الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Systemic lupus erythematosus (SLE) is a chronic autoimmune condition with multi-system involvement. One of the main causes of death in systemic lupus erythematosus (SLE) is infection (Navarra and Leynes, 2010). Often the clinical symptoms of infection are very similar to those of active lupus, making it difficult to identify the presence of an infection (AlJarhi et al., 2021). Types of infections in systemic lupus erythematosus (SLE) patients vary widely. They may be bacterial, viral, fungal or parasitic (Yuan et al., 2020).
Several laboratory markers have been studied for the differentiation between infection and disease activity in systemic lupus erythematosus (SLE) patients.
In this study we aimed to detect the role of Procalcitonin (PCT), Erythrocyte Sedimentation Rate/C-reactive protein ratio (ESR/CRP ratio), neutrophils to lymphocytes ratio (NLR) and platelets to lymphocytes ratio (PLR) in diagnosis of infection in SLE patients with fever, the diagnostic value of these markers to distinguish between infection and disease activity and their correlation with disease activity.
Forty systemic lupus erythematosus (SLE) patients and forty healthy control cases were included in this study and they were subjected to: full history taking, clinical examination, laboratory investigations. The systemic lupus erythematosus (SLE) patients were further subdivided according to clinical manifestations of infection and culture into infected systemic lupus erythematosus (SLE) patients (group Ι) and noninfected (group Ⅱ), the disease activity was measured by systemic lupus erythematosus disease activity index 2000 (SLEDIA-2K) and the quality of the life was measured by LupusQoL.
We found that there was a significance difference between infected systemic lupus erythematosus (SLE) patients (group Ι) and noninfected systemic lupus erythematosus (SLE) patients (group Ⅱ) as regarding; neutrophils to lymphocytes ratio (NLR) (p=0.023), erythrocyte sedimentation rate (ESR) (p=0.002), c-reactive protein (CRP) (p=0.005), erythrocyte sedimentation rate to c-reactive protein (ESR/CRP) ratio (p=0.002) and procalcitonin (PCT) (p<0.001), but there was no statistically significant difference regarding hemoglobulin (Hb), white blood cells (WBCs), lymphocytes, platelets and in platelet to lymphocyte ratio (PLR) (p>0.05) between infected and noninfected systemic lupus erythromatosus (SLE) patients.
Our study also found a statistically significant correlation between infection and neutrophils to lymphocytes ratio (NLR) (p=0.021), erythrocyte sedimentation rate (ESR) (p=0.001), c-reactive protein (CRP) (p=0.002), erythrocyte sedimentation rate to c-reactive protein (ESR/CRP) ratio (p=0.001) and procalcitonin (PCT) (p<0.001) in systemic lupus erythromatosus (SLE) patients.
In the other hand, we found no significance difference as regarding neutrophils to lymphocytes ratio (NLR), erythrocyte sedimentation rate to c-reactive protein (ESR/CRP) ratio and procalcitonin (PCT) between SLE patients with moderate to severe activity and mild activity. Also there was no significant correlation of inflammatory markers (neutrophils to lymphocytes ratio (NLR), erythrocyte sedimentation rate to c-reactive protein (ESR/CRP) ratio and procalcitonin (PCT)) with disease activity.
Our study revealed that procalcitonin (PCT) is a predictor, more sensitive and specific than other laboratory investigations in diagnosis of infection in systemic lupus erythromatosus (SLE) patients within the 1st 48h after the beginning of fever in systemic lupus erythromatosus (SLE) patients.