الفهرس 
SYSTEMIC LUPUS ERYTHEMATOSUSOnly 14 pages are availabe for public view
 |  | from | 183 |  |  |
| | | from | 183 | | |
Abstract
Introduction: Lupus nephritis (LN) affects almost two-thirds of Systemic lupus erythematosus (SLE) patients. Renal biopsy is the gold standard for the diagnosis of LN. However, repeated biopsies are not always performed in clinical practice, and they carry some risk. For that reason, minimally invasive techniques, such as urinary biomarkers, are a promising tool for the diagnosis and monitoring of SLE. Conventional serum markers for LN lack the sensitivity of an ideal biomarker. Several clinical studies have evaluated urinary MCP-1 in patients with SLE, reporting significantly higher levels of urinary MCP-1 in those patients with active LN than with non-active LN. In addition, some authors reported higher levels of urinary MCP-1 in patients with proliferative forms (III and IV) of LN.
Objectives: To assess of relation between urinary biomarker Monocyte chemoattractant protein-1(MCP-1) and different histopathological stages of lupus nephritis and activity and chronicity indices, find out a cheaper, less invasive diagnostic tool for patients with active lupus nephritis.
Patients and Methods: 40 SLE patients fulfilling American college of Rheumatology criteria for SLE with biopsy-proven LN class II, III, IV or V. They were selected from internal medicine department and Outpatient clinic in Ain-Shams University Hospitals, 20 patients with inactive lupus nephritis as control group.
Results: In active LN patients: Mean Creatinine was 1.71 ± 0.55 mg/dl in active cases, 0.84 ± 0.10 mg/dl in control group. Mean MCP-1 level 618.4 ± 294.2 ng/l in patients with active lupus nephritis and 120.05 ± 87.53 ng/l in patients with inactive lupus nephritis. Based on ROC curve, we found a better diagnostic performance of MCP-1 than conventional biomarkers. The area under the curve was 0.990 and the best cut-off level was >245 ng/L (sensitivity 97.5 %, Specificity 95 %).
Conclusion: Urinary MCP-1 was able to distinguish active from inactive renal disease. It has a consistently good diagnostic performance with a high sensitivity and specificity for detection of LN activity. Thus, it can be added to the panel of biomarkers either in urine or in renal biopsy, urinary MCP-1 also provides noninvasive tool to distinguish between different histopathological classes of active lupus nephritis.