Journal Article

Hypochromic red cells as a prognostic indicator of survival among patients with systemic sclerosis screened for pulmonary hypertension

Gordjani, Ojan, Ulrich, Silvia, Fiehn, Christoph, Milde, Nicklas, Grünig, Ekkehard, Eichstaedt, Christina A., Xanthouli, Panagiota, Marra, Alberto M., Blank, Norbert, Distler, Oliver, Lorenz, Hanns-Martin, Harutyunova, Satenik, Egenlauf, Benjamin, Benjamin, Nicola, Haas, Simon

2023

Overview

Background Patients with systemic sclerosis (SSc) are frequently affected by iron deficiency, particularly those with pulmonary hypertension (PH). The first data indicate the prognostic importance of hypochromic red cells (% HRC) > 2% among patients with PH. Hence, the objective of our study was to investigate the prognostic value of % HRC in SSc patients screened for PH. Methods In this retrospective, single-center cohort study, SSc patients with a screening for PH were enrolled. Clinical characteristics and laboratory and pulmonary functional parameters associated with the prognosis of SSc were analyzed using uni- and multivariable analysis. Results From 280 SSc patients screened, 171 could be included in the analysis having available data of iron metabolism (81% female, 60 ± 13 years of age, 77% limited cutaneous SSc, 65 manifest PH, and 73 pulmonary fibrosis). The patients were followed for 2.4 ± 1.8 (median 2.4) years. HRC > 2% at baseline was significantly associated with worse survival in the uni- ( p = 0.018) and multivariable ( p = 0.031) analysis independent from the presence of PH or pulmonary parenchymal manifestations. The combination of HRC > 2% and low diffusion capacity for carbon monoxide (DLCO) ≤ 65% predicted was significantly associated with survival ( p < 0.0001). Conclusion This is the first study reporting that HRC > 2% is an independent prognostic predictor of mortality and can possibly be used as a biomarker among SSc patients. The combination of HRC > 2% and DLCO ≤ 65% predicted could serve in the risk stratification of SSc patients. Larger studies are required to confirm these findings.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Anemia / Arthritis / Blood / Cardiac catheterization / Cardiovascular disease / Care and treatment / Chronic illnesses / Cohort Studies / Complications and side effects / Deficiency diseases / Diagnosis / Erythrocytes / Female / Females / Hemoglobin / Humans / Hypertension, Pulmonary - diagnosis / Hypertension, Pulmonary - etiology / Hypochromic erythrocytes / Hypochromic red cells / Inflammatory diseases / Intubation / Iron / Iron deficiency / Laboratories / Lungs / Male / Medical examination / Medical prognosis / Medical screening / Medicine / Medicine & Public Health / Methods / Orthopedics / Prevention / Prognosis / Pulmonary fibrosis / Pulmonary hypertension / Retrospective Studies / Rheumatology / Risk assessment / Risk factors / Scleroderma / Scleroderma (Disease) / Scleroderma, Systemic - complications / Scleroderma, Systemic - diagnosis / Systemic scleroderma / Systemic sclerosis / Tumors