Vatutin Mykola, Smyrnova Ganna and Taradin Gennadiy
Objective: This study aims to investigate hematological abnormalities in Ukrainian patients with rheumatoid arthritis (RA) and analyze their causes.
Patients and methods: Eighty nine patients who met the American College of Rheumatology (ACR) criteria for RA were included in this study. Individuals with no history of joint pains were enrolled as healthy controls, and matched for age and ethnicity with patients of RA. All patients received methotrexate (10.5 ± 5.5 mg/week) in combination with folic acid. Steroid hormones were prescribed to 92% (19.3 ± 3.8 mg/day) of patients; nonsteroidal anti-inflammatory drugs were taken on demand. The blood count was measured to determine the white blood cell (WBC), red blood cell (RBC), hemoglobin and thrombocyte levels. TNFα, CRP and IL-1β were also investigated.
Results: Anemia was observed in 57 (64% (95% CI 53.7-73.8%)) of the patients. Most of them (70.2% (95% CI 57.5-81.5%)) had mild degree of anemia, the rest (29.8% (95% CI 18.5-42.5%)) - moderate degree of anemia. In 13 (14.6% (95% CI 8.0-22.8%)) patients was found low WBC level (3.05 ± 0.84 G/L), mainly caused by low lymphocytes level (0.74 ± 0.21 G/L). Twenty one (23.6% (95% CI 15.3-33.1%)) patients had thrombocytosis (482.0 ± 29.1 G/L). Increased sedimentation rate (37.91 ± 15.65 mm/h) was recorded in all patients. The healthy controls had normal complete blood count. The correlation analysis revealed a negative correlation between the hemoglobin level and ESR, CRP, TNFα, IL-1β concentrations. There were statistically significant positive correlations between platelets level and ESR, CRP, TNFα, IL-1β concentrations.
Conclusion: Our findings suggest that patients with RA have serious hematological abnormalities violations that can be caused by the activity of the disease.