Title: A Study on Clinical and Immunological pattern of Systemic Lupus Erythematosus patients in a Tertiary care Hospital – A Retrospective Study
Authors: Dr Uthaya Sankar M. K, Dr Nivethini.N, Dr Rangarajan D.V
DOI: https://dx.doi.org/10.18535/jmscr/v12i08.15
Abstract
Introduction
Systemic Lupus Erythematosus (SLE) is a Chronic Multisystem Autoimmune disorder that exhibits a wide spectrum of clinical and immunological abnormalities ranging from localized cutaneous involvement to life-threatening systemic involvement. The heterogeneity of SLE manifestations is due to an interplay of genetic, environmental, and hormonal influences[1]. Onset occurs commonly in women of reproductive age, in the third and fourth decades of life, with a Male: Female ratio of about 1:10. The clinical course of the disease is unpredictable with periods of remission and flares.
Multiple organ involvement is common in SLE including the Skin, Joints, Central Nervous System and Kidneys leading to long-term morbidity and mortality [2]. Moreover, Lupus-specific Skin lesions (e.g., Malar rash and Discoid rash) serve primarily as important diagnostic clue, whereas Lupus nonspecific skin lesions (e.g., alopecia and purpura) are associated with more active disease and thus require more aggressive therapy and disease monitoring [3].
The wide spectrum of clinical manifestations in patients with SLE is partially caused by pathogenic autoantibodies. The autoantibodies may potentially target their corresponding autoantigens in the Cell Nuclei, Cytoplasm, Cell-surface membrane, Serum components, Extracellular matrix substances and miscellaneous molecules [3].
Some of these Autoantibodies such as Anti-dsDNA, Antiribosomal P, Anticardiolipin, and Anti-SSB/La are indeed pathogenic as they bind to surface-expressed cross-reactive antigens. These pathogenic autoantibodies not only directly damage the tissues to promote the release of more nuclear antigens, but derail innate and adaptive immune functions. The vicious cycle caused by these pathogenic autoantibodies sustains the chronic immunological and inflammatory abnormalities in patients with SLE[3]. In this study, the Clinical Spectrum of manifestations and Various Systems involved and Immunological pattern in Systemic Lupus Erythematosus patients is studied.
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