B-Cell-Attracting Chemokine CXCL13 As a Marker of Disease Activity in Systemic Lupus Erythematosus (SLE)

2017 ◽  
Vol 44 (02) ◽  
pp. 115-120
Author(s):  
Eman Omran ◽  
Eman El-Hakeim ◽  
Marwa Galal ◽  
Nada Nasr ◽  
Eman Mosaad

Abstract Background A correlation was detected between the chemokine CXC ligand 13 (CXCL13) and lupus nephritis, but there is no data recorded in the literature about a relationship with other disease manifestations in systemic lupus erythematosus (SLE). Therefore, we sought to investigate the relationship between CXCL13 and overall disease activity and other disease manifestations in SLE. Patients and Methods Fifty-seven SLE patients (51 female, 6 male) aged 18–60 years, fulfilling≥4 SLICC classification criteria for the classification of SLE, were enrolled in a cross-sectional study. Disease activity was scored using the SLE Disease Activity Index (SLEDAI) scoring system. The serological workup included routine lab investigations (full blood count, liver and kidney function tests, and urinalysis) as well as ESR, CRP, anti-ds DNA, C3, C4, 24-h urine protein, and creatinine clearance. Plasma CXCL13 levels were detected by ELISA. Results CXCL13 levels were elevated in active SLE patients. A significant positive correlation was found between the total score of SLEDAI and CXCL13 levels (r=0.547, p-value <0.0001). A statistically significant difference was found regarding the mean CXCL13 levels between the patient groups (classified according to SLEDAI score) (inactive <3, mild/moderate ≥3–12, severe ˃12) (p-value<0.001). The anti-ds DNA antibody titre showed a significant positive correlation with CXCL13 levels (r=0.335, p-value<0.05). The complement levels (C3, C4) showed a significant negative correlation with CXCL13 levels (p-value<0.001). Also there was a significant positive correlation between 24-h urine protein and urinary casts and CXCL13 levels (p-value<0.05). Conclusion Our study revealed elevated levels of serum CXCL13 in active SLE patients. We demonstrated a highly significant positive correlation between serum CXCL13 levels in active SLE patients and SLE disease activity, which supports the role of CXCL13 in the pathogenesis of SLE disease and its activity. Among the variants used in calculating the SLEDAI score, we detected significant relations between level of serum CXCL13 and each of total and extra-renal SLEDAI score.

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Rosalie Magro ◽  
Andrew A. Borg

Systemic Lupus Erythematosus (SLE) is a multisystemic autoimmune disorder. The aim of this study was to characterise the SLE patients living in Malta in order to estimate the prevalence and incidence of SLE and characterise the clinical presentation as well as identify any unmet needs. 107 SLE patients who fulfilled SLICC classification criteria were identified. These were invited to participate in the study by means of an interview, blood and urine tests, and filling of the following questionnaires: Fatigue Severity Scale (FSS), visual analogue scale (VAS) for fatigue, Hospital Anxiety and Depression Scale (HADS), VAS for pain, Pittsburgh Sleep Quality Index (PSQI), and modified Health Assessment Questionnaire (mHAQ). The estimated prevalence of SLE in Malta is 29.3 patients per 100,000 and the estimated incidence is 1.48 per 100,000 per year. 93.5% of SLE patients were female, and the mean age at diagnosis was 33.1 years. 60.8% were overweight or obese and body mass index (BMI) had a significant positive correlation with daily dose of prednisolone (R=0.177, p=0.046). 20.7% and 3.3% had a moderate and high disease activity, respectively, as measured by SLEDAI-2K. Disease activity had a significant positive correlation with functional disability measured by mHAQ (R=0.417, p<0.001). 56.5% had an abnormal level of fatigue (FSS >3.7) and 57.6% had a high level of anxiety (HADS ≥8). This study has identified a number of unmet needs of SLE patients, including obesity, uncontrolled disease activity, fatigue, and anxiety.


2021 ◽  
Vol 15 (1) ◽  
pp. 35-39
Author(s):  
Sadaf Andleeb ◽  
Tafazzul-E-Haque Mahmud ◽  
Aflak Rasheed ◽  
Muhammad Shahid Mehmood ◽  
Iram Gull ◽  
...  

Background: Early diagnosis and effective treatment in systemic lupus erythematosus (SLE) has very crucial role. Anti dsDNA is very important diagnostic tool and activity marker in SLE. This study aimed to determine the association of anti dsDNA antibodies titer with non-renal manifestations of systemic lupus erythematosus and systemic lupus erythematosus disease activity index (SLEDAI). Patients and methods: It was a cross-sectional study and was carried out at Department of Rheumatology and Immunology, Tertiary Care Hospital, Lahore from Feb 2021 to May 2021. The study involved 69 male and female patients satisfying the systemic lupus international collaborating clinics (SLICC) classification criteria. Questions regarding different symptoms were asked and disease activity parameters were noted excluding renal parameters. Anti-dsDNA titers were measured from standard laboratory using immunofluorescence technique and were correlated with SLEDAI score. A written informed consent was obtained from every patient. Results: The mean age of the patients was 30.7±10.2 years while the mean duration of disease 1.94±2.65 years. We observed a female predominance among these patients with male to female ratio of 1:7.6. There were fifty-four (78.3%) patients with active disease. The mean anti-dsDNA levels were significantly higher in patients with active disease (315.73±481.68 vs. 78.46±113.64 IU/mL; p-value=0.003). There was a significantly strong positive correlation between anti-dsDNA levels and SLEDAI score (r=0.358; p-value=0.006). When compared, significant difference was observed in mean anti-dsDNA titers in patients with chronic cutaneous manifestations (p-value=0.040), lymphopenia (p-value= 0.012), pleurisy/pericarditis (p-value= 0.024) and leukopenia <3000/mm3 (p-value= 0.001). Conclusion: Anti-dsDNA antibodies titers are remarkably increased in patients with non-renal manifestations of systemic lupus erythematosus particularly with chronic cutaneous manifestations and leukopenia and positively correlate with disease activity status and SLEDAI score.


2021 ◽  
Vol 3 (2) ◽  
pp. 192-202
Author(s):  
Rina Kirwiastiny ◽  
Ringgo Alfarisi ◽  
Hidayat Hidayat ◽  
Ageel Al-Aziz Marjaen

ABSTRACT : RELATIONSHIP OF SYSTEMIC LUPUS ERYTHEMATOSUS ACTIVITIES BASED ON MEX-SLEDAI SCORE WITH INCIDENCE OF ANEMIA IN SYSTEMIC LUPUS ERYTHEMATOUS PATIENTS IN THE ODAPUS LAMPUNG COMMUNITY, 2020Background : Systemic Lupus Erytematosus (SLE) is a complex autoimmune disease characterized by the presence of autoantibodies against the cell nucleus and involving many organ systems in the body. Anemia in LES patients varies between chronic disease anemia, hemolytic anemia, blood loss, renal insufficiency, infection, myelodysplasia, and aplastic anemia. What often occurs in LES anemia is due to erythropoesis suppression due to chronic inflammation. Anemia in LES patients is an immune or non-immune disease. Anemia is a non-immune disease is anemia in chronic disease, iron deficiency anemia, sideroblastic anemia, anemia in kidney disease, anemia indicated by drugs, and anemia secondary to other diseases (eg sickle cell anemia).Research purposes : This study was to determine the degree of activity of systemic lupus erythematosus based on max-sledai and hemoglobin levels in systemic lupus erythematous patients in the ODAPUS Lampung community in 2020.Methode :The analytical observational method was used using a cross sectional approach. The research subjects were 30 respondents who used the total sampling technique from members of the ODAPUS Lampung community by conducting MEX-SLEDAI interviews and blood sampling conducted from November 2019 to February 2020. Statistical test used Fisher exact test.Results: From 30 study subjects, disease activity based on MEX-SLEDAI was above the average of 21 patients (70%). And the results of blood tests were 18 patients (60%) who were not anemia and 12 patients (40%) had anemia.Conclusion     : There was a significant relationship between the degree of activity of Systemic Lupus Erythematosus based on the MEX-SLEDAI score and the incidence of anemia with p value = 0.024 meaning the p value ≤ 0.05. Keywords      : LES; Incidence of Anemia; MEX-SLEDAI    INTISARI : HUBUNGAN DERAJAT AKTIVITAS PENYAKIT LUPUS ERITEMATOSUS SISTEMIK BERDASARKAN SKOR  MEXSLEDAI DENGAN KEJADIAN ANEMIA PADA PENDERITA LUPUS ERITEMATOUS SISTEMIK DI KOMUNITAS ODAPUS LAMPUNG  Latar belakang : Systemic Lupus Erytematosus (SLE) merupakan penyakit autoimun yang kompleks ditandai oleh adanya autoantibodi terhadap inti sel dan melibatkan banyak sistem organ dalam tubuh. Anemia pada pasien LES bervariasi antara anemia penyakit kronis, anemia hemolitik, kehilangan darah, insufisiensi ginjal, infeksi, mielodisplasia, dan anemia aplastik. Yang sering terjadi anemia pada LES disebabkan supresi eritropoesis karena inflamasi yang kronis.  Anemia pada pasien LES merupakan penyakit imun atau non-imun. Anemia merupakan penyakit non-imun adalah anemia pada penyakit kronik ,anemia defisiensi besi, anemia sideroblastik, anemia pada penyakit ginjal, anemia indikasi obat, dan anemia sekunder terhadap penyakit lain ( misalnya anemia sel sabit ).Tujuan Penelitian : Penelitian ini untuk mengetahui hubungan drajat aktivitas penyakit lupus eritematosus sistemik berdasarkan max-sledai dengan kadar hemoglobin pada penderita lupus eritematous sistemik di komunitas ODAPUS lampung tahun 2020.Metode : Digunakan metode observasional analitik menggunakan pendekatan cross sectional. Subjek penelitian sebanyak 30 responden yang menggunakan teknik total sampling dari anggota komunitas ODAPUS Lampung dengan melakukan wawancara MEX-SLEDAI dan pengambilan sampel darah yang dilakukan pada bulan November 2019 s/d Februari 2020. Uji statistic menggunakan Fisher exact test.Hasil : Dari 30 subjek penelitian didapatkan aktifitas penyakit berdasarkan MEX-SLEDAI di atas rata – rata sebanyak 21 pasien (70%). Dan hasil peneriksaan darah yaitu 18 pasien (60%) yang Tidak anemia dan yang mengalami Anemia ada 12 pasien (40%).Kesimpulan   : Terdapat hubungan bermakna antara derajat aktivitas penyakit Lupus Eritematosus Sistemik berdasarkan skor MEX-SLEDAI dengan Kejadian Anemia dengan p value =0.024 berarti nilai p value ≤ 0.05. Kata Kunci     : LES; Kejadian Anemia; MEX-SLEDAI


2021 ◽  
Vol 1 (4) ◽  
pp. 370-382
Author(s):  
Rina Kriswiastiny ◽  
Festy Ladyani Mustofa ◽  
Syuhada Syuhada ◽  
Reychan Gustiawan Putra

ABSTRACT: RELATIONSHIP OF SLE (SYSTEMIC LUPUS ERYTHEMATOSUS) ACTIVITIES BASED ON MEX-SLEDAI SCORING ON DEPRESSION IN ODAPUS COMMUNITIES BANDAR LAMPUNG Background: Depression is a clinical manifestation that can occur in patients with SLE and it is suspected that the level of SLE disease activity can affect these events (Nery, et al. 2007). Ironically, this section is a part that is often overlooked by many people, including the health sector. In fact, by understanding this point of view, cross-scientific collaborative treatment such as the Internal and Psychiatry Fields can be done to improve the treatment and quality of life of patients.Objective: To determine the relationship between SLE (Systemic lupus Erythematosus) disease activity based on MEX-SLEDAI Scoring against depression in the Odapus Community, Bandar Lampung City 2020.Methodology: The type of research used in this study is correlative analytic with cross-sectional design. The sample used in this study were patients with SLE (Systemic lupus Erythematosus) based on MEX-SLEDAI Scoring for depression in the Odapus Community, Bandar Lampung City 2020. Data analysis used the Spearman test.Results: In the activity variable SLE and depression, the P value = 0.001 (P <0.05) with a correlation value of r = 0.490 was obtained.Conclusion: There is a relationship between SLE (Systemic lupus Erythematosus) disease activity based on MEX-SLEDAI Scoring against depression in Odapus Community, Bandar Lampung City 2020 with moderate correlation strength. Keywords: Lupus, Depression, MEX-Sledai  INTISARI: HUBUNGAN AKTIFITAS PENYAKIT SLE (SYSTEMIC LUPUS ERYTHEMATOSUS)  BERDASARKAN MEX-SLEDAI SCORING TERHADAP DEPRESI DI KOMUNITAS ODAPUS KOTA BANDAR LAMPUNGLatar Belakang: Depresi merupakan manifestasi klinis yang dapat muncul pada penderita SLE dan diduga tingkat aktivitas penyakit SLE dapat mempengaruhi kejadian-kejadian tersebut (Nery, dkk. 2007). Ironisnya, bagian ini merupakan bagian yang sering luput diperhatikan oleh banyak orang, termasuk bidang kesehatan. Padahal, dengan memahami sudut pandang ini, pengobatan kolaboratif lintas keilmuan seperti Bidang Interna dengan Bidang Psikiatri dapat dilakukan untuk meningkatkan pengobatan dan kualitas hidup pasien.Tujuan: Untuk mengetahui hubungan aktifitas penyakit SLE (Systemic lupus Erythematosus) berdasarkan MEX-SLEDAI Scoring terhadap depresi di Komunitas Odapus Kota Bandar Lampung 2020.Metodologi: Jenis penelitian yang digunakan dalam penelitian ini adalah analitik korelatif dengan desain cross sectional. Sampel yang digunakan pada penelitian ini adalah penderita penyakit SLE (Systemic lupus Erythematosus) berdasarkan MEX-SLEDAI Scoring terhadap depresi di Komunitas Odapus Kota Bandar Lampung 2020. Analisa data menggunakan Uji Spearman.Hasil: Pada variabel aktifitas penyakit SLE dan depresi diperoleh nilai P value = 0,001 (P<0,05) dengan nilai korelasi r = 0,490.Kesimpulan: Terdapat hubungan aktifitas penyakit SLE (Systemic lupus Erythematosus) berdasarkan MEX-SLEDAI Scoring terhadap depresi di Komunitas Odapus Kota Bandar Lampung 2020 dengan kekuatan korelasi sedang.Kata Kunci     : Lupus, Depresi, MEX-Sledai


Lupus ◽  
2017 ◽  
Vol 26 (9) ◽  
pp. 975-982 ◽  
Author(s):  
M Sahebari ◽  
G Roshandel ◽  
N Saadati ◽  
M Saghafi ◽  
N Abdolahi ◽  
...  

Background Cathelicidin (LL-37), an endogenous antimicrobial peptide, has recently been involved in the pathogenesis of autoimmune diseases. To assess whether LL-37 reflects disease activity, we measured serum levels of it in systemic lupus erythematosus (SLE) patients with active and inactive disease compared to healthy controls. LL-37 was also compared between new and old cases. Moreover, the correlation of LL-37 and pro-oxidant, antioxidant balance (PAB) was measured. Methods The study population consisted of 50 SLE patients and 28 healthy controls. Of those, 39 patients had active and 11 patients had inactive disease. Serum levels of LL-37 were measured by ELISA and PAB values by a special method. Results There was no difference in levels of LL-37 between patients and healthy controls (50.9 ± 20.8 vs. 67.7 ± 43.3 ng/ml, P = 0.31). LL-37 did not correlate with SLEDAI and its items in total patients. LL-37 had a positive correlation with SLEDAI in active patients ( P = 0.01, r = 0.4). In active patients (78% of patients), multivariate regression analysis showed significant negative correlation between LL-37 and C3 ( P = 0.01, standardized beta –0.50). No difference was found in levels of PAB between patients and controls (90.4 ± 34.1 vs. 86.9 ± 25.6 HK, P = 0.4).There was no difference in the levels of PAB between patients with active and inactive disease (93.2 ± 34.1 vs. 80.2 ± 33.7 HK, P = 0.27). No correlation was found between levels of PAB and SLEDAI items and total score. However, a positive correlation between the levels of LL-37 and PAB in SLE patients was found ( r = 0.3, P < 0.01). Conclusion Based on this study, serum LL-37 and PAB did not increase in lupus compared with healthy individuals. LL-37 serum values rose in parallel with SLEDAI in active disease. Positive correlation between serum PAB and LL-37 could be a great achievement of this study that may suggest the role of antioxidants in controlling NETosis.


Lupus ◽  
2016 ◽  
Vol 26 (2) ◽  
pp. 132-138 ◽  
Author(s):  
Y H Lee ◽  
G G Song

Objective This study aimed to systemically review the evidence regarding the relationship between circulating blood osteopontin (OPN) level and systemic lupus erythematosus (SLE), correlation between serum OPN levels and SLE activity, and association between OPN polymorphisms and SLE susceptibility. Methods We conducted a meta-analysis on the serum/plasma OPN levels in SLE patients and healthy controls, correlation coefficients between the circulating OPN level and SLE Disease Activity Index (SLEDAI) in SLE patients, and the association between OPN polymorphisms and SLE risk. Results Nine studies with 1938 SLE patients and 3037 controls were included. Meta-analysis revealed that, compared with the control group, the OPN level was significantly higher in the SLE group (SMD = 0.965, 95% CI = 0.337–1.393, p = 0.001) and in the SLE group with renal disease (SMD = 2.219, 95% CI = 0.681–3.757, p = 0.005). Meta-analysis of correlation coefficients showed a trend of positive correlation between the circulating OPN level and SLEDAI (correlation coefficient = 0.590, 95% CI = −0.025 to 0.881, p = 0.059). While no association was found between SLE and the OPN 707 T/C and 1083 G/A polymorphisms, a significant association was identified between the OPN 1239 C allele and SLE (OR = 1.192, 95% CI = 1.008–1.410, p = 0.040), and between the OPN 9250 C allele and SLE in Asians (OR = 2.070, 95% CI = 1.570–2.730, p = 2.5 × 10−7). Conclusions Our meta-analysis revealed a significantly higher circulating OPN level in SLE patients, a trend of positive correlation between OPN levels and SLE activity, and a significant association between OPN 1239 C/A and 9250 C/T polymorphisms, and SLE development.


2021 ◽  
Vol 3 (2) ◽  
pp. 192-202
Author(s):  
Rina Kirwiastiny ◽  
Ringgo Alfarisi ◽  
Hidayat Hidayat ◽  
Ageel Al-Aziz Marjaen

ABSTRACT : RELATIONSHIP OF SYSTEMIC LUPUS ERYTHEMATOSUS ACTIVITIES BASED ON MEX-SLEDAI SCORE WITH INCIDENCE OF ANEMIA IN SYSTEMIC LUPUS ERYTHEMATOUS PATIENTS IN THE ODAPUS LAMPUNG COMMUNITY, 2020Background : Systemic Lupus Erytematosus (SLE) is a complex autoimmune disease characterized by the presence of autoantibodies against the cell nucleus and involving many organ systems in the body. Anemia in LES patients varies between chronic disease anemia, hemolytic anemia, blood loss, renal insufficiency, infection, myelodysplasia, and aplastic anemia. What often occurs in LES anemia is due to erythropoesis suppression due to chronic inflammation. Anemia in LES patients is an immune or non-immune disease. Anemia is a non-immune disease is anemia in chronic disease, iron deficiency anemia, sideroblastic anemia, anemia in kidney disease, anemia indicated by drugs, and anemia secondary to other diseases (eg sickle cell anemia).Research purposes : This study was to determine the degree of activity of systemic lupus erythematosus based on max-sledai and hemoglobin levels in systemic lupus erythematous patients in the ODAPUS Lampung community in 2020.Methode :The analytical observational method was used using a cross sectional approach. The research subjects were 30 respondents who used the total sampling technique from members of the ODAPUS Lampung community by conducting MEX-SLEDAI interviews and blood sampling conducted from November 2019 to February 2020. Statistical test used Fisher exact test.Results: From 30 study subjects, disease activity based on MEX-SLEDAI was above the average of 21 patients (70%). And the results of blood tests were 18 patients (60%) who were not anemia and 12 patients (40%) had anemia.Conclusion     : There was a significant relationship between the degree of activity of Systemic Lupus Erythematosus based on the MEX-SLEDAI score and the incidence of anemia with p value = 0.024 meaning the p value ≤ 0.05. Keywords      : LES; Incidence of Anemia; MEX-SLEDAI    INTISARI : HUBUNGAN DERAJAT AKTIVITAS PENYAKIT LUPUS ERITEMATOSUS SISTEMIK BERDASARKAN SKOR  MEXSLEDAI DENGAN KEJADIAN ANEMIA PADA PENDERITA LUPUS ERITEMATOUS SISTEMIK DI KOMUNITAS ODAPUS LAMPUNG  Latar belakang : Systemic Lupus Erytematosus (SLE) merupakan penyakit autoimun yang kompleks ditandai oleh adanya autoantibodi terhadap inti sel dan melibatkan banyak sistem organ dalam tubuh. Anemia pada pasien LES bervariasi antara anemia penyakit kronis, anemia hemolitik, kehilangan darah, insufisiensi ginjal, infeksi, mielodisplasia, dan anemia aplastik. Yang sering terjadi anemia pada LES disebabkan supresi eritropoesis karena inflamasi yang kronis.  Anemia pada pasien LES merupakan penyakit imun atau non-imun. Anemia merupakan penyakit non-imun adalah anemia pada penyakit kronik ,anemia defisiensi besi, anemia sideroblastik, anemia pada penyakit ginjal, anemia indikasi obat, dan anemia sekunder terhadap penyakit lain ( misalnya anemia sel sabit ).Tujuan Penelitian : Penelitian ini untuk mengetahui hubungan drajat aktivitas penyakit lupus eritematosus sistemik berdasarkan max-sledai dengan kadar hemoglobin pada penderita lupus eritematous sistemik di komunitas ODAPUS lampung tahun 2020.Metode : Digunakan metode observasional analitik menggunakan pendekatan cross sectional. Subjek penelitian sebanyak 30 responden yang menggunakan teknik total sampling dari anggota komunitas ODAPUS Lampung dengan melakukan wawancara MEX-SLEDAI dan pengambilan sampel darah yang dilakukan pada bulan November 2019 s/d Februari 2020. Uji statistic menggunakan Fisher exact test.Hasil : Dari 30 subjek penelitian didapatkan aktifitas penyakit berdasarkan MEX-SLEDAI di atas rata – rata sebanyak 21 pasien (70%). Dan hasil peneriksaan darah yaitu 18 pasien (60%) yang Tidak anemia dan yang mengalami Anemia ada 12 pasien (40%).Kesimpulan   : Terdapat hubungan bermakna antara derajat aktivitas penyakit Lupus Eritematosus Sistemik berdasarkan skor MEX-SLEDAI dengan Kejadian Anemia dengan p value =0.024 berarti nilai p value ≤ 0.05. Kata Kunci     : LES; Kejadian Anemia; MEX-SLEDAI


2016 ◽  
Vol 51 (3) ◽  
pp. 156
Author(s):  
Desantika Wuryana ◽  
Bagus PP Suryana ◽  
Yulistiani Yulistiani

Cyclosporine and methylprednisolone combination are second line therapy for moderate to severe systemic lupus erythemathosus. Some study suggest that the combination were effective to decrease of systemic lupus erythematosus disease activity. But record from the study, cyclosporine cause nephrotoxicity side effect. Therefore, this study should be considered to monitore therapy effect on disease activity and renal side effect. The aim of this study is to analyze the effect of cyclosporine and methylprednisolone combination therapy on disease activity in systemic lupus erythematosus (SLE) assessed by MEX-SLEDAI and renal side effect assessed by creatinine, ureum and proteinuria. A cohort, observational prospective study was conducted to determine the effect of cyclosporine and methylprednisolone combination therapy on disease activity of SLE and renal side effect of this combination. Patients who met criteria were given cyclosporine and methylprednisolone combination that normally renal function tests. MEX-SLEDAI score, creatinine, ureum and proteinuria were measured for fourth times (one time in one mounth), before study, 1st mounth, 2nd mounth, and 3rd mounth. The study comprised 9 patients SLE were given cyclosporine and methylprednisolone combination that normally renal function tests. All patients were female and had productive age. At 3rd mounth, there was increase patients who had MEX-SLEDAI score <2 (55,6%) and one patient (11,1%) had increase of creatinine, ureum and proteinuria. In conclusion, cyclosporine and methylprednisolone combination therapy showed the effectiveness and safety in 88,9% patients and renal dysfunction in 11,1% patients.


Author(s):  
Seravina Adila Izzati ◽  
Ovi Sofia ◽  
Cesarius Singgih Wahono ◽  
Nadia Artha Dewi ◽  
Ovi Sofia

Introduction: Lupus retinopathy and posterior uveitis are complications due to systemic lupus erythematosus which can threaten the vision. The presence of posterior segment manifestation is suggestive of high disease activity. The aim of this study is to identify posterior segment manifestation (Lupus Retinopathy and Posterior Uveitis) in SLE patient and their correlation with SLE disease activity using The Mexican-SLEDAI (MEX-SLEDAI) score.                                                                                                                                                                Methods: This was an analytical observational study with cross-sectional design, conducted from August to October 2020 and involved 114 SLE patients in Dr. Saiful Anwar General Hospital. We calculated MEX-SLEDAI score to assess SLE disease activity. All participant that met inclusion criteria underwent ophthalmology examinations using a portable slit-lamp, head indirect ophthalmoscope, and fundus finding were documented using portable fundus imaging.   Result: Lupus retinopathy (LR) presents in 25/114 (21.9%) and posterior uveitis (PU) occurs in 2/114 (1.8%) SLE patients. The mean age of patient with LR, PU, and without retinopathy were 32.92; 37.00; and 31.08 years respectively. The posterior segment findings were hemorrhages, cotton wool spots, hard exudates, and vasculitis reflecting vascular damage. The most common manifestation found in retina was cotton wool spot. The mean of MEX-SLEDAI score of SLE patient with LR (7.200 ± 3.905) and SLE patient with PU (3.500 ± 2.121) was higher than the mean of SLE patient without LR and PU (2.871 ± 2.534). There was a significant association between LR and MEX-SLEDAI score (p=0.000). An insignificant association between PU and MEX-SLEDAI score was found (p=0.353)   Conclusion There is a significance correlation between lupus retinopathy and SLE disease activity based on MEX-SLEDAI scores. The mean of MEX-SLEDAI score in SLE patients with lupus retinopathy was higher than SLE with posterior uvetis and SLE without posterior segment manifestations.


2021 ◽  
Vol 11 (2) ◽  
pp. 97-102
Author(s):  
Saiful Bahar Khan ◽  
Rafi Nazrul Islam ◽  
Md Saif Bin Mizan ◽  
AKM Shahidur Rahman ◽  
Shah Md Zakir Hossain ◽  
...  

Background: Lupus nephritis (LN) is one of the most common and serious manifestations of systemic lupus erythematosus (SLE) that causes significant morbidity and mortality. Certain biomarkers for LN are sometimes able to assess treatment response in lupus nephritis. This study aimed to compare serum complement levels (C3 and C4) as markers of treatment response of LN and their relation to the LN class in renal biopsy. Methods: This prospective observational study was conducted in the Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from July 2018 to August 2019. Twenty seven patients who were diagnosed with LN after kidney biopsy were included in this study. Serum complement levels (C3 and C4), 24 hours urinary total protein (24-hr UTP) and anti-double-stranded DNA (anti-ds DNA) were measured in all patients at baseline, 3 months and 6 months after treatment initiation. These biomarker values before and after treatment were compared between the proliferative and non-proliferative LN patients. Results: Serum C3 levels were significantly different between patients with proliferative LN (Class III and Class IV) and non-proliferative LN (Class V) at baseline (0.47 ± 0.32 g/l versus 0.89 ± 0.43 g/l, p=0.009) and levels changed significantly 6 months after treatment initiation (p<0.001) and likewise for serum C4 levels (0.10 ± 0.06 g/l versus 0.24 ± 0.26 g/l, p=0.040). The values of 24-hr UTP and anti-ds-DNA were significantly different 6 months after treatment with p value <0.05 in both groups but C3 (p<0.001) and renal Systemic Lupus Erythematosus Disease Activity Index (rSLEDAI) (p<0.001) were only significant in the proliferative group. On the other hand, after 6 months treatment, C4 levels became relatively higher but that was not significant in both groups (p>0.05). Conclusion: After 6 months of treatment, serum C3 and C4 levels increased towards normal in both LN groups. Serum C3 and C4 levels in patients with LN correlate with disease activity. Therefore, serum complement (C3 and C4) levels may be utilized as serological biomarkers for treatment response of LN. Birdem Med J 2021; 11(2): 97-102


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