Autoimmune haemolytic anaemia and antiphospholipid antibodies in paediatrics: a systematic review and meta-analysis

Mira Merashli, Alessia Arcaro, Maria Graf, Fabrizio Gentile, Paul R.J. Ames

Research output: Contribution to journalArticle

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.

Original languageEnglish
JournalClinical Rheumatology
DOIs
Publication statusAccepted/In press - 2020

Keywords

  • Antiphospholipid syndrome
  • Autoimmune haemolytic anaemia
  • Lupus

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