Impact of anticardiolipin antibodies and hyperprolactinemia on laboratory, immunological and histopathological parameters of lupus nephritis

الملخص EN

Objective : Hyperprolactinemia and anticardiolipin antibodies (ACL) have been involved in the pathogenesis of systemic lupus erythematosus (SLE).

However, the significance of both has not yet been fully investigated in lupus nephritis.

So this study was planned to evaluate the impact of both ACL and prolactin on laboratory, immunological and histopathological findings in such patients.

Material : The study included 28 female SLE patients (Group I).

Their mean age was 27.3 ± 8.87 years and mean disease duration was 5.2 ± 2.36 years.

Ten apparently normal subjects, matched for age and sex served as controls (Group II).

Methods: SLE patients were classified into two subgroups: GIa (14 patients with renal affection) and GIb (14 patients without renal affection).

All patients were subjected to full history taking with stress on clinical manifestations of renal dysfunction, laboratory investigations for SLE, serum prolactin and IgG ACL.

Light and electron microscopic examination of renal biopsies from GIa patients and controls were done.

Results : There was a statistically significant difference of both serum prolactin and IgG ACL between G1 & GII (p < 0.01 & p < 0.05 respectively) with a higher level of GIa as compared to GIb patients (p < 0.05).

There was a positive correlation between serum prolactin and both proteinuria (p < 0.05), and anti-ds DNA (p < 0.05).

On the other hand, there was a positive correlation between IgG ACL and proteinuria (p < 0.05) Lupus nephritis activity index was found to correlate with ACL (p < 0.05), serum prolactin, (p< 0.001), serum creatinine (p < 0.01), proteinuria, (p < 0.05) and anti ds-DNA (p < 0.05).

Serum prolactin was found to be a sensitive (64.2 %) and a specific (100 %) marker in the diagnosis of lupus nephritis while IgG ACL is a specific one (100 %).

Conclusion : Hyperprolactinemia and IgG ACL might play a role in the pathogenesis of lupus nephritis.

Prolactin not only has a direct effect, but it also stimulates the production of some antibodies like ACL and anti-ds-DNA.

So, a possible novel role of dopamine receptor agonists in down-regulating the autoimmune phenomena should be investigated in such patients.

In evaluation of lupus nephritis, we may consider serum prolactin as a sensitive and a specific marker while IgG ACL as a specific one.