الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Systemic lupus Erythromatosis (SLE) is an autoimmune disorder that affects multiple organ systems including the skin, kidneys, and brain. The exact cause is unknown but genetic factors, ethnic origin, environmental factors, and medications may all be involved in its development. Clinical features are highly variable, ranging from skin and joint involvement to organ threatening and life threatening disease. SLE is typically associated with waxing and waning clinical course, but some patients have continuous disease activity. Osteoporosis, a disease characterized by reduced bone mass and increased skeletal fragility. Osteoporosis is common in SLE patients. Inflammation or SLE-related medications can increase bone turnover, which eventually weakens bone architecture, then reduces bone strength and increases the risk of fracture . The current study aimed to evaluate BMD in patients with SLE. In order to evaluate this, we examined BMD using DEXA scan and measurement of Intact PTH. In the current study, we examined 30 lupus patients that were divided into 2 groups. One group included 15 newly diagnosed patients (Group II) and the other one included 15 treated lupus patients (Group III). The diagnosed as SLE met 4 or more criteria of ACR for SLE. SLEDAI & SLICC/ACR index were made for all patients. We had 10 healthy adult persons as a control (Group I). Treated lupus patients received treatment in the form of corticosteroid and immunosuppressive drugs (Azatioprine , CYC , Mycophenolate Mofetil). Care was taken to exclude patients with renal impairment (S. creatinine > 1.4), patient with parathyroid disorders or other endocrinal disorder, prolonged immobilization, chronic liver disease, otherconnective tissue diseases, malignant diseases and pregnancy or breast feeding. All patients were subjected to thorough history taking, physical examination, investigations including complete blood count, liver profile , blood urea and s. creatinine, serum electrolyte, erythrocyte sedimentation rate, C-reactive protein, urine analysis, alk. Ph., ANA , anti ds DNA , intact PTH and DEXA scan . The present study revealed that: - According to distribution of diagnostic features of SLE ( Malar rash , photosensitivity , oral ulcers , discoid rash , Artheritis , serositis and cerebral manifestations ). 100 % of diagnosed lupus patients had Oral ulcers . Malar rash , photosensitivity , arthritis and cerebral manifestations were present in newly diagnosed lupus patients and treated lupus patients as 93.3 % , 86.7 %, 66.6 % and 6.7 % respectively. Discoid rash was present in 13.3 % of newly diagnosed lupus patients . Serositis was present in 26.7 % of newly diagnosed lupus patients . - 33.3 % of newly diagnosed lupus patients had prolonged fever as a presentation. - ESR is significantly higher in newly diagnosed lupus patients . - C3 and C4 are significantly lower in newly diagnosed lupus patients reflecting disease activity. - CRP is negative in studied SLE patients. - All diagnosed lupus patients have positive ANA and anti ds DNA . - Patients with SLE have low BMD in comparison to healthy adults of same age and gender. - 40% of newly diagnosed lupus patients had osteopenia, 60% of treated lupus patients had osteopenia and 20% had osteoporosis. - Most of patients with low BMD were on Azathioprine treatment-There is no significant effect as regard duration of treatment of SLE and dose of steroid on BMD . - Females are the most affected with low BMD as most of studied SLE patients were Females - Patients with SLE, who have low BMD, have high ESR , low Hemoglobin and lower C3 and C4 - There is a significant correlation between Z score and po4--- and Intact PTH of newly diagnosed lupus patients. - There is a significant correlation between T score and Z score and Hemoglobin level of treated lupus patients. - There is no significant difference in BMD between newly diagnosed lupus patients and treated lupus patients as regard SLEDAI and SLICC/ACR damage index.