Rheumatology International

, Volume 36, Issue 2, pp 271–276 | Cite as

Splenectomy increases the subsequent risk of systemic lupus erythematosus

  • Chao-Yu Hsu
  • Hsuan-Ju Chen
  • Chung Y. Hsu
  • Chia-Hung KaoEmail author
Original Article - Observational Research


Splenectomy may be necessary to treat systemic lupus erythematosus (SLE) patients with thrombocytopenia; however, whether performing a splenectomy on patients without SLE increases the subsequent risk of SLE remains unknown. Therefore, this study was conducted to determine the association between splenectomy and SLE. We conducted a cohort study by using data from the Taiwan National Health Institute Research Database to identify 10,298 patients with received a splenectomy between 2000 and 2006 and 41,192 participants without received a splenectomy who were selected by frequency matched based on sex, age, and the index year. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95 % confidence intervals (CIs) of developing SLE associated with splenectomy compared with patients who did not receive a splenectomy. During the study period, the overall incidence density rate of SLE was higher in the splenectomy cohort than in the non-splenectomy cohort (adjusted HR 10.55; 95 % CI 50.55–20.05). The incidence density rates of SLE in women and men who received a splenectomy were higher than those of patients who did not receive a splenectomy. Non-traumatic splenectomy increases the subsequent risk of SLE. The risk of SLE should be considered before performing a splenectomy, particularly in women and younger patients.


Splenectomy Systemic lupus erythematosus Non-traumatic 



Systemic lupus erythematosus


National Health Insurance Research Database


International Classification of Diseases, Ninth Revision, Clinical Modification


Hazard ratios


Confidence interval



This study is supported in part by Taiwan Ministry of Health and Welfare Clinical Trial and Research Center of Excellence (MOHW104-TDU-B-212-113002); China Medical University Hospital, Academia Sinica Taiwan Biobank, Stroke Biosignature Project (BM104010092); NRPB Stroke Clinical Trial Consortium (MOST 103-2325-B-039 -006); Tseng-Lien Lin Foundation, Taichung, Taiwan; Taiwan Brain Disease Foundation, Taipei, Taiwan; Katsuzo and Kiyo Aoshima Memorial Funds, Japan; and CMU under the Aim for Top University Plan of the Ministry of Education, Taiwan. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. No additional external funding received for this study.

Author contribution

All authors have contributed substantially to, and are in agreement with the content of, the manuscript: Conception/Design: Chao-Yu Hsu, Chia-Hung Kao; Provision of study materials: Chia-Hung Kao; Collection and/or assembly of data: all authors; Data analysis and interpretation: all authors; Manuscript preparation: All authors; Final approval of manuscript: All authors. The guarantor of the paper, taking responsibility for the integrity of the work as a whole, from inception to published article: Chia-Hung Kao.

Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Chao-Yu Hsu
    • 1
    • 2
    • 3
    • 4
    • 5
  • Hsuan-Ju Chen
    • 6
    • 7
  • Chung Y. Hsu
    • 8
  • Chia-Hung Kao
    • 8
    • 9
    Email author
  1. 1.Department of Medical Education and ResearchPuli Christian HospitalPuliTaiwan
  2. 2.Department of OptometryCentral Taiwan University of Science and TechnologyTaichungTaiwan
  3. 3.Center for General EducationNational Taichung University of Science and TechnologyTaichungTaiwan
  4. 4.The General Education CenterChaoyang University of TechnologyTaichungTaiwan
  5. 5.Department of General EducationNational Chin-Yi University of TechnologyTaichungTaiwan
  6. 6.Management Office for Health DataChina Medical University HospitalTaichungTaiwan
  7. 7.College of MedicineChina Medical UniversityTaichungTaiwan
  8. 8.Graduate Institute of Clinical Medical Science and School of Medicine, College of MedicineChina Medical UniversityTaichungTaiwan
  9. 9.Department of Nuclear Medicine and PET CenterChina Medical University HospitalTaichungTaiwan

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