scholarly journals The Relationship between Neutrophil Lymphocyte Ratio with Disease Activity in Systemic Lupus Erythematosus

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Gede Kambayana ◽  
I Gusti Agung Friskha Surya Putra ◽  
Pande Ketut Kurniari ◽  
Tjokorda Raka Putra
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Systemic Lupus ◽  
Cross Sectional ◽  
Positive Correlation ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
The Relationship

Background. Systemic Lupus Erythematosus (SLE) is an Autoimmune inflammatory disease that is systemic and chronic inflammation with heterogeneous of history, clinical manifestations, and prognosis. The disease activity of SLE has been proven as a predictor of organ damage and death by evidenced of inflammatory markers involved in this disease. Neutrophil to Lymphocyte Ratio (NLR) is useful for estimating the activity of autoimmune disease and inflammation that easily obtained from blood test and low cost and measurable as new biomarker to assess inflammatory response or activity of SLE. This study aimed to determine the relationship between NRL and Disease Activity based on Mex-SLEDAI in patients SLE. Methods. This study is an analytic study with cross sectional design. It started from November 2016 until March 2017. Mex-SLEDAI and blood sampling used in this study. Result. Total sample in this study is 54 patients with median age was 28.5 years, with mostly female (85,2%). Result analysis with positive correlation between NLR with disease activity on SLE (r=0.399  p=0.003  n=54), thus the Scatter plot shows there is a correlation between NRL with Mex-SLEDAI. Conclusion. Positive correlation between NLR and disease activity of the SLE, the higher of the disease activity/Mex-SLEDAI will be followed by the increase of NLR.

scholarly journals The Relationship of Neutrophil Lymphocyte Ratio and Levels of Vitamin D against Disease Activity Systemic Lupus Erythematosus

2021 ◽  
Vol 8 (10) ◽  
pp. 320-325
Author(s):  
Ahmad Fauzi Lubis ◽  
Zuhrial Zubir ◽  
Ananda Wibawanta Ginting
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Vitamin D ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Systemic Lupus Erythematosus Disease ◽  
Systemic Lupus ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Vitamin D Levels ◽  
The Relationship

Background: Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by the presence of autoantibodies against cell nuclei and immune complexes involving multiple organ systems in the body. The Lupus Foundation estimates about 1.5 million cases of SLE in America and at least 5 million cases of SLE in the world and from year to year, the number of people with lupus also tends to increase. Several laboratory findings are also associated with signs and symptoms of SLE activity including the ratio of neutrophil lymphocytes and vitamin D levels. Method: This study is an observational analytic study using medical record data from central installation patients at H. Adam Malik Hospital in the period December 2019 to March 2021. The sample is calculated using the large proportion estimation formula. Then the distribution test was carried out with the Shapiro Wilk test. Bivariate analysis was carried out to determine the relationship between neutrophil lymphocyte ratio and vitamin D levels with the MEX SLEDAI score using the ANOVA test if the data was normally distributed. Results: 75 subjects participated in the study and there were 12 people (16%) experiencing mild systemic lupus erythematosus, 38 people (51%) moderate degree, and 25 people (33%) severe degree. The neutrophil-lymphocyte ratio was associated with systemic lupus erythematosus disease activity (p=0.001) and vitamin D levels were associated with systemic lupus erythematosus disease activity. Conclusion: Neutrophil-lymphocyte ratio and vitamin D levels are associated with systemic lupus erythematosus disease activity. Keywords: neutrophil lymphocyte ratio, vitamin D levels, systemic lupus erythematosus.

scholarly journals Characterisation of Patients with Systemic Lupus Erythematosus in Malta: A Population Based Cohort Cross-Sectional Study

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Rosalie Magro ◽  
Andrew A. Borg
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Significant Positive Correlation ◽  
Functional Disability ◽  
Unmet Needs ◽  
Depression Scale ◽  
Systemic Lupus ◽  
Cross Sectional ◽  
Positive Correlation

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.

scholarly journals Lupus Low Disease Activity State Associated with Lower Fatigue

2019 ◽  
Vol 11 (2) ◽  
Author(s):  
Ryan Ardian Saputro ◽  
Santi Andayani ◽  
Stefanie Yuliana Usman ◽  
Laniyati Hamijoyo
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Cross Sectional Study ◽  
Asia Pacific ◽  
Systemic Lupus ◽  
Cross Sectional ◽  
Low Disease Activity ◽  
Activity State

Background: Systemic Lupus Erythematosus (SLE) is an autoimmune disease with heterogeneous clinical manifestations including fatigue. Previous studies aimed at proving the relationship between fatigue and SLE disease activity showed conflicting results. In 2015, Asia Pacific Lupus Collaboration (APLC) developed low disease activity criteria, named Lupus Low Disease Activity State (LLDAS). Patients who spend more time in LLDAS have significantly lower morbidity. This study aimed to evaluate the association between disease activity based on LLDAS and fatigue.    Methods: This is a analytical cross-sectional study. Subjects were SLE patients at rheumatology clinic in Dr. Hasan Sadikin Hospital, Bandung during June-January 2018. Subjects were evaluated based on LLDAS criteria and divided into 2 groups: LLDAS and non-LLDAS. Fatigue status of the subjects was assessed with Fatigue Severity Scale (FSS). Results: A hundred and thirty-three subjects were included in this study, divided into 63 subjects in LLDAS group and 60 subjects in non-LLDAS group. Nineteen subjects (30.2%) in LLDAS group had fatigue and 39 subjects (65%) in non-LLDAS had fatigue. There was a significant association between LLDAS and fatigue (p< 0.001). Nonetheless, fatigue level in LLDAS group was still high since disease activity was not the only factor related to fatigue. Fatigue may be a distinct clinical manifestation of neuropsychiatric lupus and may be independent of lupus disease activity Conclusions: There was a significant association between LLDAS and fatigue showed by lower fatigue level was found in the LLDAS group than in the non-LLDAS group.   Keywords: Systemic lupus erythematosus, disease activity, Lupus Low Disease Activity State, fatigue

scholarly journals The Relationship between Neutrophil Lymphocyte Ratio and Platelet Lymphocyte Ratio to Degree of Activity in Systemic Lupus Erythematosus

2021 ◽  
Vol 8 (10) ◽  
pp. 374-382
Author(s):  
Irsyadil Fikri ◽  
Zuhrial Zubir ◽  
Ananda Wibawanta Ginting
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Bivariate Analysis ◽  
Systemic Lupus ◽  
Autoantibody Production ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Platelet Lymphocyte Ratio ◽  
The Relationship ◽  
Normally Distributed

Background: Systemic lupus erythematosus is a chronic autoimmune inflammatory disease with a wide spectrum of clinical and serological manifestations caused by autoantibody production, complement activation, and immune complex deposition. Several studies have shown that the neutrophil-lymphocyte ratio and the platelet-lymphocyte ratio are closely correlated with systemic lupus erythematosus and its disease activity so that they can be used as diagnostic indicators and monitoring of systemic lupus erythematosus. Objective: To determine the relationship between the ratio of neutrophil lymphocytes and the ratio of platelets to lymphocytes on the degree of activity of lupus disease in patients with systemic lupus erythematosus. Methods: This is an observational analytic study using medical record data from central installation patients at H. Adam Malik Hospital in the period January to December 2019. The sample was calculated using the unpaired comparative sample size formula for more than two groups of one measurement. Then the distribution test was carried out with the Shapiro Wilk test. Bivariate analysis was conducted to determine the relationship between the ratio of neutrophil lymphocytes and the ratio of platelets to lymphocytes with the MEX SLEDAI score using the ANOVA test if the data were normally distributed, or the Kruskal-Wallis test if the data was not normally distributed. Then proceed with the Mann-Whitney post hoc test to see which groups have differences. The sum of deviations (α) is 0.05, statistically significant if p<0.05. Results: 120 subjects participated in the study and 33 people (27.5%) had mild systemic lupus erythematosus, 47 (39.2%) moderate degrees, and 40 people (33.3%) severe degrees. Conclusion: The neutrophil-lymphocyte ratio and the platelet-lymphocyte ratio are associated with the degree of lupus activity in patients with systemic lupus erythematosus. Keywords: neutrophil-lymphocyte ratio, platelet lymphocyte ratio, systemic lupus erythematosus.

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

Impact of markers of endothelial injury and hypercoagulability on systemic lupus erythematosus

Lupus ◽  
2020 ◽  
Vol 29 (2) ◽  
pp. 182-190
Author(s):  
W Batista Cicarini ◽  
R C Figueiredo Duarte ◽  
K Silvestre Ferreira ◽  
C de Mello Gomes Loures ◽  
R Vargas Consoli ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Activity Index ◽  
Disease Activity Index ◽  
Endothelial Injury ◽  
Control Group ◽  
Systemic Lupus ◽  
Low Concentrations ◽  
The Relationship

We have explored the relationship between possible hemostatic changes and clinical manifestation of the systemic lupus erythematosus (SLE) as a function of greater or lesser disease activity according to Systemic Lupus Erythematosus Disease Activity Index-2000 (SLEDAI-2K) criteria. Endothelial injury and hypercoagulability were investigated in patients with SLE by measuring thrombomodulin (TM), D-dimer (DDi) and thrombin generation (TG) potential. A total of 90 participants were distributed into three groups: 1) women with SLE presenting with low disease activity (laSLE) (SLEDAI-2K ≤ 4), 2) women with SLE presenting with moderate to high disease activity (mhaSLE) (SLEDAI-2K > 4), and 3) a control group comprising healthy women. Levels of TM and DDi were higher both in the laSLE and mhaSLE groups compared to controls and in mhaSLE compared to the laSLE group. With respect to TG assay, lagtime and endogen thrombin potential, low concentrations of tissue factor provided the best results for discrimination among groups. Analysis of these data allow us to conclude that TM, DDi and TG are potentially useful markers for discriminating patients with very active from those with lower active disease. Higher SLE activity may cause endothelial injury, resulting in higher TG and consequently a hypercoagulability state underlying the picture of thrombosis common in this inflammatory disease.

Adult systemic lupus erythematosus in Egypt: The nation-wide spectrum of 3661 patients and world-wide standpoint

Lupus ◽  
2021 ◽  
pp. 096120332110142
Author(s):  
Tamer A Gheita ◽  
Rasha Abdel Noor ◽  
Esam Abualfadl ◽  
Osama S Abousehly ◽  
Iman I El-Gazzar ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Age Of Onset ◽  
Wide Spectrum ◽  
Age At Onset ◽  
Disease Onset ◽  
Clinical Manifestations ◽  
Population Based ◽  
Systemic Lupus ◽  
Cross Sectional

Objective The aim of this study was to present the epidemiology, clinical manifestations and treatment pattern of systemic lupus erythematosus (SLE) in Egyptian patients over the country and compare the findings to large cohorts worldwide. Objectives were extended to focus on the age at onset and gender driven influence on the disease characteristics. Patients and method This population-based, multicenter, cross-sectional study included 3661 adult SLE patients from Egyptian rheumatology departments across the nation. Demographic, clinical, and therapeutic data were assessed for all patients. Results The study included 3661 patients; 3296 females and 365 males (9.03:1) and the median age was 30 years (17–79 years), disease duration 4 years (0–75 years) while the median age at disease onset was 25 years (4–75 years). The overall estimated prevalence of adult SLE in Egypt was 6.1/100,000 population (1.2/100,000 males and 11.3/100,000 females).There were 316 (8.6%) juvenile-onset (Jo-SLE) and 3345 adult-onset (Ao-SLE). Age at onset was highest in South and lowest in Cairo (p < 0.0001). Conclusion SLE in Egypt had a wide variety of clinical and immunological manifestations, with some similarities with that in other nations and differences within the same country. The clinical characteristics, autoantibodies and comorbidities are comparable between Ao-SLE and Jo-SLE. The frequency of various clinical and immunological manifestations varied between gender. Additional studies are needed to determine the underlying factors contributing to gender and age of onset differences.

scholarly journals The Main Challenges in Systemic Lupus Erythematosus: Where Do We Stand?

2021 ◽  
Vol 10 (2) ◽  
pp. 243
Author(s):  
Matteo Piga ◽  
Laurent Arnaud
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Systemic Disease ◽  
Unmet Need ◽  
Clinical Manifestations ◽  
New Drugs ◽  
Systemic Lupus ◽  
Major Step ◽  
Damage Accrual

Systemic lupus erythematosus (SLE) is an immune-mediated multi-systemic disease characterized by a wide variability of clinical manifestations and a course frequently subject to unpredictable flares. Despite significant advances in the understanding of the pathophysiology and optimization of medical care, patients with SLE still have significant mortality and carry a risk of progressive organ damage accrual and reduced health-related quality of life. New tools allow earlier classification of SLE, whereas tailored early intervention and treatment strategies targeted to clinical remission or low disease activity could offer the opportunity to reduce damage, thus improving long-term outcomes. Nevertheless, the early diagnosis of SLE is still an unmet need for many patients. Further disentangling the SLE susceptibility and complex pathogenesis will allow to identify more accurate biomarkers and implement new ways to measure disease activity. This could represent a major step forward to find new trials modalities for developing new drugs, optimizing the use of currently available therapeutics and minimizing glucocorticoids. Preventing and treating comorbidities in SLE, improving the management of hard-to-treat manifestations including management of SLE during pregnancy are among the remaining major unmet needs. This review provides insights and a research agenda for the main challenges in SLE.

Elevated levels of IL-24 in systemic lupus erythematosus patients

Lupus ◽  
2019 ◽  
Vol 28 (6) ◽  
pp. 748-754 ◽  
Author(s):  
R C Li ◽  
J Guo ◽  
L C Su ◽  
A F Huang
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Inflammatory Cytokine ◽  
Activity Index ◽  
Clinical Manifestations ◽  
Mrna Levels ◽  
Healthy Controls ◽  
Systemic Lupus ◽  
Good Ability

Objective This study aimed to assess IL-24 levels and their association with clinical manifestations in patients with systemic lupus erythematosus (SLE). Methods There were 75 patients with SLE and 58 healthy controls recruited in this study. Serum levels of IL-24 were measured by enzyme-linked immunosorbent assays, and mRNA levels of IL-24 were tested by quantitative real-time polymerase chain reaction . The area under the curve of the receiver operating characteristic (ROC) curve was used for diagnostic ability of the inflammatory cytokine. Results Serum IL-24 levels were significantly higher in SLE patients than that in healthy controls. SLE patients with nephritis had higher IL-24 levels than those without nephritis. Active SLE patients showed higher expression of IL-24 as compared to less active disease patients. The mRNA levels of IL-24 were much higher in SLE patients. Correlation analysis showed significant correlation between serum IL-24 levels and SLE disease activity index. In addition, ROC analysis may suggest good ability of serum IL-24 in differentiating SLE. Conclusion The inflammatory cytokine correlated with SLE disease activity, and may be involved in this disease pathogenesis.

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