الفهرس 
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Abstract
Introduction: Systemic lupus erythematous (SLE) is a chronic systemic autoimmune disease of different severity and course, featured by a tendency for flare. Lupus nephritis (LN) is among the most devastating SLE manifestations. LN affects 30 percent to 50 percent of all SLE cases, and 20 percent of affected cases acquire end-stage renal disease. LN is linked to a 4 fold rise in morbidity and mortality rates. Aim: Assessment of the relation between level of plasma endocan and activity in patient with systemic lupus and Lupus Nephritis. Patients and Methods: The study was conducted on a total of 89 patients with SLE divided into three groups active LN (30 patients),remittent LN (30 patients) and active lupus without nephritis (29 patients). Both male and female aged 18-60 years were included and recruited from patients attending the nephrology and rheumatology department and clinics ,Mansoura university hospitals, for one year duration between July 2021 and July 2022. All patients were subjected to: complete history taking , clinical examinations, laboratory investigations including complete blood count, serum creatinine, liver function tests (albumin, SGOT, SGPT, bilirubin), CRP, serum calcium, serum phosphorus, assessment of SLE activity: Anti ds-DNA, Erythrocyte sedimentation rate (ESR), serum C3 and C4, assessment of proteinuria: urine analysis, 24-hour urinary protein, urinary albumin/creatinine ratio or urinary protein/creatinine ratio, virology screen(HCV Ab, HBsAg, HIV) and serum endocan, abdominal ultrasound and renal biopsy when indicated. Results : The study revealed serum endocan was statistically significantly higher than the median of 1.0 ng/ml for the whole cohort and for each group (p < 0.001). Serum endocan is not a statistically significant discriminator between all three groups. However, serum endocan was found to be a sensitive marker in discriminating lupus nephritis (groups 1 & 2) vs. lupus without nephritis (group 3) at a cut-off value of ≤291.38 with 85% sensitivity. Also, serum endocan was found to be a sensitive marker in discriminating active lupus with and without nephritis (groups 1 & 3) vs. remittent lupus (group 2) at a cut-off value of ≤413.39 with 98.3% sensitivity. The research revealed a statistically significant difference in serum endocan between the different classes of lupus nephritis. Post-hoc analysis revealed that this difference existed between class IV vs. class II (p = 0.045). It also demonstrated that serum endocan level is a statistically significant very good discriminator of grades III/IV vs. grades II/V at a cut-off value > 254.37 ng/L with 100% specificity and PPV. The results showed no statistically significant difference in serum endocan between those with and without arthritis, neuro-psychiatric, and muco-cutaneous manifestations. Conclusion: Serum endocan level increased in SLE patients which is plausible as SLE is an autoimmune and inflammatory disease. Endocan could serve as a discriminator between proliferative and non-proliferative classes of LN together with the other markers of LN. Yet, the results don’t suggest that it could be considered as a reliable marker in diagnosing LN or active SLE without nephritis.