Comparative study of kidney affection in SLE patients with and without antiphospholipid syndrome

To evaluate the incidence, clinical associations and outcome of APS nephropathy in SLE patients with 2[ry] APS. We studied 64 female SLE patients with nephritis; 32 of them had 2[ry] APS [group 1] and the rest without 2[ry] APS [group 2]. Demographic, clinical and serological data were prospectively evaluated. Systemic lupus erythematosus disease activity index [SLEDAI] and Systemic Lupus International Collaboration Clinics/ACR damage index [SLICC] were assessed. Renal duplex, renal [99m]Tc-dimercaptosuccinic] scan [DMSA scan] and renal magnetic resonance angiography [MRA] were all used to detect renal vascular affection. There were statistically significant differences between the two examined groups regarding damage index [p = 0.000], hypertension [p = 0.02], thrombocytopenia [p = 0.000], LDL [p = 0.008], C3 [p = 0.01] and TMA [p = 0.04]. In group 1: MR angiography detected 7 patients with RAS: 5 patients with renal artery thrombosis that showed a significant association with TMA and proteinuria [p = 0.002, p = 0.004: p < 0.001, p = 0.02, respectively]. Patients with RAS had DBP, s.creatinine and TGs [p = 0.004, p = 0.005 and p = 0.0003, respectively]. Renal DMSA detected 6 patients with cortical scar which showed a significant association with TMA, proteinuria, livedoreticularis and arthritis [p = 0.001, p = 0.01, p = 0.04 and p = 0.03, respectively] those patients had DBP and RI [p = 0.000 and p = 0.006, respectively]. aPL testing should become a routine investigation in patients evaluated for RAS or renal infarctions especially with hypertension and unexplainable deteriorating renal function. To confirm our results we propose that larger scale, multicentre studies with longer evaluation periods

25-Hydroxy vitamin D levels and its relation to disease activity and cardiovascular risk factors in women with systemic lupus erythematosus

To evaluate the associations of serum 25 hydroxy [OH] vitamin D [25[OH]D] levels with cardiovascular risk factors as well as disease activity in women with SLE. Fifty women with SLE as well as 30 controls were included in our study. Data collected included, demographics, SLE activity and damage assessments, cardiovascular risk factors, medications and laboratory assessment of inflammatory markers and 25[OH]D levels. Stepwise logistic regression analysis were used to estimate the association of 25[OH]D levels with cardiovascular risk factors. A significant lower 25[OH]D levels was found in SLE patients compared to controls [P < 0.001]. A positive correlation was found between 25[OH]D and diastolic blood pressure, fasting blood sugar, cholesterol, triglycerides, LDL, BMI, as well as proteinuria and C3 levels. Furthermore, a significant positive correlation was found between 25[OH]D and the RT carotid artery stenosis and RT carotid artery plaque and the intima media thickness of both left and right carotid arteries. Lower 25[OH]D levels were also significantly associated with higher SLE disease activity and damage scores and steroid cumulative dose. Stepwise logistic regression analysis showed that higher BMI, diastolic blood pressure, cholesterol, triglycerides, LDL and diabetes mellitus act as predictors of lower 25[OH]D levels. Our study found an association between lower 25[OH]D levels and increased cardiovascular disease [CVD] risk factors, as well as increased SLE disease activity and damage indices. Future studies are needed to determine relation of 25[OH]D and cardiovascular risk factors in patients with lupus