Serum adrenomedullin level in rheumatoid arthritis vs systemic lupus erythematosus

Abstract EN

Objectives : this study was conducted to measure the level of serum adrenomedullin (AM) in rheumatoid arthritis (RA) and systemic lupus erythematous (SLE) to find out its role in their pathogenesis and its correlation with clinical and laboratory parameters of disease activity.

Methods : Twenty five RA patients (Group I), fifteen SLE patients (Group II) and ten healthy controls were included in this study.

They were subjected to full history taking, thorough clinical examination and the following investigations: CBC, ESR, RF, ANA, Anti ds-DNA and measurement of serum adrenomedullin level with ELISA.

Assessment of disease activity was done using Duke score (Duke et al., 1983) for RA patients and SLEDAI score (Bombardier et al., 1992) for SLE.

Results: Serum level of adrenomedullin was significantly higher in RA (16.3 ± 3.8 p mol / L) compared to control (3.14 ± 1.6 p mol / L) (p < 0.001).

Also, it showed a highly significant difference (p < 0.001) between SLE patients (7.8 ± 3.2 p mol / L) compared to controls (3.14 ± 1.6 p mol / L).

Moreover, a highly significant difference (p < 0.001) was found between RA and SLE patients as regards serum AM level.

A significant correlation (p < 0.05) was found between AM level and activity score of RA (Duke score) and ESR while a significant negative correlation was (p < 0.05) found between AM level and Hb level in RA patients.

As regards SLE, there was a significant correlation (p < 0.05) between AM level and both ESR and WBCs.

Conclusions : serum level of AM was elevated in both RA and SLE (more in RA than SLE) patients and it was correlated with disease activity parameter in RA (only with ESR in SLE).

These findings emphasize that AM is involved in the pathogenesis of RA and SLE.

Recommendations : The pathogen etic role of the AM in rheumatic diseases needs to be assessed in larger groups of patients over an extended period of time.