Diagnostic Value of Urinary Dysmorphic Erythrocytes in SLE Patients with Three Different Methods

2021 ◽  
Vol 28 (1) ◽  
pp. 41
Author(s):  
Ersa Bayung Maulidan ◽  
Ferdy Royland Marpaung
Keyword(s):  
Lupus Erythematosus ◽  
Activity Index ◽  
Clinical Manifestations ◽  
Disease Activity Index ◽  
Diagnostic Value ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Significant Difference ◽  
Sensitivity Specificity ◽  
Dysmorphic Erythrocytes

Systemic Lupus Erythematosus (SLE) is an autoimmune disease with various clinical manifestations. Lupus nephritis isthe most common severe manifestation with a poor prognosis. Hematuria is included in the Lupus Activity Criteria Count(LACC) and SLE Disease Activity Index (SLEDAI). Phase Contrast Microscope (PCM) availability as a recommended instrumentfor dysmorphic erythrocytes evaluation is exclusive, thus causing this examination to be performed rarely. This study aimedto investigate the diagnostic value of dysmorphic erythrocytes in SLE patients with hematuria using Low Condenser LightMicroscope (LCLM), PCM, and UF-500i. This research was a cross-sectional study with consecutive sampling; 58 fresh urinesamples were examined with UF-500i during May-July 2019. Percentage of dysmorphic erythrocytes were evaluated usingLCLM and PCM. Difference percentages of dysmorphic erythrocytes were analyzed using the Wilcoxon Signed Ranks test,degree of agreement by Kappa coefficient, cut-off, sensitivity, and specificity by ROC curve. Dysmorphic erythrocytepercentage in LCLM and PCM showed a significant difference (p < 0.001) and a low degree of agreement (Kappa=0.373).Dysmorphic erythrocyte cut-off with LCLM was 7.5% (sensitivity 70%, specificity 68%) and PCM was 6.5% (sensitivity 74%,specificity 65%). Dysmorphic? flagging from UF-500i showed a sensitivity, specificity, PPV, NPV of 78%, 52%, 58% and 73%,respectively. LCLM can be considered a substitute for PCM for evaluating dysmorphic erythrocytes with its cut-off, so theclinician will be more alert to abnormalities that cause hematuria. Further research with larger samples and definitediagnosis with a kidney biopsy is needed to obtain more accurate results.

scholarly journals Mean Platelet Volume (MPV) as an indicator of  disease activity and severity in lupus

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 126 ◽  
Author(s):  
Abidullah Khan ◽  
Iqbal Haider ◽  
Maimoona Ayub ◽  
Salman Khan
Keyword(s):  
Disease Activity ◽  
Lupus Erythematosus ◽  
Mean Platelet Volume ◽  
Activity Index ◽  
Disease Activity Index ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Strong Positive Correlation ◽  
Platelet Volume ◽  
Cross Sectional

Background: Amongst the different clinical and laboratory parameters used to monitor disease activity in systemic lupus erythematosus (SLE), mean platelet volume (MPV) is a novel biomarker. Although MPV has been studied in other rheumatological conditions like rheumatoid arthritis, its role in adult SLE needs to be defined, especially in Pakistan. Methods: The aim of this study was to evaluate the role of MPV as a biomarker of disease activity in SLE. Fifty patients were recruited through a consecutive non-probability sampling technique for this cross-sectional study.  On the basis of their SLE disease activity index (SLEDAI) score of greater or lesser than 5, these 50 participants were divided into two equal groups respectively;25 patients with active SLE, and another 25 participants with stable, inactive lupus. MPV was measured in each group and compared using SPSS version 16. MPV was also correlated with SLEDAI and erythrocyte sedimentation rate (ESR). Independent sample t-test and Spearman’s rho and Pearson’s correlation tests were applied. Sensitivity and specificity of MPV were checked through ROC analysis.    Results: The MPV of patients with active SLE (n=25, mean [M]=7.12, SD=1.01) was numerically lower than those in the inactive-SLE group (n=25, M= 10.12, SD=0.97), and this was statistically significant ( P<0.001). MPV had an inverse relationship with both ESR (r=-0.93, P<0.001) and SLEDAI (rs= -0.89, P<0.001). However, there was a strong positive correlation between ESR and SLEDAI (rs=0.90, P<0.001). For MPV, a cutoff value of less than 8.5fl had a sensitivity of 92% and a specificity of 100% ( P< 0.001).  Conclusions: Higher disease activity in SLE is associated with a correspondingly low MPV.

scholarly journals Mean Platelet Volume (MPV) as an indicator of  disease activity and severity in lupus

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 126 ◽  
Author(s):  
Abidullah Khan ◽  
Iqbal Haider ◽  
Maimoona Ayub ◽  
Salman Khan
Keyword(s):  
Disease Activity ◽  
Lupus Erythematosus ◽  
Mean Platelet Volume ◽  
Activity Index ◽  
Disease Activity Index ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Strong Positive Correlation ◽  
Platelet Volume ◽  
Cross Sectional

Background: Amongst the different clinical and laboratory parameters used to monitor disease activity in systemic lupus erythematosus (SLE), mean platelet volume (MPV) is a novel biomarker. Although MPV has been studied in other rheumatological conditions like rheumatoid arthritis, its role in adult SLE needs to be defined, especially in Pakistan. Methods: The aim of this study was to evaluate the role of MPV as a biomarker of disease activity in SLE. Fifty patients were recruited through a consecutive non-probability sampling technique for this cross-sectional study.  On the basis of their SLE disease activity index (SLEDAI) score of greater or lesser than 5, these 50 participants were divided into two equal groups respectively;25 patients with active SLE, and another 25 participants with stable, inactive lupus. MPV was measured in each group and compared using SPSS version 16. MPV was also correlated with SLEDAI and erythrocyte sedimentation rate (ESR). Independent sample t-test and Pearson’s correlation tests were applied. Sensitivity and specificity of MPV were checked through ROC analysis.   Results: The MPV of patients with active SLE (n=25, mean [M]=7.12, SD=1.01) was numerically lower than those in the inactive-SLE group (n=25, M= 10.12, SD=0.97), and this was statistically significant (P<0.001). MPV had an inverse relationship with both ESR (r=-0.93, P<0.001) and SLEDAI (r= -0.94, P<0.001). However, there was a strong positive correlation between ESR and SLEDAI (r=0.95, P<0.001). For MPV, a cutoff value of less than 8.5fl had a sensitivity of 92% and a specificity of 100% (P< 0.001). Conclusions: Higher disease activity in SLE is associated with a correspondingly low MPV.

scholarly journals The Usefulness of Endothelial Cell Adhesion Molecules and Anti-C1q Antibody in Monitoring Systemic Lupus Erythematosus Disease Activity

2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Hasni Mahayidin ◽  
Nurul Khaiza Yahya ◽  
Wan Syamimee Wan Ghazali ◽  
Asmahan Mohd Ismail ◽  
Wan Zuraida Wan Ab Hamid
Keyword(s):  
Disease Activity ◽  
Lupus Erythematosus ◽  
Activity Index ◽  
Inverse Correlation ◽  
Disease Activity Index ◽  
Serum Levels ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Positive Correlations ◽  
Global Disease Activity

Objectives. The study was conducted to determine the correlation of ICAM-1, VCAM-1, and anti-C1q antibody levels with SLE disease activity index (SLEDAI) and standard SLE disease activity immunological markers (anti-dsDNA and sera C3 and C4). Study Design. This was a cross-sectional study. Materials and Methods. Blood samples were obtained from 95 SLE patients (45 active SLE and 50 nonactive SLE) and 50 controls. The subjects were assessed using SLEDAI and score of more than five is determined as having active SLE. The sera were tested for serum ICAM-1, VCAM-1, and anti-C1q (ELISA), anti-dsDNA (CLIFT), serum C3, and serum C4 (immunonephelometry). Results. Anti-dsDNA and anti-C1q antibody showed good positive correlations with SLEDAI (r=0.529, P<0.001 and r=0.559, P<0.001, resp.). VCAM-1 and sera C3 and C4 showed fair correlation with SLEDAI (r=0.294, P=0.004; r=-0.312, P=0.002; and r=-0.382, P<0.001, resp.). ICAM-1 level showed no significant correlation with SLEDAI (P=0.062). There were significant correlations of VCAM-1 and anti-C1q antibody with anti-dsDNA (r=0.226, P=0.006 and r=0.511, P<0.001, resp.). VCAM-1 showed poor inverse correlation with serum C3 (r=-0.183, P=0.028) and fair inverse correlation with serum C4 (r=-0.251, P=0.002). Anti-C1q antibody demonstrated fair inverse correlation with both sera C3 and C4 (r=-0.420, P≤0.001 and r=-0.398, P<0.001, resp.). However, ICAM-1 showed no significant correlation with anti-dsDNA and sera C3 and C4 (P=0.259, P=0.626 and P=0.338, resp.). Conclusions. The serum levels of anti-C1q antibody in SLE patients showed the best correlation with the SLEDAI and standard immunological tests for SLE disease activity. These data support that anti-C1q antibody is a useful marker for monitoring SLE global disease activity. The potential of VCAM-1 needs further confirmation.

THE CLINICAL, LABORATORY MANIFESTATIONS AND HISTOPATHOLOGY IN NEPHROTIC PATIENTS WITH LUPUS NEPHRITIS

2018 ◽  
pp. 52-58
Author(s):  
Le Thuan Nguyen ◽  
Bui Bao Hoang
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Clinical Laboratory ◽  
Activity Index ◽  
Clinical Manifestations ◽  
Systemic Lupus ◽  
Cross Sectional ◽  
Organ Systems ◽  
Tubulointerstitial Lesions

Introduction: Systemic lupus erythematosus (SLE) is an autoimmune disease involving multiple organ systems. The kidney appears to be the most commonly affected organ, especially nephrotic is a serious kidney injury. The clinical, laboratory manifestations and histopathology are very useful for diagnosis, provide the means of predicting prognosis and guiding therapy in nephrotic patients with lupus nephritis. Methods: Descriptive cross-sectional study of nephrotic patients with lupus treated in the Department of Nephrology Trung Vuong Hospital and Cho Ray Hospital between May/2014 and May/2017. Renal histopathological lesions were classified according to International Society of Nephrology/Renal Pathology Society - ISN/RPS ’s 2003. The clinical, laboratory manifestations and histopathological features were described. Results: Of 32 LN with nephritic range proteinuria cases studied, 93.7% were women. The 3 most common clinical manifestations were edema (93.8%), hypertension (96.8%) and pallor (68.9%), musculoskeletal manifestions (46.9%), malar rash (40.6%). There was significant rise in laboratory and immunological manifestions with hematuria (78.1%), Hb < 12g/dL (93.5%), increased Cholesterol (100%), and Triglycerid (87.5%), Creatinine > 1.4 mg/dL (87.5%), increased BUN 71.9%, ANA (+) 93.8%, Anti Ds DNA(+) 96.9%, low C3: 96.9%, low C4: 84.4%. The most various and severe features were noted in class IV with active tubulointerstitial lesions and high activity index. Conclusion: Lupus nephritis with nephrotic range proteinuria has the more severity of histopathological feature and the more severity of the more systemic organ involvements and laboratory disorders were noted. Key words: Systemic lupus, erythematosus (SLE) lupus nepphritis, clinical

Cut off point of neutrophil-to-lymphocyte ratio as a marker of active disease in systemic lupus erythematosus

Lupus ◽  
2020 ◽  
Vol 29 (12) ◽  
pp. 1566-1570
Author(s):  
Akhmad Syaikhu Firizal ◽  
Adhi Kristianto Sugianli ◽  
Laniyati Hamijoyo
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Inflammatory Diseases ◽  
Activity Index ◽  
Disease Activity Index ◽  
Neutrophil To Lymphocyte Ratio ◽  
Systemic Lupus ◽  
Cross Sectional ◽  
Lymphocyte Ratio ◽  
Active Disease

Aim We aimed to measure sensitivity, specificity, and to determine the cut-off value (COV) ratio of neutrophil-to-lymphocyte (NLR) in patients with active systemic lupus erythematosus (SLE). Methods A cross sectional study was conducted using the retrospective data from Hasan Sadikin Lupus Registry (HSLR). The inclusion criteria were SLE patients aged 18 years or older who had documented data of neutrophil, lymphocyte, and SLE disease activity index (SLEDAI). Patients with infections, malignancies, and other inflammatory diseases recorded in registry were excluded. SLEDAI with a score of ≤ 4 is considered inactive and score of > 4 is considered active. The neutrophil-to-lymphocyte ratio was calculated by dividing the absolute number of neutrophils by the absoulte number of lymphocytes. Receiver Operating Characteristic (ROC) curve was used to analyze and determine optimal COV of NLR. Results The total sample in this study were 112 subjects with a dominant of female (95.54%) and the mean age of 34.45 ± 9.40 years. The median of SLEDAI was 4.5 with a range from 0 to 16, while the median of NLR was 2.68 with a range of 0.59 to 19.02. The ROC analysis showed the optimal cut-off in this study was 2.94 with sensitivity and specificity as high as 60.71% and 76.79%, respectively. Conclusion Neutrophil-to-lymphocyte ratio with cut off value of 2.94 can be used to determine active disease of systemic lupus eythematousus.

scholarly journals Food intolerances and associated symptoms in patients undergoing Fobi-Capella technique without gastric ring

2015 ◽  
Vol 28 (1) ◽  
pp. 36-39 ◽  
Author(s):  
Marcella de Arruda MOREIRA ◽  
Patrícia Ramos Maciel ESPÍNOLA ◽  
Camila Wanderley de AZEVEDO ◽  
Cinthia Karla Rodrigues do Monte GUEDES
Keyword(s):  
Clinical Manifestations ◽  
Cross Sectional Study ◽  
Food Intolerance ◽  
World Health ◽  
Cross Sectional ◽  
Significant Difference ◽  
One Year ◽  
Health Organization ◽  
Nutritional Monitoring ◽  
Height Data

BACKGROUND: Bariatric surgery is considered the only effective method to treat refractory obesity, and especially for those in which clinical treatment was not successful. However, the appearance of food intolerances and clinical manifestations are quite common. AIM: To identify food intolerances and associated them to symptoms in patients undergoing Fobi-Capella technique without gastric ring. METHODS: This was a cross-sectional study of adult patients who had more than one year after surgery. Demographic, anthropometric, weight and preoperative height data were investigated. Nutritional status was classified according to the criteria established by the World Health Organization. It was considered food intolerance the presence of nausea, vomiting, diarrhea or bloating after eating a particular food. RESULTS: The sample consisted of 61 patients who attended the nutritional consultation of which 26 (42.6%) had food intolerance, mostly related to red meat (n=12; 34.3%) during the first six months of operation; there was a significant difference between the periods between 0 and 6 months, and 7 to 12 (p=0.02). Among the symptoms reported by patients, nausea was the most recurrent until the 6th month, but without significant differences between the two periods (p=0.06). CONCLUSION: The Fobi-Capella procedure without gastric ring promoted high frequency of intolerance to meat in general, especially for the red, chicken and fish, on this sequence; nausea was the most frequent symptom. These data suggest the need for adequate nutritional monitoring throughout the postoperative period.

Fibromyalgia in Spondyloarthritis: Effect on Disease Activity Assessment in Clinical Practice

2016 ◽  
Vol 43 (11) ◽  
pp. 2056-2063 ◽  
Author(s):  
Jean Wach ◽  
Marie-Claude Letroublon ◽  
Fabienne Coury ◽  
Jacques Guy Tebib
Keyword(s):  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Activity Index ◽  
Short Form ◽  
Disease Activity Index ◽  
Patient Characteristics ◽  
Cross Sectional Study ◽  
Moderate Activity ◽  
Cross Sectional ◽  
American College Of Rheumatology

Objective.Spondyloarthritis (SpA) is the second most frequent inflammatory rheumatic disease, characterized by spinal involvement, peripheral arthritis, or enthesitis with marked pain, stiffness, and fatigue. Fibromyalgia (FM) may be associated with SpA, and shares some common symptoms. We aimed to determine how FM influences assessment of SpA disease activity, which is mainly dependent on patient-based outcome measures such as the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) or the Ankylosing Spondylitis Disease Activity Score (ASDAS).Methods.This single-center cross-sectional study included consecutive patients with SpA according to the Assessment of SpondyloArthritis International Society criteria. FM was diagnosed according to the 1990 American College of Rheumatology criteria. Patient characteristics, BASDAI, ASDAS/C-reactive protein (CRP), Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Metrology Index, and the Medical Outcomes Study Short Form-36 questionnaire were recorded and compared.Results.The study included 103 patients with SpA; 81 with axial and 22 with peripheral forms. Eighteen patients presented with concomitant FM, of whom 12 had axial SpA and 6 peripheral SpA. Demographic characteristics did not differ except for sex, with a female predominance in the FM group that was more marked in peripheral forms. BASDAI was higher in patients with FM [median (IQR): 4.2 (4.2) vs 2.2 (3.1); p = 0.0068], whereas ASDAS-CRP was not significantly different [median (IQR): 2.7 (2) vs 2 (1.3); p = 0.1264]. Nevertheless, median ASDAS-CRP corresponded to high disease activity in patients with SpA or FM compared with moderate activity in non-FM patients.Conclusion.FM is a frequent comorbidity in patients with SpA, especially in peripheral forms. In patients with SpA-FM, disease activity may be overestimated when measured by BASDAI and to a lesser extent by ASDAS-CRP, and this overestimation could lead to inappropriate treatment escalation.

scholarly journals Association Between Housing Instability and Severity of Psoriasis and Psoriatic Arthritis: A Cross-Sectional Study

2020 ◽  
Vol 4 (4) ◽  
pp. 321-327
Author(s):  
Jalal Maghfour ◽  
Frances Gill ◽  
Justin Olson ◽  
Andrea Murina
Keyword(s):  
Psoriatic Arthritis ◽  
Activity Index ◽  
Disease Activity Index ◽  
Cross Sectional Study ◽  
Equation Model ◽  
Housing Instability ◽  
Cross Sectional ◽  
Housing Status ◽  
The Impact ◽  
Question Survey

Introduction: Psoriasis and psoriatic arthritis are interrelated chronic inflammatory disorders that can be exacerbated by stress. The impact of housing instability on severity of psoriasis and psoriatic arthritis (PsA) has not been examined.Methods: An eight-question survey was administered to 59 psoriasis participants, with and without PsA, to assess participants' housing status. The severity of psoriasis and PsA diseases was assessed using Body Surface Area (BSA) and clinical Disease Activity Index of Psoriatic Arthritis (cDAPSA) measurements respectively. A multivariate linear regression model was used to predict BSA and cDAPSA scores differences among participants.Results: Housing unstable psoriasis participants had a higher average BSA than housing stable psoriasis participants (14% vs 7.1%). Using a regression equation model, housing status and smoking were significant predictors (p<0.04). Housing unstable PsA participants [13 (33%)] were also found to have a higher average cDAPSA than housing-stable psA participants [26 (66%)] (31 vs 16.7).  Housing instability was the only variable to predict differences in cDAPSA scores among PsA participants (p=0.021). Housing unstable participants had a higher BSA even on biologics (21.3% vs 1.65%; P < 0.001), oral therapy (14.6% vs 4 %; P<0.001) and phototherapy (10% vs 4%; P=0.031).Discussion: This study demonstrated that housing instability might be associated with an increased severity of psoriasis and PsA. Housing instability, as a psychosocial stressor, could be an important element to consider in the management of psoriasis patients.

scholarly journals Relationship between Microalbuminuria and Disease Activity in Patients with Ulcerative Colitis

2019 ◽  
Vol 12 (1) ◽  
pp. 34-38
Author(s):  
Kourosh Masnadi Shirazi ◽  
Sima Khayati ◽  
Maryam Baradaran Binazir ◽  
Zeinab Nikniaz
Keyword(s):  
Ulcerative Colitis ◽  
Disease Activity ◽  
Activity Index ◽  
Disease Activity Index ◽  
Fecal Calprotectin ◽  
Cross Sectional Study ◽  
Inactive Disease ◽  
Cross Sectional ◽  
Non Invasive ◽  
The Mean

BACKGROUND Introducing a non-invasive method for determining disease activity is important in patients with ulcerative colitis (UC). So in this study, we aimed to assess the association between disease activity index and microalbuminuria in patients with UC. METHODS In the present cross-sectional study, 84 patients with UC were selected. The disease activity was calculated by the partial Mayo clinic score. Microalbuminuria was assessed using the immunoturbidimetric method in a first-voided sample in the morning in two consecutive days and the mean of these two measurements was reported as urinary microalbumin level. Serum C reactive protein (CRP), erythrocyte sedimentation rate (ESR), and fecal calprotectin were measured respectively using conventional turbidimetric immunoassay, Westergren method, and ELISA methods. RESULTS The mean age of the participants was 40.01 ± 12.85 years, 60.8% of them were female and 53.5% had microalbuminuria. The frequency of microalbuminuria was significantly higher in patients with active compared with inactive inflammatory bowel disease (IBD). There were significant differences between the patients with active and inactive disease regarding CRP, ESR, and calprotectin (p < 0.001). Moreover, there was a strong correlation between microalbuminuria and CRP (r = 0.89, p < 0.001), ESR (r = 0.92, p < 0.001), and calprotectin (r = 0.91, p < 0.001). CONCLUSION Microalbuminuria could be used as a non-invasive marker of disease activity in patients with UC.

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