الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
SLE is a chronic autoimmune inflammatory disease that affects any part of the body. Although the specific cause of SLE is unknown; many genetic susceptibility factors, environmental triggers, antigen antibody responses, B and T cell interactions and immune clearance processes interact to generate and perpetuate autoimmunity. SLE is a disease of young women, but may occur from infancy to old age. Symptoms vary from person to person, and may come and go, depend on what part of the body is affected. The SLE disease can be mild, moderate or sever. Hematological abnormalities (thrombocytopenia, leucopenias and anemia) are among the commonest manifestations seen in SLE disease. They result from the immune mediated bone marrow failure, inflammations, excessive peripheral cells destruction, certain drugs and infections.
Red cell distribution width is one of the parameters routinely reported in complete blood count test. RDW is a quantitative measure of the heterogeneity of the volume of red blood cells with higher values reflecting greater heterogeneity in cell sizes (anisocytosis). It is originally used together with the mean corpuscular volume in clinical practice to differentiate between causes of anemia. RDW has been reported as an inflammatory biomarker in various conditions.
This This This This This study aimed to evaluatestudy aimed to evaluatestudy aimed to evaluatestudy aimed to evaluatestudy aimed to evaluatestudy aimed to evaluatestudy aimed to evaluatestudy aimed to evaluatestudy aimed to evaluatestudy aimed to evaluatestudy aimed to evaluatestudy aimed to evaluatestudy aimed to evaluatestudy aimed to evaluatestudy aimed to evaluatestudy aimed to evaluatestudy aimed to evaluatestudy aimed to evaluatestudy aimed to evaluatestudy aimed to evaluatestudy aimed to evaluatestudy aimed to evaluatestudy aimed to evaluate RDW in lupus patients as an activity marker.
Summary, Conclusion and Recommendation
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The study included 60 SLE patients. Lupus patients were classified by the 2012 SLICC classification criteria. Lupus activity was measured and graded by SLEDAI score. Patients were subdivided according to grades of the disease activity into 20 systemic lupus patients with high activity (group I) and 38 systemic lupus patients with very high activity (group II). Two female patients presented with moderate activity but we had to exclude them due to small number.
SLE Patients with pregnancy, Infections, other causes of anemia, other connective tissue disease or malignant diseases were also excluded from the study.
All patients were subjected to thorough history taking, physical examination and investigations including ANA, anti ds DNA, C3, C4, anticardiolipin antibodies, lupus anticoagulant, urine analysis, urine protein/ creatinine ratio, CBC, reticulocytes, iron profile, ESR, CRP, kidney function tests and liver function tests.
The study revealed that all SLE patients had a positive ANA and anti ds DNA.ESR .ESR was was was high in our lupus patients.C3 high in our lupus patients.C3 high in our lupus patients.C3 high in our lupus patients.C3 high in our lupus patients.C3 high in our lupus patients.C3 high in our lupus patients.C3 high in our lupus patients.C3 high in our lupus patients.C3 high in our lupus patients.C3 high in our lupus patients.C3 high in our lupus patients.C3 high in our lupus patients.C3 high in our lupus patients.C3 high in our lupus patients.C3 high in our lupus patients.C3 high in our lupus patients.C3 high in our lupus patients.C3 high in our lupus patients.C3 high in our lupus patients.C3 high in our lupus patients.C3 high in our lupus patients.C3 high in our lupus patients.C3 high in our lupus patients.C3 high in our lupus patients.C3 high in our lupus patients.C3 and C4 were low and C4 were low and C4 were low and C4 were low and C4 were low and C4 were low and C4 were low and C4 were low and C4 were low and C4 were low and C4 were low and C4 were low and C4 were low in thethethe studstudstudstudied ed ed lupus patientslupus patientslupus patientslupus patientslupus patientslupus patientslupus patientslupus patients lupus patientslupus patientslupus patientslupus patientslupus patients. There was no association between SLE activity and age, sex or the duration of the disease. CRP is negative in CRP is negative in CRP is negative in CRP is negative in CRP is negative in CRP is negative in CRP is negative in CRP is negative in CRP is negative in CRP is negative in CRP is negative in CRP is negative in CRP is negative in CRP is negative in CRP is negative in CRP is negative in all all thethethe studied SLEstudied SLEstudied SLEstudied SLEstudied SLEstudied SLE studied SLE studied SLE patients.patients. patients.patients. patients.patients.patients.
RDW value was higher in lupus patients with very high activity than in those with high activity. There was a highly significant correlation between RDW and the SLEDAI score. There was a highly significant correlation between RDW and ESR.
Summary, Conclusion and Recommendation
63
from this study we concluded that there was a statistically significant more increasing in RDW value in lupus patients with very high activity than in those with high activity. By analysis the ROC curve for RDW; the cut-off value was17.5, with a sensitivity of 89.5% and specificity of 90.9% for lupus patients with very high activity; so RDW could be a sensitive, specific, simple, fast and cost effective marker of lupus activity.
Because it is been the first time (to our knowledge) where the RDW value is used as a marker of lupus activity we may recommend ,after reducing the limiting factors of this study, further researches to determine whether RDW could be a valuable marker of lupus activity.