Hematologic Manifestations in Systemic Lupus Erythematosus:A Systematic Review of Clinical Patterns, Prognostic Implications,and Epidemiology

Systemic lupus erythematosus (SLE) is a long-term autoimmune disease that has various clinical manifestations, the hematologic abnormalities among which are frequent and vary in clinical severity. These may cause simple cytopenias up to extreme autoimmune cytopenias, and significantly affect the activity of the disease, prognosis, and treatment. The proposed systematic review is expected to synthesise existing data on the prevalence, clinical features, and prognostic consequences of hematologic involvement in patients with SLE in children and adults. The studied data were searched in PubMed, PMC, WHO IMSEAR, and other databases to find publications published in 2025. They included observational studies, cohort studies, cross-sectional studies and reviews that were relevant. Information was coming out on the hematologic parameters, the occurrence of cytopenias, disease-related activity, autoantibody profiles, and the presence of splenomegaly. The inclusion studies were evaluated by the Newcastle-Ottawa Scale to assess quality, and the PRISMA was used to report them. Among the studies that were included, hematologic abnormalities that were most common were anaemia, leukopenia, and thrombocytopenia, though autoimmune hemolytic anaemia and immune thrombocytopenia occurred in a subset of patients. Guidelines showed that the incidence of cytopenias was high in pediatric populations, in contrast with adults. Hematologic aberrations were often related to augmented disease activity, involvement of the kidneys, and the presence of autoantibodies. Splenomegaly, being less prevalent, showed an association with bad cytopenias and poor prognosis across various cohorts. Hematologic presentations are inherent parts of SLE and have both diagnostic, prognostic, and treatment ramifications. Early detection and surveillance of the hematologic involvement can promote person-specific management approaches, enhance the outcomes, and guide future research topics related to the pathogenesis of the disease and targeted therapies.