بررسی علایم بالینی و آزمایشگاهی بیماران مبتلا به لوپوس اریتماتوز سیستمیک در شهر اصفهان

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 دانشیار، گروه داخلی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

2 دستیار، گروه داخلی، دانشکده‌ی پزشکی و کمیته ی تحقیقات دانشجویی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

3 استادیار، گروه داخلی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

چکیده

مقدمه: لوپوس اریتماتوز سیستمیک یک بیماری التهابی با علت ناشناخته است که می‌تواند ارگان‌های مختلف بدن را درگیر کند. با توجه به تفاوت‌هایی که چهره‌ی بیماری در جوامع مختلف دارد، بر آن شدیم بیماران مبتلا به لوپوس شهر اصفهان را مورد مطالعه قرار دهیم.روش‌ها: 200 بیمار مبتلا به لوپوس طی سال‌های 84-1383 در درمانگاه روماتولوژی بیمارستان الزهرا (س) اصفهان مورد بررسی قرار گرفتند.یافته‌ها: بیماران در زمان مراجعه مبتلا به علایم عضلانی استخوانی (65 درصد)، خونی (57 درصد)، پوستی– مخاطی (52 درصد)، عمومی شامل تب، خستگی، ضعف و بی‌حالی (41 درصد)، کلیوی (28 درصد)، عروقی (14 درصد)، تظاهرات عصبی (12 درصد)، قلبی ریوی (11 درصد) و گوارشی (3 درصد) بودند. آنتی‌بادی ضد هسته در 92 درصد، آنتی‌بادی ضد DNA دو رشته‌ای در 81 درصد، CRP (C-reactive protein) در 25 درصد، آنتی کواگولانت لوپوسی در 5/72 درصد، آنتی کاردیولیپین IgM و IgG به ترتیب در 2/24 و 2/31 درصد از بیماران مشاهده شد. همچنین آنمی با هموگلوبین کمتر از 10 میلی‌گرم در دسی‌لیتر در 5/24 درصد (49 بیمار)، لکوپنی با گلبول سفید کمتر از 4000 سلول در میلی‌متر مکعب در 19 درصد (38 بیمار) و ترمبوسیتوپنی با پلاکت کمتر از 150000 سلول در میلی‌متر مکعب در 9 درصد (18 بیمار) بیماران مشاهده گردید. ESR (Erythrocyte sedimentation rate) بالای 30 میلی‌متر مکعب در ساعت نیز در 55 درصد از بیماران دیده شد. 5/51 درصد بیماران هموگلوبین کمتر از 5/11 میلی‌گرم در دسی‌لیتر داشتند.نتیجه‌گیری: با توجه به تنوع علایم در بیماران مبتلا به لوپوس و تأثیر آن‌ها بر پیش‌آگهی بیماری زمینه‌ای، انجام معاینات دقیق به طور معمول و به محض تشخیص لوپوس در این افراد ضروری به نظر می‌رسد.

کلیدواژه‌ها


عنوان مقاله [English]

Clinical and Laboratory Signs among Systemic Lupus Erythematosus Patients in Isfahan

نویسندگان [English]

  • Zahra Sayed Bonakdar 1
  • Siavash Nasiri 2
  • Mansoor Karimifar 3
  • Hadi Karimzadeh 1
  • Mansour Salesi 3
  • Peyman Mottaghi 1
1 Associate Professor, Department of Internal Medicine, School of Medical Sciences, Isfahan, Iran
2 Resident, Department of Internal Medicine, School of Medicine And Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
3 Assistant Professor, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
چکیده [English]

Background: Systemic lupus erythematosus is an inflammatory disease with unknown etiology which affects different organs in the body. Since lupus has different features in various ethnic groups, we decided to evaluate lupus patients in Isfahan, Iran.Methods: In this study, 200 patients (183 women and 17 men) with definitive diagnosis of the disease were evaluated in the rheumatology clinic, Alzahra Hospital, Isfahan, Iran, during 2004-2005.Findings: The mean age of patients was 31.6 ± 10 years. Clinical signs and symptoms due to which the patients referred to the clinic for first time referred included musculoskeletal symptoms (65%), hematological symptoms (57%), mucocutaneous signs (52%), general symptoms (fever, fatigue, weakness and lethargy) (41%), renal symptoms (28%), cardiovascular symptoms (14%), neurological signs (12%), cardiac and pulmonary defects (11%) and gastrointestinal symptoms (3%).According to the results, anti-nuclear antibodies appeared in 92% of the patients, anti-dsDNA antibodies in 81%, CRP in 25%, lupus anticoagulant in 72.5%, and IgM and IgG anti-cardiolipin in respectively 24.2% and 31.2%. Anemia with hemoglobin levels less than 10 mg/dl was seen in 49 patients (24.5%), leukopenia with white blood cell counts less than 4000/mm3 in 38 patients (19%) and thrombocytopenia with platelets less than 150,000 mm3 in 18 patients (9%). Erythrocyte sedimentation rates above 30 mm3 were also detected in 55% of the patients. Conclusion: Considering the diversity of symptoms in patients with lupus and the impacts these symptoms have on the disease prognosis, accurate examinations need to be performed routinely and as soon as lupus is diagnosed.

کلیدواژه‌ها [English]

  • Systemic Lupus Erythematosus
  • Clinical symptoms
  • Laboratory signs
  • BILAG index
  • Disease activity
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