الفهرس 
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Abstract
Systemic lupus erythematosus (SLE) is an autoimmune disease in which the body’s immune system mistakenly attacks healthy tissue in many parts of the body. Symptoms vary between people and may be mild to severe. Common symptoms include painful and swollen joints, fever, chest pain, hair loss, mouth ulcers, swollen lymph nodes, feeling tired, and a red rash which is most commonly on the face. Often there are periods of illness, called flares, and periods of remission during which there are few symptoms (Lisnevskaia et al. 2014).
Systemic lupus erythematosus (SLE or lupus) is a systemic autoimmune disease characterized by generation of autoantibodies particularly against components in the cell nucleus (Rahman and Isenberg 2008).The current work hypothesized that low serum sodium level could be a determinant of lupus inflammatory activity.
Hence, the aim of the study design was to evaluate theHyponatremia in lupus disease could be related tovariable factors including medications, namely diuretics,and renal sodium loss due to renal tubular injury throughthe immune-mediated pathways by the infiltration of interstitium with inflammatory complexes and tubular membrane damage, leading to acute kidney injury (AKI). (Kinloch AJ, et. al2014)So, patients with tubule-interstitial nephritis proven by renal biopsy were excluded from this study. There is no well-established association between hyponatremiaand SLE other than with renal disease causing a reduction in renaltubular sodium absorption and sodium loss as a consequence tochronic inflammation (Eisenhut M2006) and with some pharmacological therapies (Jayachandran NV et. al2008). Therefore, patients with renal failure and those on CYC therapy were excluded in order to investigate the relationship between hyponatremia and disease activity. The exact mechanism of the development of hyponatremia in SLE diseases is notestablished yet. However, the (SIADH) secretion which is the mostcommon cause of eurvolemic hyponatremia had been reported in SLE patients (Martín JS etal1996) (Elisaf MS etal1999) (Mirsattari SM et al 1998).
Hypophosphatemia is observed not only in genetic diseases such as X‐linked hypophosphatemia (Drezner, et. al. 2000) autosomal dominant hypophosphatemia, and McCune–Albright syndrome (Yamamoto, et al 1996)but also in acquired states including tumor‐induced osteomalaciaand malnutrition. Recent studies have revealed that fibroblast growth factor 23 seems to play a key role in phosphate metabolism, (White, et al 2001) .although mechanisms of hypophosphatemia in these conditions are not fully understood. A recent report showed that serum phosphorus concentrations were decreased in early sepsis, and tumor necrosis factor α (TNF‐α) and interleukin 6 (IL‐6) were suggested to be causes of hypophosphatemia in this pathologic condition. (Barak ,et al1998), In SLE, those cytokines have been shown to be involved in the disease activity,which led us to speculate about whether P metabolism in SLE might be aberrant, especially in patients with active disease.,(IKUMA et al 2003) The pathogenesis of hypophosphatemia in SLE patients is currently unknown. As both TNF-α and IL-6 significantly correlated with serum P concentrations, it is possible that these cytokines may reduce serum P directly or indirectly (Del Giglio A et. al1991). Reported that, in patients with liver metastases, hepatic arterial infusion of recombinant TNF induced severe hypophosphatemia in a dose-related manner. (Barak et. Al 1998).Recently reported high incidence of hypophosphatemia in early sepsis and demonstrated significant association between serum P concentrations and inflammatory cytokines such as TNF-α and IL-6.8(Ikuma Fujiwara et al 2003)
In our study patients were included 94 females (94%) and 6 males (6%) with a the mean was 34.2 years
Measuring and study of SLE associated with electrolytes change especially Na and P reveal associated changes, in our study we found statistically significant change between hyponatremia and hypophosphatemia and SLE activity. So hyponatremia and hypophosphatemia maybe used as predictors for activity.