Evaluation of Hematological Alterations Associated with Arthritis among Individuals in Karbala City
DOI:
https://doi.org/10.29303/wd2e8208Keywords:
Arthritis, Hematological changes, Anemia, Inflammatory markers, Cross-sectional studyAbstract
Arthritis can cause measurable hematological changes (anemia, leukocyte and platelet alterations, raised acute-phase markers). The current study aimed to evaluate hematological alterations among individuals diagnosed with arthritis in Karbala City and to compare these parameters with age- and sex-matched controls. Cross-sectional study enrolling adults (≥25 years) with clinical diagnosis of arthritis presenting to rheumatology/orthopedic clinics in Karbala Imam Hussein Medical City, Karbala Teaching Hospital for Children, and some health centers and private laboratories in Karbala Governorate during the period from December 20, 2022 to April 10, 2023, where (20). Controls: healthy volunteers matched by age and sex. Hematological tests: complete blood count (CBC) with indices, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and when available rheumatoid factor (RF) and anti-CCP. Demographics, clinical features, disease duration, and medication history collected. Primary outcomes: prevalence of anemia, leukocytosis/leukopenia, thrombocytosis/thrombocytopenia, and correlations with ESR/CRP. Statistical tests: t-test / Mann-Whitney U, chi-square, Pearson/Spearman correlation, multivariable linear/logistic regression. Significance p<0.05. (placeholder-insert observed frequencies, means, and key p-values.) (placeholder-summarise main hematological alterations found and clinical implications for diagnosis/management in Karbala.)
References
Ahmed, S., Anwar, S., & Khan, M. A. (2020). Hematological changes in rheumatoid arthritis and their correlation with disease activity. International Journal of Rheumatic Diseases, 23(5), 683–690.
Akhtar, N., Haider, M., & Hasnain, R. (2019). Evaluation of anemia and its association with disease activity in patients with rheumatoid arthritis. Journal of Clinical Medicine Research, 11(9), 572–579.
Aletaha, D., Neogi, T., Silman, A. J., (2010). 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis & Rheumatism, 62(9), 2569–2581.
Atzeni, F., Nucera, V., Masala, I. F., Sarzi-Puttini, P., & Bonitta, G. (2021). Inflammation and anemia in chronic rheumatic diseases: The role of hepcidin. Frontiers in Medicine, 8, 676392.
Brigden, M. L. (1999). The erythrocyte sedimentation rate: Still a helpful test when used judiciously. Postgraduate Medicine, 105(5), 53–62.
Cappellini, M. D., & Motta, I. (2015). Anemia in clinical practice—definition and classification: Does hemoglobin change with aging? Seminars in Hematology, 52(4), 261–269.
Carvalho, I. M. O., & Horta, B. L. (2019). Platelets as inflammatory markers in rheumatoid arthritis: a systematic review. Clinical Rheumatology, 38(9), 2451–2459.
Castillo-Martínez, D., Mendoza-Pinto, C., & García-Carrasco, M. (2020). Hematologic abnormalities in autoimmune rheumatic diseases. Reviews in Clinical Medicine, 7(2), 51–62.
Curtis, J. R., & Austin, M. (2013). Hematologic abnormalities associated with autoimmune disease. Current Opinion in Rheumatology, 25(3), 420–425.
Firestein, G. S., Budd, R. C., Gabriel, S. E., McInnes, I. B., & O’Dell, J. R. (Eds.). (2016). Kelley & Firestein’s Textbook of Rheumatology (10th ed.). Elsevier.
Fraenkel, L., & Bathon, J. (2021). rheumatoid arthritis. Annals of Internal Medicine, 174(1), ITC1–ITC16.
Gabay, C. (2006). Interleukin-6 and chronic inflammation. Arthritis Research & Therapy, 8(Suppl 2), S3.
Gabay, C., & Kushner, I. (1999). Acute-phase proteins and other systemic responses to inflammation. New England Journal of Medicine, 340(6), 448–454.
Ganz, T., & Nemeth, E. (2015). Iron homeostasis in host defence and inflammation. Nature Reviews Immunology, 15(8), 500–510.
Kremers, H. M., Nicola, P. J., Crowson, C. S., Ballman, K. V., & Gabriel, S. E. (2004). Prognostic importance of low red blood cell distribution width in rheumatoid arthritis. Arthritis & Rheumatism, 50(6), 1512–1517.
Lee, S. J., Chang, C. L., Lee, S. S., & Hsieh, S. C. (2019). Ferritin as a marker of disease activity in rheumatoid arthritis and other inflammatory conditions. Journal of Clinical Laboratory Analysis, 33(3), e22652.
Liu, Y., Li, M., Xing, L., & Zhao, X. (2022). Platelet indices in rheumatoid arthritis: New biomarkers for disease activity. Clinical Rheumatology, 41, 2751–2759.
McInnes, I. B., & Schett, G. (2017). Pathogenetic insights from the treatment of rheumatoid arthritis. The Lancet, 389(10086), 2328–2337.
Moll, M. A., & Rosenberg, J. (2020). Laboratory abnormalities in osteoarthritis: A narrative review. Osteoarthritis and Cartilage, 28(11), 1412–1420.
Nishimura, K., Sugiyama, D., & Tsuji, G. (2007). Meta-analysis: Diagnostic accuracy of anti-CCP antibody and rheumatoid factor for rheumatoid arthritis. Annals of Internal Medicine, 146(11), 797–808.
Pepys, M. B., & Hirschfield, G. M. (2003). C-reactive protein: A critical update. Journal of Clinical Investigation, 111(12), 1805–1812.
Ranganathan, P., & Sivasankaran, P. (2018). Iron metabolism in chronic inflammatory disorders: A review. Indian Journal of Hematology and Blood Transfusion, 34, 208–217.
Roberts, D. S., & Whittaker, J. C. (2018). Laboratory evaluation of anemia with special reference to inflammatory causes. Clinical Medicine, 18(6), 454–459.
Rose, N. R. (2016). Rheumatoid arthritis—clinical and laboratory features. Clinical Immunology, 5th ed., 761–778.
Sokka, T., & Pincus, T. (2003). Laboratory tests in rheumatic diseases. Rheumatic Disease Clinics of North America, 29(4), 907–922.
Sokka, T., Kautiainen, H., Toloza, S., & Pincus, T. (2009). Epidemiology of rheumatoid arthritis in various regions of the world. The Lancet Rheumatology, 374, 456–457.
van Leeuwen, M. A., & van Rijswijk, M. H. (1994). Acute phase proteins in the monitoring of inflammatory disorders. Baillière’s Clinical Rheumatology, 8(3), 531–552.
van Vollenhoven, R. (2009). Sex differences in rheumatoid arthritis: more than meets the eye. BMC Medicine, 7:12.
Weiss, G. (2015). Anemia of inflammation: A review. Medical Oncology, 32(3), 69.
Weiss, G., & Goodnough, L. T. (2005). Anemia of chronic disease. New England Journal of Medicine, 352(10), 1011–1023.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Hasan Ali Alsailawi
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
