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Original Research

Acta Inform Med. 2008; 16(4): 191-196


Processing and Analysis of Clinical-laboratory Features in the Therapy of Lupus Nephritis

Dzelaludin Junuzovic, Senad Bajramovic.




Abstract

Introducrion: Computers and information technology significantly improve the work in various laboratories (clinical-biochemistry, hematology, immunology, cytology, etc) since it automates the testing and speeds up delivery of findings. The number of completed clinical-laboratory analysis in the developed countries shows high rate of growth that annually ranges from 10-17. Systemic lupus erythematosus is the disorder of immune regulation which is manifested by activation of T and B lymphocytes, production of antibodies, and the formation of immune complex causing damage to tissues. SLE is a disease that progresses over time and has been intriguing to the doctors for more than a century while holding being a prototype of autoimmune disease. Kidney function loss is the most serious complication of SLE which represents a threat for long-term survival. Goal: The aim is to show the clinical and laboratory parameters of lupus nephritis and principle of therapeutic protocol for the treatment of lupus nephritis using aggressive immunosuppressive therapy at the Institute of Nephrology of Clinical Center of the Sarajevo University by monitoring activity of disease. Patients and methods: Randomized retrospective study includes 14 patients with SLE and lupus nephritis that are treated at the Institute of Nephrology of Clinical Center University of Sarajevo in the period from the beginning of 2000 to 2003. Discussion: In our retrospective study, all patients were females with mean age of 34.5±13.5 years. Mean age at the beginning of SLE was 30.5±12.5 years. Most often clinical manifestations observed in patients with SLE are general ones (85.7%) - skeletal muscle (64.3%), skin (78.6%), hematologic (64.3), cardiac and pulmonal (42.9), neurologic (21.4%), thrombosis (35.7%), eye (14.3%) and abortion (7%). Conclusion: Females in reproductive age have SLE and lupus nephritis more frequently , which indicates that hormonal status (estrogen) has important role in illness pathogenesis. Most relevant parameters in evaluation of illness activity are the levels of complement components C3 and C4, level of antidsDNA, activity of urine sediment and proteinuria level. Aggressive immunosuppressive therapy that includes corticosteroids and cyclophosphamide, with control of side effects and its prevention, and duly treatment can lead to improvement of clinical symptoms and improvement of patient life. As long as new therapeutic modalities and more efficient treatment of autoimmune illnesses is not available, the greatest impact on mortality and morbidity can be achieved by monitoring late manifestations and treatment of extracranial manifestations that can lead to kidney function loss.

Key words: lupus nephritis, SLE, therapy, laboratory, clinical findings






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