Nailfold capillaroscopic in lupus nephritis patients and its relation to vascular endothelial marker CD31 | ||||
| Journal of Recent Advances in Medicine | ||||
| Volume 6, Issue 1, January 2025, Page 45-53 PDF (1.58 MB) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/jram.2025.325184.1267 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
AL shaimaa A. Ali  1; Seham A. El Azzab1; Sarah Y. Abdelaziz2; Amal M. Elmesiry1; Salwa S. Elgendy1; Marwa A. Mohamed1
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| 1Rheumatology and Rehabilitation Department, Faculty of Medicine for Girls, Cairo, Al-Azhar University, Egypt. | ||||
| 2Clinical Pathology Department, Faculty of Medicine for Girls, Cairo, Al-Azhar University, Egypt. | ||||
| Abstract | ||||
| ABSTRACT Background: Lupus nephritis (LN), commonly arises early in the disease, often within the first 6-36 months, and may occasionally be present at the time of diagnosis. Nailfold capillaroscopy (NFC) is a non-invasive technique for assessing microcirculation and is useful in diagnosing various connective-tissue disorders. Cluster of differentiation 31 (CD31), known as platelet endothelial cell adhesion molecule (PECAM) -1 is a vascular endothelial marker encoded by the PECAM1 gene on chromosome 17. Objective: Evaluate CD31 as a vascular endothelial marker in LN patients and its correlation with peripheral microvascular involvement assessed by NFC. Methods: This case-control study conducted on 45 patients with LN and 45 lupus patients without nephritis. All participants underwent clinical assessments and serum CD31 level evaluation. Disease activity was measured using the SLE Disease Activity Index (SLEDAI). NFC was performed using a digital microscope at 500x magnification. Results: Serum CD31 levels were significantly higher in the LN group compared to the lupus non-nephritis group (p= 0.001). There was a statistically significant difference in capillary width (p= 0.001) and hemorrhage (p = 0.002), both of which were increased in the LN group. Most patients with major NFC score have CD31 levels ≥70 and SLEDAI (p=0.002, p=0.044, respectively). Additionally, patients with major NFC score have renal biopsy grade 3, 4 and 5, while most patients with normal NFC score have renal biopsy grade 2 (p=0.001). The CD31 cutoff ≥70 ng /ml have excellent diagnostic performance for microvascular involvement in SLE with (sensitivity of 97.8%, specificity of 97.8%, PPV of 97.6%, and NPV of 91.7%). Conclusions: Serum CD31 levels could serve as a valuable marker for assessing disease activity and renal involvement in SLE patients. Abnormalities observed through NFC may indicate the degree of microvascular involvement and correlate with systemic organ manifestations in SLE. | ||||
| Keywords | ||||
| Nailfold capillaroscopy; CD31; systemic lupus erythematosus; SLE; lupus nephritis | ||||
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