الفهرس | Only 14 pages are availabe for public view |
Abstract Aim of the Work This study aims to determine the frequency of IgA deficiency in patients with systemic lupus erythematosus, and to evaluate potential differences in clinical and laboratory features between SLE patients with IgA deficiency and those with normal IgA concentration. Summary Systemic Lupus Erythematosus is an autoimmune disorder that involves multisystem microvascular inflammation with the generation of autoantibodies. Although the specific cause of SLE is unknown, multiple factors are associated with the development of the disease. These include genetic, racial, hormonal, and environmental factors. Many immune disturbances, both innate and acquired, occur in SLE (Cooper et al., 1998). The objective of this study was to determine the frequency of IgA deficiency in Patients with systemic lupus erythematosus, and to evaluate potential differences in clinical and laboratory features between SLE patients with IgA deficiency and those with normal IgA concentration. Fourty-five SLE patients diagnosed according to the American College of Rheumatology (ACR) criteria for the classification of SLE were included in this study. The control group included 15 healthy persons. The frequency of IgAD in SLE patients was 20% while none of the control group had IgAD. There was a statistically significant higher association of Positive ANA (p= 0.042) in patients with IgA deficiency. The frequency rate of positive ANA in SLE patients with IgA deficiency was (33.33 %). There was no statistically significant difference between SLE patients with normal IgA and those with IgA deficiency as regards other laboratory features as cytopenias (leukopenia, thrombocytopenia, lymphopenia, or hemolytic anemia), blood urea, serum creatinine, anti Ds DNA, positive C reactive protein or elevated ESR. Lupus nephritis was present in (33.33%) of the IgAD group, and in (69.44%) of SLE patients with normal IgA level, but this did not reach a statistical significance difference. There was no statistically significant difference between SLE patients with normal IgA and those with IgA deficiency as regards other SLE manifestations as; constitutional symptoms, mucocutaneous manifestations, vasculitic lesions, serositis, neuropsychiatry or GIT manifestations. There was a positive statistically significant correlation between IgA serum level and age of the patients (r = 0.379, p<0.05), disease duration (r = 0.309, p<0.05), lupus nephritis (r = 0.298, p<0.05), serum creatinine (r = 0.294, p<0.05) and positive ANA (r = 0.354, p<0.05). There was a negative statistically significant correlation between IgA serum level and weight loss (r = -0.354, p<0.05), urticarial rash (r = -0.302, p<0.05), papular rash (r = -0.302, p<0.05). IgA serum level showed no statistically significant correlation with other clinical & laboratory parameters of patients under study. Also there was no statistically significant correlation between IgA serum level and disease activity measured by SLE-DAI and SLAM indices. Conclusion In this study there was a higher frequency of IgAD in patients with SLE than in the control group. Apart from the increased frequency of positive ANA and lupus nephritis in the IgAD group, there was no statistically significant difference between SLE patients with normal IgA and those with IgA deficiency as regards other clinical and laboratory features . IgA serum level was positively correlated with age of the patients, disease duration, lupus nephritis, serum creatinine and positive ANA. While it was negatively correlated with weight loss, urticarial rash and papular rash. |