الفهرس 
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Abstract
The aim of this study is to assess the level of serum sTM in SLE Egyptian patients and correlate it with disease activity and severity. This study was conducted on 90 SLE patients with age ranged and 60 apparently healthy volunteers with matched age and sex. All the patients were subjected to All SLE patients were subjected to the following : History taking, Examination: General & local, Assessment of Disease activity : SLEDAI score, Assessment of accumulated organ damage : SLICC/ ACR damage index (SDI), Radiological investigations, Electrocardiogram, Laboratory investigations, CBC, C3,C4, ANA, AntidsDNA, urine analysis and 24 hr protein in urine, determination of human thrombomodulin level in serum using ELIZA. The results revealed Significant positive correlation between sTM level and SLEDAI, renal SLEDAI and SDI scores, The serum C3 and C4 level inversely correlated with the sTM level. Significant increase in sTM level in SLE patients with +ve ANA than those with –ve ANA while no significant correlation was found between anti-dsDNA titre and sTM level in patients with SLE. Significant positive correlation between sTM level and presence of proteinuria, urinary casts, RBCs in urine and pus in urine .Also, serum creatinine show significant correlation with sTM level. These reflect sTM correlation with renal involvement in SLE patient. No significant correlation between sTM level with the ESR and CRP in the patients. No significant correlation between sTM level and the HB concentration, RBCs count, WBCs count or the platelets count. Significant higher sTM level in SLE patients with nephritis rather than patients without nephritis, significantly higher sTM level in SLE patients with hypertension than patients without hypertension, No significant association was found between the sTM level and the constitutional manifestations. Also, the muco-cutaneous manifestations did not show significant association with sTM level.The musculoskeletal manifestations had no significant association with the sTM level. Similarly, pericardial effusion, valvular affection, vasculitis, Raynaud’s disease, pleurisy, eye manifestations, neurologic manifestations nor GIT manifestations had shown significant association with the serum level of sTM level. No significant correlation between sTM level and gender of the patients. to conclude, that serum sTM appears to be useful in assessing disease activity and severity in SLE and degree of renal affection. Also, it may help as indicator for predicting flare and vascular complications or monitoring the successful therapeutic response. The present study is suggestive for the role of serum sTM as indicator of endothelial damage, which may occurs in the pathogenesis of SLE especially with renal involvement. We recommend to Follow up of sTM in SLE patients for longer periods during disease activity and remission. Future studies are required that could apply elevated sTM level in laboratory parameters of SLE disease activity and damage indices.