scholarly journals The Relationship between Platelet to Lymphocyte Ratio and Platelet Indices with Disease Severity Level of Systemic Lupus Erythematosus

2021 ◽  
Vol 27 (3) ◽  
pp. 295
Author(s):  
Purbosari Lisnaedy ◽  
Umi Solekhah Intansari
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Platelet Count ◽  
Disease Activity ◽  
Disease Severity ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Platelet To Lymphocyte Ratio ◽  
Sledai Score ◽  
Platelet Indices ◽  
Very High

Systemic Lupus Erythematosus (SLE) is an episodic, chronic autoimmune inflammatory disease characterized by remission and flare phases. Laboratory parameters required to assess the severity of disease activity in SLE include platelet count and platelet indices. Several studies regarding the Platelet to Lymphocyte Ratio (PLR) and platelet indices on the severity of SLE patients remain inconsistent. This study aimed to evaluate the relationship between PLR value and platelet index with the degree of disease severity in SLE patients. This study used a retrospective analytic observational design in SLE patients from January 2016 to December 2019 at Dr. Sardjito Central Hospital. Disease severity was assessed using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score. Platelet to Lymphocyte Ratio (PLR) values and platelet indices were measured with a hematology analyzer. The data were analyzed using correlation, bivariate, multiple regression tests, and the ROC curve to determine the PLR cut-off. There were 55 SLE patients with high activity (SLEDAI 11-19; n=30(54,54%)) and very high activity (SLEDAI 20; n=25(45.45%)). There was a significant correlation (p <0.05) between the PLR value, platelet count, plateletcrit, and Mean Platelet Volume (MPV) with SLEDAI scores (p <0.05), but only the MPV variable was significant as an independent variable (p=0.0357). In the ROC curve, a cut-off PLR value of 124 was obtained with a sensitivity of 68.0%, specificity of 66.7%, likelihood ratio=2.04 (AUC=0.659 with p-value=0.035) to detect very high disease activity. Based on the PLR value, platelet count and plateletcrit negatively correlated with SLEDAI score but were related to the very high degree of thrombocytopenia in disease activity. The MPV value reflected the high platelet turnover, which had a positive correlation with the SLEDAI score. Patients with a PLR value ≤124 were 2.04 times more likely to have a SLEDAI score of 20, indicating potential use as a predictor of disease activity. The PLR value and platelet indices were significantly related to the degree of SLE activity.

scholarly journals EFFECTIVITY AND RENAL SAFETY OF CYCLOSPORINE AND METHYLPREDNISOLONE COMBINATION THERAPY IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS (SLE)

2016 ◽  
Vol 51 (3) ◽  
pp. 156
Author(s):  
Desantika Wuryana ◽  
Bagus PP Suryana ◽  
Yulistiani Yulistiani
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Renal Function ◽  
Combination Therapy ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Side Effect ◽  
Systemic Lupus ◽  
Sledai Score ◽  
Function Tests ◽  
Renal Function Tests

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.

scholarly journals SYSTEMIC LUPUS ERYTHEMATOSUS DISEASE ACTIVITY CORRELATED WITH POSTERIOR SEGMENT MANIFESTATIONS USING MEX-SLEDAI SCORE

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Seravina Adila Izzati ◽  
Ovi Sofia ◽  
Cesarius Singgih Wahono ◽  
Nadia Artha Dewi ◽  
Ovi Sofia
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Posterior Uveitis ◽  
Posterior Segment ◽  
Cotton Wool ◽  
Systemic Lupus ◽  
Sledai Score ◽  
The Mean ◽  
Lupus Retinopathy

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.

scholarly journals Correlation of plasma and urine Wnt5A with the disease activity and cutaneous lesion severity in patients with systemic lupus erythematosus

2021 ◽  
Author(s):  
Shuhong Chi ◽  
Jing Xue ◽  
Xiaodong Chen ◽  
Xiaoming Liu ◽  
Yanhong Ji
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Disease Severity ◽  
Lupus Erythematosus ◽  
Clinical Relevance ◽  
Function Analysis ◽  
Potential Candidate ◽  
Systemic Lupus ◽  
Cutaneous Involvement ◽  
Potential Biomarker

AbstractReliable noninvasive biomarkers are needed to accurately assess disease activity and prognosis in patients with systemic lupus erythematosus (SLE). The purpose of this study was to investigate the clinical relevance of Wnt5A with disease activity and severity with cutaneous involvement in particular in SLE patients; its concentrations in plasma and urine were examined and analyzed. In the cross-sectional study, the clinical relevance of Wnt5A protein was evaluated in both plasma and urine of SLE patients and healthy cohorts using commercial enzyme-linked immunosorbent assays (ELISA). Significantly, more abundances of Wnt5A protein were determined in both of plasmas and urines of SLE patients compared to healthy cohorts (p < 0.0001), which were even higher in active disease (AD) SLE patients relative to low disease activity (LDA) SLE patients (p < 0.0001). Meanwhile, the ROC curve analysis demonstrated that the plasma and urine Wnt5A were potential candidate biomarkers for identifying the disease activity and severity in SLE patients. The discriminant function analysis further revealed that the plasma and urine Wnt5A were separated and distinct for AD SLE patients and healthy controls. In consistence, the disease severity was correlated with the plasma and urine Wnt5A as ascertained by CLASI activity score and the prevalence of serositis in SLE patients. These results suggest that Wnt5A, as a summary measure for different inflammatory processes, could be a potential biomarker for accessing the disease activity, and a noninvasive biomarker for evaluating the disease severity in terms of cutaneous involvement in SLE patients.

Collagen triple helix repeat containing-1: a novel biomarker associated with disease activity in Systemic lupus erythematosus

Lupus ◽  
2018 ◽  
Vol 27 (13) ◽  
pp. 2076-2085 ◽  
Author(s):  
Q Wu ◽  
Q Yang ◽  
H Sun
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Triple Helix ◽  
Inactive Disease ◽  
Enzyme Linked Immunosorbent Assay ◽  
Healthy Controls ◽  
Systemic Lupus ◽  
Sledai Score ◽  
Collagen Triple Helix

Objective The objective of this article is to investigate whether the aberrant expression of collagen triple helix repeat containing-1 (CTHRC1) from patients with systemic lupus erythematosus (SLE) could contribute to the pathogenesis of lupus. Methods We divided SLE patients into active groups (Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score ≥ 6) and inactive groups (SLEDAI score < 6). Serum concentrations of CTHRC1, interferon alpha, interleukin (IL)-28A and IL-28B were determined using an enzyme-linked immunosorbent assay in a group of 40 patients with SLE. Results were compared with those from 23 healthy controls. Results Serum CTHRC1 protein levels were higher in patients with SLE compared with healthy controls. Patients with active disease displayed higher CTHRC1 levels compared with those with inactive disease as well. There was a positive association between serum CTHRC1 levels and SLEDAI and erythrocyte sedimentation rate, and a negative correlation with complement 3 and 4. Moreover, serum CTHRC1 levels were higher in SLE patients with arthritis and anemia compared with patients without the above-mentioned manifestations. Conclusions These findings indicate CTHRC1 probably plays an important part in the pathogenesis of SLE, and is positively associated with disease activity, while it also likely refers to the development of arthritis and anemia in SLE. Therefore, CTHRC1 may provide a novel research target and shed new light on the pathogenesis and therapy of SLE.

scholarly journals High disease activity status suggests more severe disease and damage accrual in systemic lupus erythematosus

2020 ◽  
Vol 7 (1) ◽  
pp. e000372
Author(s):  
Rachel Koelmeyer ◽  
Hieu Tri Nim ◽  
Mandana Nikpour ◽  
Ying B Sun ◽  
Amy Kao ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Disease Severity ◽  
Lupus Erythematosus ◽  
Activity Index ◽  
Severe Disease ◽  
High Disease Activity ◽  
Physician Global Assessment ◽  
Systemic Lupus ◽  
Damage Accrual

ObjectiveDisease severity in SLE is an important concept related to disease activity, treatment burden and prognosis. We set out to evaluate if high disease activity status (HDAS), based on ever attainment of a Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) disease activity score of ≥10, is an indicator for disease severity in SLE.MethodsUsing prospectively collected data, we assessed the association of HDAS with sociodemographic and disease characteristics and adverse clinical outcomes using logistic regression or generalised estimating equations.ResultsOf 286 patients with SLE, who were observed for a median (range) of 5.1 years (1–10.8 years), 43.7% experienced HDAS at least once during the observational period. Autoantibody positivity, particularly anti-dsDNA and anti-Sm positivity, were associated with increased likelihood of HDAS. Age ≥45 years at diagnosis was associated with reduced likelihood of HDAS (p=0.002). Patients with HDAS had higher Physician Global Assessment score (>1: OR 8.1, p<0.001) and were more likely to meet criteria for flare (mild/moderate flare: OR 4.4, p<0.001; severe flare: OR 17.2, p<0.001) at the time of experiencing HDAS. They were also more likely to have overall higher disease activity, as defined by time-adjusted mean SLEDAI-2K score in the highest quartile (OR 11.7, 95% CI 5.1 to 26.6; p>0.001), higher corticosteroid exposure (corticosteroid dose in highest quartile: OR 7.7, 95% CI 3.9 to 15.3; p<0.001) and damage accrual (OR 2.3, 95% CI 1.3 to 3.9; p=0.003) when compared with non-HDAS patients.ConclusionsHDAS is associated with more severe disease, as measured by higher disease activity across time, corticosteroid exposure and damage accrual. The occurrence of HDAS may be a useful prognostic marker in the management of SLE.

scholarly journals The Homogeneous Multiplexed System-a New Method for Autoantibody Profile in Systemic Lupus Erythematosus

2005 ◽  
Vol 12 (2) ◽  
pp. 107-111 ◽  
Author(s):  
Gisele Zandman-Goddard ◽  
Boris Gilburd ◽  
Ora Shovman ◽  
Miri Blank ◽  
Svetlana Berdichevski ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Severity ◽  
Lupus Erythematosus ◽  
Severe Disease ◽  
Clinical Manifestations ◽  
Systemic Lupus ◽  
Autoantibody Production ◽  
Sledai Score ◽  
Autoantibody Profile ◽  
Multiplex System

Systemic lupus erythematosus (SLE) is a multi-systemic autoimmune disease leading to immunological aberrations and excessive multiple autoantibody production. The aim of this study was to investigate the prevalence of multiple autoantibodies in SLE patients utilizing the multiplex system method.We analyzed the presence of elevated titers of anti-Ro, anti-La, anti-RNP, anti-Sm, anti-Jo1, anti-centromere, anti-Scl-70, anti-histone, and anti-dsDNA antibodies in 199 serum samples (113 SLE patients, 86 healthy donors). We compared the type, level and number of autoantibodies and the correlation between the autoantibody profile and disease severity utilizing the SLEDAI score.Elevated titers of at least one autoantibody were detected in 48% of 42 SLE patients. Elevated titers of anti-Ro antibodies were most commonly detected. The distribution of specific autoantibodies was: anti-Ro- 23.8%, anti-dsDNA- 19%, anti-histone- 19%, anti-RNP- 14.2%, anti-La antibodies- 11.9%, anti-Sm- 7.1%, anti-Scl 70-4.7%, and anti-centromere- 2.4%. Utilizing ROC analysis, the sensitivity and specificity of anti-DNA antibodies at a cutoff value of 34 IU/ml were 87.1% and 79.4% respectively. Elevated titers of anti-Jo1 antibody were not detected. There was a correlation with the titer of anti-Ro antibodies and disease activity by the SLEDAI score. Seven patients harbored one autoantibody only, 15 patients harbored 2-3 autoantibodies, 3 patients harbored 4-5 autoantibodies, and one patient harbored 6 autoantibodies. A correlation between the number of autoantibodies per patient and disease severity was found. One patient with a multitude of autoantibodies had severe lupus and a myriad of clinical manifestations.In conclusion, the multiplex system is specific and sensitive, provides an autoantibody profile in a single test, and may be useful as a diagnostic test for SLE. Elevated anti-Ro antibodies are associated with severe disease. An autoantibody load may be indicative of more severe disease.

scholarly journals Assessment of SLEDAI Score in Children with Lupus Nephritis Class III-IV in Vietnam National Children’s Hospital

2020 ◽  
Vol 36 (2) ◽  
Author(s):  
Duong Thi Thanh Binh ◽  
Nguyen Thu Huong ◽  
Nguyen Thi Kien ◽  
Pham Van Dem ◽  
Tran Minh Dien
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Nephritis ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Activity Index ◽  
Disease Activity Index ◽  
Class Iii ◽  
Systemic Lupus ◽  
Sledai Score ◽  
Pediatric Systemic Lupus Erythematosus

This study describes clinical, paraclinical characteristics and treatment response in children with nephritis class II-IV caused by systemic lupus erythematosus and validates SLEDAI for the evaluation of disease activity and the appropriate treatment strategy. A cross-sectional descriptive study was carried out on 40 children, 37 girls (92%) and 3 boys (8%), with an average age of 11.7 years with lupus nephritis class III- IV in Vietnam National Children’s Hospital in 2019. The study results show that the average score of SLEDAI in the children with pericardial and pleural effusions was 20.94 ± 4.09; high blood pressure, 20.89 ± 4.23; and gross hematuria, 20.29 ± 5.03, which were higher than those in children without these manifestations with p< 0.05. The most common kidney manifestations were nephrotic-range nephritis with renal failure (40%) and Glomerulonephritis (35%), corresponding to an average SLEDAI score of 24.25 ± 5.52 and 24.33 ± 3.2, respectively (p = 0.001). SLEDAI had an inverse correlation with the C3 complement value (r -0.315, p <0.05). The average SLEDAI score decreased gradually from 18.75 ± 4.22 to 3.38 ± 3.95 points (p <0.001) after 12 months of treatment.  The study concludes that SLEDAI score was higher in patients with pleural and/or pericardial effusions, hypertension and gross hematuria, nephrotic-range nephritis with kidney failure or glomerulonephritis. SLEDAI score corresponded with the C3 complement value and the average SLEDAI score decreased gradually with treatment. Keywords: Lupus Nephritis class III- IV, SLEDAI. References [1] George Bertsias, Ricard Cervera và Dimitrios T Boumpas, Systemic Lupus Erythematosus: Pathogenesis and Clinical Features<sample chapter 20_mod 17_Systemic Lupus nephritis 2012.pdf> (2012), EULAR Textbook on Rheumatic Diseases, EULAR, 476-505.[2] D.M. Levy and S. Kamphuis, Systemic lupus erythematosus in children and adolescents. Pediatr Clin North Am59(2) (2012)345-64.[3] Thai Thien Nam, 2018, Lupus in National Children,s Hospital, [4] C.Bombardier, M.B. Hurwitz et al, Derivation of the SLEDAI: A disease activity index for lupus patients. The committee on prognosis studies in SLE, Arthritis Rheum 35(6) (1992) 630-640.[5] R. Shamim, S. Farman, S. Batool et al, Association of systemic lupus erythematosus disease activity index score with clinical and laboratory parameters in pediatric onset systemic lupus erythematosus. Pak J Med Sci. 36(3) (2020) 467-472.[6] Le Thuy Hang, Assesment of SLEDAI score and panthology in children with lupus nephritis, 2016, Pediatrician thesis, Hanoi Medical University.[7] S.K.S.M. Nazri, K.K. Wong and W.Z.W.A. Hamid, Pediatric systemic lupus erythematosus. Retrospective analysis of clinico-laboratory parameters and their association with Systemic Lupus Erythematosus Disease Activity Index score, Saudi Med J. 39(6) (2018) 627-631. [8] Nguyen Thuy Duong, clinical, paraclinical and pathology characteristics in children with nephritis caused by systemic lupus erythematosus, 2011, Master thesis, Hanoi Medical University.[9] S.N. Wong, W.K. Chan, J.Hui et al, Membranous lupus nephritis in Chinese children--a case series and review of the literature. Pediatr Nephrol, 24(10)(2009) 1989-1996.[10] N.T.N. Dung, H.T. Loan, S. Nielsen et al, Juvenile systemic lupus erythematosus onset patterns in Vietnamese children: a descriptive study of 45 children. Pediatric Rheumatology Online Journal, 10 (2010) 38-48.[11] T. Pusongchai, J. Jungthirapanich, S. Khositseth, Pediatric Systemic Lupus Erythematosus in Thammasat University Hospital, J Med Assoc Thai. 93(12) (2010) 283-290.    

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