الفهرس 
Juvenile-onset systemic lupus erythematosus (jSLE)
Renal manifestationsOnly 14 pages are availabe for public view
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Abstract
SLE is a multisystem chronic autoimmune disease. Disease development has been related to dysregulated apoptosis. (181)The decreased clearance of apoptotic bodies and the accelerated apoptosis of circulating lymphocytes lead to the release of increased amounts of intact nuclear antigens and defect in clearance of these nuclear antigen lead to inflammation, auto-antigen exposure drive to an autoimmune response and combine with autoantibodies to form immune complexes.(182) Recent studies showed a clear global change in immunological architecture. Studies have found either normal or increased or decreased levels of CD8+ T cells and a decrease in CD4+ T cells, with a consequent decrease of the CD4+ /CD8+ T cell ratio in jSLE patients.(183) Aim of the work to evaluate the role of apoptosis through measuring level of annexien V, CD4, CD8 and the ratio between them in the jSLE with >relation to disease activity and LN. This case-control study was carried out in Pediatric department in Tanta University and Immuno-genetic Division at National Research Centerin 12 months from June 2020 to May 2021 upon 50
patients with SLE according to ACR criteria and age <18 years The patients were classified into 2 groupsG1: twenty five patients with active jSLE (SLEDAI >4) and G2:twenty five patients with inactive jSLE (SLEDAI≤4) and G3:twenty
five healthy controls. The study was approved by the Ethical Committee of Faculty of Medicine, Tanta University with acceptance No. 31926/11/17 Methods Participants included in this study were subjected to the following:
Full history such as personal history, family history, drug history and surgical history was done.Physical examination: General examination (general appearance, vital signs & anthropometric measures).Organ examination (Skin lesions, Mucous membranes, Musculo-skeletal, Neurological, Respiratory, Cardiac, Abdominal,
Extremities and lymph node, visual and auditory.
Laboratory investigations: Routine laboratory investigations including CRP, ESR, Complete blood count (HB, TLC and PLTs), Renal functions (Urea, Creatinine and Ptn in 24hs), Liver functions (ALT, AST and albumin level),
Urinalysis( RBCs and casts) and Complement levels(C3 and C4) Immunological laboratory investigations including (ANA), Anti-DNA antibodies, Anti-Smith, Anti-RO, Anti-LA, Coomb’s test, Lupus anticoagulant
antibodies (LAC), Anticardiolipin antibodies (ACL), Beta 2 glycoprotein
antibodies (B2GP)< Specific immunological laboratory tests for the research study: All by the
flow cytometry assays were performed within 2-3 hours after blood extraction to ensure that the results were as close as possible to the in vivo situation early apoptosis (Annexin V Staining) and CD4, CD8 and CD4/ CD8 ratio.