الفهرس 
OVERVIEW OF HAEMOSTASISOnly 14 pages are availabe for public view
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Abstract
Systemic lupus erythematosus is a chronic multisystem autoimmune disease with a broad range of clinical manifestations. The prevalence of vascular events in SLE patients ranges between 10% and 30%, for symptomatic coronary artery disease 6–20%, stroke 2–15%, and subclinical coronary artery disease 30–40%.
Thrombin activatable fibrinolysis inhibitor (TAFI) has an antifibrinolytic action by removal of the C-terminal lysine residues of fibrin,which acts as template onto which both tPA and plasminogen bind thereby enhancing the catalytic efficiency of plasmin formation. , further enhances plasmin formation and is a better substrate for tPA. Elevated TAFI levels in plasma are correlated with an elevated risk for venous thrombosis.
Also it has anti-inflammatory action through removal of C-terminal arginines so it inactivates several inflammatory mediators, including bradykinin, the anaphylotoxins C3a and C5a, and osteopontin . The inhibition of plasmin generation is also part of the anti-inflammatory activity of TAFI.
The present study aimed to assess plasma concentrations of TAFI and its association to different laboratory findings in SLE patients and whether it has a role as a biomarker for thrombotic complications in the disease.
The study included forty patients having SLE, in addition to 20age and sex matched healthy controls; SLE Patients were divided according to previous history of thrombotic events into two groups: first group including 20 patients with past thrombotic events and second group including 20 patients without.
All patients and controls were subjected to full history taking, full clinical examination and laboratory investigations including CBC , PT, PTT, fibrinogen level, ANA, antids-DNA, C3 and C4 and TAFI assay using ELISA.
The study has demonstrated that both groups of SLE patients had a highly significant increase in TAFI level compared to controls. Also there was a significant association between TAFI levels and ANA titres in those patients but no similar association with antids-DNA. Other complications were also correlated with elevated TAFI levels.
Diagnostic performance study using ROC curve analysis was applied to obtain the most sensitive and specific cut off level for TAFI above which the SLE patients will be more reliable to develop thrombotic complications. TAFI was >2.2ug/ml with 97.5% and 90% diagnostic sensitivity and specificity respectively.
In conclusion, the evaluation of TAFI by ELISA can be used as a diagnostic tool for SLE. The present results are suggestive of the role of Thrombin activatable fibrinolysis inhibitor in development of thrombotic complications in SLP patients. Also it was found to be a biomarker which is significantly associated with SLE renal and arthritis complications.