Lupus eritematoso sistêmico e artrite reumatoide: avaliação dos perfis hematológico e hemostático avaliado pelo teste de geração de trombina.

Abstract

Introduction: Systemic lupus erythematosus (SLE) is characterized by being an autoimmune disease, of inflammatory nature and of unknown cause, resulting from the production of antibodies directed against nuclear and cytoplasmic antigens, affecting different organs with numerous clinical manifestations. Another relevant autoimmune disease is rheumatoid arthritis (RA), which is characterized as a chronic, inflammatory disease that affects the joints, causing chronic and intense joint pain. Both diseases can present hematological and hemostatic alterations and occur predominantly in females. An analysis of the literature on such alterations as a component of the pathophysiological picture of autoimmune diseases SLE and RA reveals inconsistency and, therefore, additional studies are needed. Objective: In this context, the general objective of the present study was to evaluate the impact of SLE and RA on the hematological and hemostatic profiles and compare the results among themselves and with those obtained from a group of healthy women (controls). Methodology: After free and informed consent, a total of 40 women participated in the study, including 21 with SLE and 10 with RA, in addition to 6 healthy women. Hematological alterations were investigated using whole blood counts, whose parameters were used to calculate various indices related to inflammation, such as the neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), systemic inflammation response index (SIRI), aggregate systemic inflammation index (AISI), and systemic immune inflammation index (SII). As for hemostatic alterations, these were investigated using the Thrombin Generation Test (CAT method). Results: The hemogram parameters and derived indices did not show significant difference between the studied groups, however the dRN/L inflammation index suggests a greater inflammatory process in patients with SLE compared to those with RA. A joint analysis of TGT parameters indicated more hemostatic changes in SLE compared to RA based on ETP (Endogen Thrombin Potential) values, for both Tissue Factor concentrations (p=0.005 for Low Tissue Factor and p=0.001 for High Tissue Factor).Conclusion: These results may have a clinical perspective given that a tendency towards hypercoagulability in women with active SLE was observed using the TGT in the present study.