{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T16:37:28Z","timestamp":1773419848457,"version":"3.50.1"},"reference-count":34,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"unspecified","delay-in-days":71,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2026,1,29]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to evaluate the prevalence of hyposplenism in patients with systemic lupus erythematosus (SLE) and its association with an increased risk of infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-centre study included patients with SLE who underwent a systematic evaluation for Howell-Jolly bodies (HJB) on peripheral blood smear, a marker of hyposplenism. Patients exhibiting HJB were classified as having hyposplenism (cases), whereas those without such inclusions were considered to have normal splenic function (controls). We collected radiological data to assess spleen morphology. The prevalence of infections and thrombosis was recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In a tertiary care cohort of 245 patients, 23 (9.4%) demonstrated HJB on peripheral smear, after exclusion of those with a history of splenectomy or intrinsic haemolytic anaemia. In multivariable analysis, three factors were independently associated with hyposplenism: paediatric-onset SLE (OR 5.2, 95%\u2009CI 1.3 to 21.2, p=0.02), antiphospholipid syndrome (OR 6.8, 95%\u2009CI 2.2 to 20.8, p=0.001) and history of constitutional symptoms of SLE (OR 3.9, 95%\u2009CI 1.2 to 12.4, p=0.02). Patients with HJB had a higher risk of infection-related hospitalisation (OR 7.3, 95%\u2009CI 2.4 to 21.8, p&lt;0.001), particularly pneumococcal infections (5\/23 cases (21.7%) vs 1\/222 controls (0.5%), p&lt;0.001), but no increased risk of thrombosis (OR 1.6, 95%\u2009CI 0.3 to 7.8, p=0.57). Hyposplenism was associated with splenic hypoplasia identified on abdominal CT scan (6\/23 assessed cases (26%) vs 0\/166 assessed controls (0%), p&lt;0.001), but not with splenic calcifications. Hyposplenism was also associated with eosinophilia, neutrophilia, monocytosis and thrombocytosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Hyposplenism was observed in 9.4% of patients with SLE in a tertiary care cohort and was significantly associated with an increased risk of infection and radiological splenic hypoplasia. These findings highlight the importance of preventive measures for impaired splenic function, including patient and physician education, vaccination and infection surveillance in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rmdopen-2025-006355","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T14:35:24Z","timestamp":1773412524000},"page":"e006355","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Hyposplenism in systemic lupus erythematosus: biological and radiological characteristics and its association with increased risk of infection"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5454-903X","authenticated-orcid":false,"given":"Ludovic","family":"Trefond","sequence":"first","affiliation":[{"name":"Service de M\u00e9decine Interne 2, Centre de R\u00e9f\u00e9rence des maladies auto-immunes et auto-inflammatoires syst\u00e9miques rares de l'adulte d'Ile-de-France, Centre et Martinique, Institut E3M, Inserm UMRS, Centre d\u2019Immunologie et des Maladies Infectieuses (CIMI-Paris), Sorbonne Universit\u00e9, Assistance Publique\u2013H\u00f4pitaux de Paris (APHP), Groupement Hospitalier Piti\u00e9-Salp\u00eatri\u00e8re (GHPS), Paris, France"},{"name":"Service de M\u00e9decine Interne, Centre de R\u00e9f\u00e9rence pour les maladies auto-immunes et auto-inflammatoires syst\u00e9miques rares d'Auvergne, Centre Hospitalier Universitaire Gabriel-Montpied, M2iSH, Inserm UMR 1071, Universit\u00e9 Clermont\u2013Auvergne, Clermont-Ferrand, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7653-6528","authenticated-orcid":false,"given":"Alexis","family":"Mathian","sequence":"additional","affiliation":[{"name":"Service de M\u00e9decine Interne 2, Centre de R\u00e9f\u00e9rence des maladies auto-immunes et auto-inflammatoires syst\u00e9miques rares de l'adulte d'Ile-de-France, Centre et Martinique, Institut E3M, Inserm UMRS, Centre d\u2019Immunologie et des Maladies Infectieuses (CIMI-Paris), Sorbonne Universit\u00e9, Assistance Publique\u2013H\u00f4pitaux de Paris (APHP), Groupement Hospitalier Piti\u00e9-Salp\u00eatri\u00e8re (GHPS), Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samia","family":"Boussouar","sequence":"additional","affiliation":[{"name":"Service d\u2019Imagerie cardiovasculaire et thoracique-ICT, Sorbonne Universit\u00e9, APHP, GHPS, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karim","family":"Maloum","sequence":"additional","affiliation":[{"name":"Service d\u2019h\u00e9matologie biologique, APHP, GHPS, Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine","family":"Settegrana","sequence":"additional","affiliation":[{"name":"Service d\u2019h\u00e9matologie biologique, APHP, GHPS, Paris, 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(CIMI-Paris), Sorbonne Universit\u00e9, Assistance Publique\u2013H\u00f4pitaux de Paris (APHP), Groupement Hospitalier Piti\u00e9-Salp\u00eatri\u00e8re (GHPS), Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3389-9473","authenticated-orcid":false,"given":"Matthias","family":"Papo","sequence":"additional","affiliation":[{"name":"Service de M\u00e9decine Interne 2, Centre de R\u00e9f\u00e9rence des maladies auto-immunes et auto-inflammatoires syst\u00e9miques rares de l'adulte d'Ile-de-France, Centre et Martinique, Institut E3M, Inserm UMRS, Centre d\u2019Immunologie et des Maladies Infectieuses (CIMI-Paris), Sorbonne Universit\u00e9, Assistance Publique\u2013H\u00f4pitaux de Paris (APHP), Groupement Hospitalier Piti\u00e9-Salp\u00eatri\u00e8re (GHPS), Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fran\u00e7ois","family":"Chasset","sequence":"additional","affiliation":[{"name":"Service de 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