 138 SLE-TMA patients were enrolled in seven tertiary hospitals across China. TMA diagnoses were defined by two major and at least one minor criteria. The major criteria included (1) microvascular hemolytic anemia accompanied by peripheral schistocytes, an increase in serum lactate dehydrogenase level and (2) thrombocytopenia (<100 × 109/L). Minor criteria included (1) neuropsychiatric, (2) renal involvement (glomerular-origin hematuria, proteinuria, or renal dysfunction), and (3) other organ involvements. Renal TMA was also included, defined as endothelial cell swelling, lumen narrowing or obliteration, and intracapillary schistocytes o...