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Document Type

Original Article

Abstract

Background: A crucial step in modifying the course of lupus nephritis is the early identification of kidney disease in systemic lupus patients. Lupus nephritis affects around 30% to 60% of SLE patients and 70% of juvenile SLE. Renal biopsy, which is an invasive procedure with hazards, is considered the gold standard to diagnose Lupus Nephritis. Ceruloplasmin (CP) is an acute phase protein that transports most of the circulating copper and functions as an iron oxidase that is associated to iron metabolism, and has been found that urinary exosomal Ceruloplasmin increased in kidney diseases due to local tissue pro-inflammatory cytokines such TNF-a, IL-6, and IL-1a. this study aimed to evaluate the utility of urinary ceruloplasmin as a new biomarker to differentiate lupus nephritis from non-nephritis, and to evaluate correlation to lupus activity. Patients and Methods: Case control study included sixty lupus patients and thirty controls. The case group subdivided into 30 Lupus nephritis (LN) & 30 Non-nephritis (NN) patients. The following were measured: CBC, ESR urine analysis, urinary Ceruloplasmin, serum creatinine, 24-hr protein in urine, eGFR (MDRD Equation), C3&C4, Anti-dsDNA, and ANA. Results: Elevated levels of urinary Ceruloplasmin were higher in lupus patients than controls and by further stratification; ceruloplasmin found to be greater in nephritis group than non-nephritis group, also, ceruloplasmin found to have a significant positive correlation to nephritis activity, and disease duration, and a negative correlation to eGFR, C3&C4 Conclusion: Urinary Ceruloplasmin has a potentiality to differentiate lupus nephritis from non-nephritis.

Keywords

Ceruloplasmin; Biomarker; Lupus Nephritis; SLE.

Subject Area

Rheumatology and Medical Rehabilitation

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