Original article
English
Basma El-habbash, Rajab Tarsin, Khaled El-Muntaser
Department of Rheumatology, Tripoli Medical Centre, Tripoli, Libya
JMJ 2008,Vol.8, No.3:195-198
Abstract
The aetiology of systemic lupus erythematosus (SLE) is unknown, but autoantibodies, especially anti-double strand DNA antibodies (anti-dsDNA) are thought to play an essential part in the pathogenesis of this disease (1). Objectives: 1-To determine the relationship between anti-dsDNA and clinical manifestation of SLE. 2-Do anti-dsDNA antibodies predict the clinical manifestations of SLE? 3-To determine the mean of flare per patient in anti-dsDNA positive and negative patients. Methods: 130 patients, all fulfill the revised ACR criteria 1997 for SLE, who were registered in Rheumatology clinic in Tripoli Medical Centre were studied. Anti-dsDNA antibody levels at the start of disease were measured to all patients. Clinical manifestations initially and during flares and number of flares of both groups (anti-dsDNA positive and negative patients) were collected from the files of those patients. Results:130 patients enrolled in the study, all were females, their age was between (12-55) years and the mean duration of follow up was 45 months. 70 patients (54%) were anti- dsDNA positive and 60 patients (46%) were anti-dsDNA negative. Renal, serositis and haematological manifestations, as initial features, all were associated with anti-dsDNA positive group (disciminant coefficients = 0.5, 0.5, 0.4 respectively). Arthritis was weakly associated with anti-dsDNA positive group (discriminant coefficient= 0.1). No association was found between neurological manifestations and Anti-dsDNA (desciminant coefficients = – 0.02). Mucocutaneous manifestations were negatively associated with the anti-dsDNA (desciminant coefficients = – 0.1). The Anti-dsDNA positive group had a mean of 1.6 flares per patient and anti-dsDNA negative group has a mean of 1.9 flares per patient. No significant difference was found between both groups regarding type of flares (mucocutaneous, arthritis, renal, haematological, neurological, pulmonary and cardiac flares). P-value=0.135, 0.214, 0.793, 1.00, 0.360, 1.00, 0.632 respectively. Conclusion: 1-Anti-dsDNA antibodies, measured at the start of disease, were associated with certain clinical manifestations of SLE which are renal, serositis, haematological and articular features and can be used as a predictor for these initial features. 2-Anti-dsDNA antibodies, measured at the start of disease, will not predict the type and the number of subsequent flares.
Keywords: Anti-double strand DNA antibodies (anti-dsDNA), Systemic lupus erythematosus (SLE).
Link/DOI: http://www.jmj.org.ly/PDF/autumn2008/195.pdf