Značaj kliničkih i biohemijskih parametara za tok, prognozu i kvalitet života bolesnika sa sistemskim eritemskim lupusom

Abstract

Successful treatment and control of SLE requires precise assessment of disease activity and quality of life, as well as determination of biologic markers in order to administer proper therapy, to achieve disease remission, or to prevent or delay damage to the involved organs and treatment complications. This paper aimed to assess disease activity, degree of organ damage, and quality of life of SLE patients, using appropriate questionnaires and establishing their correlation; to determine the prevalence, specificity, and sensitivity of anti-nucleosome antibodies, anti-C1q antibodies, and serum and urinary monocyte chemoattractant protein-1 (MCP-1), and to identify their possible association with active forms of SLE and lupus nephritis. The studied group comprised 85 SLE patients, while 30 healthy examinees comprised the control group. In all examinees, in addition to standard clinical examination and supplementary diagnostic procedures, the levels of anti-nucleosome antibodies, anti-C1q antibodies, and serum and urinary MCP-1 were determined by way of the ELISA method. Disease activity was also assessed using the SLEDAI, ECLAM, and LAI questionnaires and by way of global physician assessment; organ damage was assessed using the SDI damage index, quality of life was assessed using the SF-36 questionnaire, and fatigue severity was measured using the FSS fatigue scale. Based on the completed study, a conclusion may be drawn that disease activity did not correlate with organ damage, quality of life, and fatigue severity. Anti-C1q antibodies and simultaneous positivity of anti-nucleosome, anti-C1q and anti-dsDNA antibodies were associated with lupus nephritis activity. Urinary MCP-1 demonstrated a highest association with active lupus nephritis forms, being in high positive correlation with the degree of proteinuria and in negative correlation with glomerular filtration rate.