Résumé
Background: Systemic lupus erythematosus [SLE] is a multi-factorial, chronic autoimmune disorder, characterized by dysfunction of T and B lymphocytes. It affects various vital organ systems, and 70% to 90% of SLE patients are females. Lupus nephritis [LN] is one of the common complications in patients with SLE and influences overall outcome of these patients. About two-thirds of patients with SLE have renal disease at some stage which is a leading cause of mortality in these patient .Iron is critical in nearly all cell functions and the ability of a cell, tissue and organism to procure this metal is obligatory for survival. Iron is necessary for normal immune function, and relative iron deficiency is associated with mild immunosuppression. Concentrations of this metal in excess of those required for function can present both an oxidative stress and elevate risks for infection. As a result, the human has evolved to have a complex mechanism of regulating iron and limiting its availability. Ferritin levels correlate with disease activity in patients with SLE and developing of lupus nephritis
Objective: To correlate between Iron profile and SLE activity and developing lupus nephritis
Materials and Methods: A prospective study was conducted on 75 adult persons: 25 Patients with SLE with proteinuria, patients with SLE without proteinuria, 25person have no SLE [control group].These person were Admitted at internal medicine department and outpatient clinic of Al-Hussein university hospital, Cairo, Egypt. SLE patients were diagnosed according to the American College of Rheumatology [ACR] criteria, Lupus Activity assessment by C3 and C4, Lupus nephritis assessment using Albumin /creatinine ratio. Iron profile was measured and included: serum iron, serum TIBC, transferrin saturation and Serum ferritin levels were tested by ELISA
Results: There were no significant statistical difference between groups as regard age or sex however, There were significant difference between groups as regard S.iron, S. ferritin, TIBC and TSAT, Between group analysis results showed significantly lower s.iron and TSAT level of SLE patients with and without proteinuria in comparison with control group. While S. ferritin is significantly high in SLE patients with proteinuria in comparison with SLE patients without proteinuria and control group. And this data go with activity markers of SLE
Conclusions: 1] Hyperferritinemia is a useful marker in assessment of disease activity and severity of Albuminuria in SLE patients complicated by lupus nephritis, treatment of hyperferritinemia can result in decreased Albuminuria and delayed renal damage. 2] Iron homoeostasis is important in normal immune function and Iron disturbance can result in mild immunosuppression