C4d deposits on circulating erythrocytes as a biomarker for active lupus nephritis / Hala Ramadan Hashem ; Supervised Hanan Abdelhalim Abdelrehiem , Mona Salah Eldin Hamdy , Wesam Ismail Mostafa

Thesis (Ph.D.) - Cairo University - Faculty of Medicine- Department of Internal Medicine

Background: Lupus nephritis (LN) is one of the most severe SLE manifestations. Anti-ds DNA titres and C3 &C4 have been used to monitor patients with LN. An accurate determination of the activity of LN is by a kidney biopsy. C4d levels in plasma & renal tissues correlate with the degree of LN activity (James, et al,2005). Objective: Assessment of E-C4d &G-C4d deposits in LN patients and determine if there is a correlation between E- C4d &LN activity. Subjects and methods: number of participants in this study was 61 classified as follow (15 lupus nephritis, 15 renal disease non lupus, 16 lupus non nephritis and 15 healthy subjects). All patients were subjected to careful history, thorough clinical examination and the following laboratory tests: CBC, ESR, serum albumin, serum creatinine, Urine analysis, ANA, Anti dsDNA, serum C3& C4, anticardiolipin (IgG&IgM) and urine albumin/creatinine ratio. C4d on RBCs were measured by flow cytometry.Histopathological evaluation of renal biopsies and immunohistochimestry staining for C4d for LN & renal disease non lupus patients. Assessment of SLEDAI for SLE patients. Results: E-c4d&G-c4d deposits were significantly higher in LN patients compared to control groups.There is a correlation between E-C4d and lupus nephritis activity.Conclusions: E-C4d is correlated with LN activity, so it might help in using E-C4d as a biomarker in detection of lupus nephritis activity

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