Splenectomy increases the subsequent risk of systemic lupus erythematosus
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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.
KeywordsSplenectomy Systemic lupus erythematosus Non-traumatic
Systemic lupus erythematosus
National Health Insurance Research Database
International Classification of Diseases, Ninth Revision, Clinical Modification
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.
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.
- 2.Jarukitsopa S, Hoganson DD, Crowson CS et al (2015) Epidemiology of systemic lupus erythematosus and cutaneous lupus in a predominantly white population in the United States. Arthritis Care Res (Hoboken) 67(6):817–28Google Scholar
- 10.Liu CY, Hung Y, Chuang Y et al (2006) Incorporating development stratification of Taiwan townships into sampling design of large scale health interview survey. J Health Manag 4:1–22Google Scholar
- 16.Ramos-Casals M, Brito-Zerón P, Kostov BA et al (2015) Google-driven search for big data in autoimmune geoepidemiology: analysis of 394,827 patients with systemic autoimmune diseases. Autoimmun Rev 14(8):670–679Google Scholar
- 18.Rees F, Doherty M, Grainge M, Davenport G, Lanyon P, Zhang W (2014) The incidence and prevalence of systemic lupus erythematosus in the UK, 1999–2012. Ann Rheum Dis. doi: 10.1136/annrheumdis-2014-206334
- 21.Syplyviy V, Andreyeshchev S, Akymenko A, Dotsenko V, Evtushenko O (2014) Immune status of patients after splenectomy, performed for the spleen traumatic injury in remote terms and choice of preparations for its correction. Klinichna Khirurgiya 12:43–47Google Scholar