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Abstract Background: Systemic lupus erythematosus (SLE) is a systemic autoimmune condition with a wide spectrum of clinical manifestations and unpredictable disease activity. There are various clinical and laboratory methods to assess the lupus activity. Objectives: Assessment of the possible relationship between D- dimer combined with Red cell distribution width (RDW) and activity of systemic lupus erythematosus. Subjects and methods: This cross-sectional study was conducted on 50 subjects: 25 SLE patients with active disease, 25 SLE patients with inactive disease and 25 healthy subjects as a control group. The activity was scored according to SLEDAI-2K, All candidates were subjected to thorough full history taking, complete clinical examination, and laboratory investigations including complement (C3,C4) ,antinuclear antibody (ANA), anti-douple stranded DNA (anti-dsDNA), D-dimer, RDW and systemic lupus erythematosus disease activity index (SLEDAI) were estimated. Results: The mean level of RDW in the SLE active group ±SD of (16.90 ± 1.27) was significantly higher than that in the SLE inactive group ±SD of (14.38 ± 1.01) and control group ±SD of (13.37 ± 0.99),with statistically significant difference (p < 0.001). The median (IQR) of D-dimer in the SLE active group was 450 (300-550), which was significantly higher than that in SLE inactive group 144 (120-160) and control group 80 (70 - 100), with statistically significant differences (p < 0.001). Both RDW and D-dimer were positively correlated with the SLEDAI score (r = 0.999, p > 0.001), (r = 0.671, p > 0.001). The results of receiver operating characteristic curve showed that the area under the curve of RDW and D-dimer alone was 0.945, 0.961, respectively, while the area under the curve of RDW combined with D-Dimer was the largest 0.986. |