“Unmasking the Hemolytic Face of Lupus: A Retrospective Study on AIHA and Disease Activity”

Background: Autoimmune hemolytic anemia (AIHA) is a significant hematologic complication in systemic lupus erythematosus (SLE), often associated with heightened disease activity and immune dysregulation. Objective: To determine the incidence of AIHA in SLE patients and analyze its clinical and serological correlations in a tertiary care setting in India Methods: This retrospective observational study reviewed medical records of 80 SLE patients diagnosed using the 2012 SLICC criteria between January 2020 and December 2023. AIHA was defined by anemia with hemolysis markers and a positive direct antiglobulin test. Clinical, hematologic, and immunologic parameters were compared between patients with and without AIHA. Results: AIHA was observed in 15% (12/80) of patients. Compared to non-AIHA patients, those with AIHA had significantly lower hemoglobin, higher reticulocyte counts, elevated LDH, and 100% Coombs positivity. AIHA patients also exhibited a significantly higher frequency of anti-dsDNA positivity (91.7% vs. 70.6%), low complement levels (C3 and C4), and higher SLEDAI scores (14.2 vs. 8.6; p<0.001), indicating more active disease. Conclusion: AIHA is a prominent haematologic symptom of SLE that is closely linked to serologic markers and disease activity. Timely and effective care of SLE requires early identification and distinction from other causes of anaemia..