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YES. What is anemia?
Anemia is a drop in red blood cells, which results in a reduction in hemoglobin levels. Hemoglobin is an oxygen transporter that is the essential constituent of red blood cells.
There are anemias of very different origins, related to chronic bleeding (for example, due to heavy menstruations), iron deficiency, chronic inflammation or excessive destruction of red blood cells.
How are lupus anemias explained?
In lupus, it is possible to have anemia for several reasons.
Most often, anemia is caused by inflammation due to systemic lupus (inflammatory anemia). It will be corrected with the treatment of the disease.
The most severe anemia is related to antiglobulin autoantibodies. These autoantibodies lead to the destruction of red blood cells. This is called autoimmune hemolytic anaemia. This hemolysis results in an often quite brutal and significant drop in the level of hemoglobin.
This type of anemia is quite rare but is often an emergency that requires significant treatments.
Many treatments can lead to anemia through different mechanisms. It is therefore necessary, as a rule, to always consider a medicinal origin.
Anemia can also be linked to a production defect of young red blood cells in the bone marrow, but this form is exceptional.
The origin of this production defect is also linked to a disruption of the immune system.
If renal function is strongly impaired, the production of red blood cells is decreased. This mechanism is not unique to lupus.
In any case, anemia may not be directly related to lupus, but may be explained by another associated phenomenon, such as chronic bleeding, iron deficiency or another abnormality (e.g. vitamin B12 deficiency or hypothyroidism).
The discovery of anemia therefore justifies a questioning, a clinical examination and blood samples, to try to understand and treat it.
What should be done in case of anemia?
In case of significant anemia, the cause should be treated as soon as possible and, in case of poor tolerance, red blood cells should be transfused.
Lupus can lead to anemia, which is a drop in red blood cells. This anemia can have different origins, but the most severe form is a destruction of red blood cells by antiglobulin autoantibodies. This is called "autoimmune hemolytic anemia”. Other causes of anemia exist during lupus and we should always make sure that it is not a simple cause such as iron loss (through chronic bleeding), lack of vitamin (vitamin B12) or medication.