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Table () socio demographic characteristics of 63 SLE patients

Factor Number PercentSexMale 6 9.5

Female 57 90.5Age /YMean SD 122.3Median (Range) 12(5-18)Year of BirthRange (1991-2008)Parentalconsanguinity+ve 16 25.4ResidenceGovernorate

33 52.3

6 9.5 1 1.6 4 6.3 3 4.8 2 3.2

1 1.6 1 1.6

2 3.2 1 1.6

Missing data 9 14.3Diagnosis yearRange 1999-2010

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Table ()

Initial presentationsymptoms

Number Percent

General toxicity symptoms 42 66.7Fever 34 54.0Anorexia 4 6.3Weight loss 16 25.4Malaise 26 41.3

Musculoskeletalmanifestations

46 73

Myalgia- muscle weakness 16 25.4Arthralgia-Arthritis 40 63.5Other musculoskeletalinvolvement

1 1.6

Bullous skin

Cutaneouesmanifestations

43 68.3

Butterfly rash 28 44.4Photo sensitivity 16 25.4Alopecia 11 17.5Mucosal ulceration 10 15.9Other cutaneouesinvolvement

8 12.7

Vasculitic rash 2

Discoid rash 1LL ulcer 1Maculopapular rash 1

Palmer &feet erythema 1Missing data 2

Renal (urologicalmanifestations )

23 36.5

Hematuria 5 7.9Edema 15 23.8Hypertension 6 9.5Oliguria 3 4.8

Dysurea 1 1.6

Neurologicalmanifestations

15 23.8

Headache 5 7.9Convulsion 4 6.3Psychosis 3 4.8Depressive features 3 4.8Other neurologicalsymptoms

2 3.2

Hypertonia 1 Tremors 1

Ocular manifestations 3 4.8

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Visual field defect 2 3.2Other ocular involvement 2 3.2

Bilateral cataract 1Bilateral papilledema 1

Cardio-respiratorysymptoms 11 17.5

Chest pain 2 3.2Palpitation 6 9.5Dyspnea orthopenia 7 11.1Pulmonary chest pain 3 4.8Dyspnea 2 3.2Cough 1 1.6

Vascular manifestations 30 47.6Pallor 23 36.5Bleeding tendency 11 17.5

Raynauds phenomenon 1 1.6

Gastrointestinal symptoms 10 15.9Recurrent-Persistentabdominal pain

4 6.3

Hematemsis 1 1.6Abdominal enlargement 3 4.8Other Gastrointestinalinvolvement

4 6.3

Ascitis 1Vomiting 2

Missing data 1

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Table () treatment type used in 63 SLE patients from 2005-2010

Treatmenttype

Users NO Percent Duration/months

Cumulativedose/gm

Median(range )

Median(range )

NSAID 2 3.2 12.5(5,20) 37(11,63)Plaquenil 10 15.9 - 121(2-323)Cyclopho 27 42.9 7(1-13) 4(1-10)Imuran 17 27 12(2-28) 22(4-200)IV Ig 4 6.3 5 months

,missing 3

8(1-24)

Mprednisone

31 49.2 8(1-21) 7(1-66)

predinsone 58 92.1 18(2-49) 12.6(1-306)Ca 45 71.4 18(2-45) 210(2-600)cellcept 2 3.2 198.5(5,392) -sandimune 4 6.3 7(1-8) 13.9(4-42)mesotrixate

1 1.6 4months 2 gm

Table () SLCCIDI SCORE

Score Number PercentSLCCDI1 Ocul RCh orOA1

1 1.6

1C-Cardiomyopathy1 1 1.61Cr-Valvulardisease1

1 1.6

1C-Pericarditis for 6mo 1

2 3.2

1 Venous thrombosis1

3 4.8

1Scaring alopecia1 2 3.21Skin ulcer more6mo1

1 1.6

1DM 1 2 3.2Total score (0-2)

Score 0 53 84.1Score 1 8 12.7Score 2 2 3.2

Table ()SLE related complication

Complication Number PercentAlopecia 2 3.2

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DM 2 3.2Valvular affection 2 3.2Optic atrophy 1 1.6APLS 5 7.9DVT 3 4.8Auto immune hepatitis

2 3.2Macrophages activationsyndrome

1 1.6

Pancreatitis 1 1.6Pseudotumor cerebrai 1 1.6Thyroiditis 1 1.6Vitiligo 1 1.6Ulcer 1 1.6Ulcerative colitis 1 1.6

Table ()

Factor Number Percent

Renal biopsy /lupusnephritis+ve results 32 50.8Lupus nephritisclassesClass I 1 3.1Class II 12 37.5Class III 10 31.3Class IV 8 25.0

Class V 1 3.1

Table () outcome

Outcome Number PercentCompleteremission

28 44.4

Mild activity 17 27Moderateactivity

10 15.9

High activity 4 6.3V .highactivity

1 1.6

Death 3 4.8Addisonin crisis 1

Renal failure 1Loss follow up 11 17.5N.B: Mild activity SLEDI scores (1-5),.,..,.

Table ()SLEDI Score

Relaps

e 1

Relapse

2

Relapse

3

Relapse 4 Current

n(%) n(%) n(%) n(%) n(%)

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8 Seizure 3(4.8) 2)3.2( -- -- 1(1.6)8 Psychosis 1(1.6) -- -- -- 2(3.2)4 Arthritis 2(3.2) -- -- -- 04 Hematuria 3(4.8) 2)3.2( 1(1.6) -- 7(11.1)4 Proteinuria 9(14.3) 4)6.3( 1(1.6) -- 11(17.5)

4 Pyuria 2(3.2) 1)1.6( 1(1.6) -- 5(7.9)2 New malar rash 1(1.6) -- -- -- 1(1.6)2 Mucousmembranes

1(1.6) 1(1.6) -- -- 0

2 Pericarditis 1(1.6) -- --- -- 2(3.2)2 Low complement 3(4.8) 2(3.2) 1(1.6) -- 6(9.6)2 Increased DNAbinding

8(12.7) 2(3.2) 1(1.6) -- 12(19)

1Thrombocytopenia

4(6.3) 2(3.2) 3(4.8) 0 3(4.8)

1 Leucopenia 4(6.3) 1(1.6) 0 0 3(4.8)Casts -- 1(1.6) -- -- 2(3.2)

Organic brainsyndrome

-- -- -- -- 1(1.6)

Visual -- -- -- -- 1(1.6)Lupus headache -- -- -- -- 3(4.8)Vasculitis -- -- -- -- 1(1.6)Alopecia -- -- -- -- 4(6.3)Number of +vepatients

18(28.6)

6(9.5) 3(3.2) 0 30(47.6)

Responder 17(94.4)

6(100) 2(66.7) 0 ?

Total score range 0-20 0-20 0-13 0 0-34

Table () frequency of missing laboratory investigations from initial

presentation, through all relapses & in current activity of the disease

Initial Relapse1

Relapse 2

Relapse 3

Relapse 4

Current

n(%) n(%) n(%) n(%) n(%) n(%)

CBC TLC 3(4.8) 58(92.1) 62(98.4

)-- 60(95.2) 31(49.2

)

Neutrophils 19(30.2)

59(93.7) 62(98.4)

-- 62(98.4) 53(84.1)

Lymphocytes 24(38.1)

59(93.7) 62)98.4(

- 60(95.2) 51(81)

Monocytes 47(74.6)

63(100) - - 63(100) 55(87.3)

Esinophils 56(88.9)

- - -- 62(98.4)

Bands 62(98.4)

-- -- -- --

Hemoglobin 4(6.3) 59(93.7) - - 62(98.4) 32(50.8)

MCV 51(81) - - 62(98.4) 59(93.7)

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Retics 42(66.7)

62(98.4) - - - 61(96.8)

Platelets 5(7.9) 56(88.9) 63(100) 61(96.8)

61(96.8) 30(47.6)

CRP 18(28.

6)

62(98.4) -- --- 61(96.8) 57(90.5

)ESR 11(17.5)

58(92.1) 62(98.4)

- 62(98.4) 40(63.5)

Renal &HepaticfunctionsSerum creatinine 14(22.

2)61(96.8) -- - 62(98.4) 47(74.6

)BUN 34(54) 60(95.2) -- - - 54(85.7

)Serum Albumin 22(34.

9)62(98.4) -- - - 54(85.7

)ALT 49(77.

8)

59(93.7) -- -- -- 54(85.7

)AST 57(90.

5)63(100) -- -- -- 57(90.5

) T.bilirubin 58(92.

1)-- -- -- -- 62(98.4

)D.bilirubin 61(96.

8)-- -- -- -- 63(100)

Serum Ca 59(93.7)

-- -- -- -- -

Serum Ph 61(96.8)

-- -- -- -- -

Serum uric acid 51(81) 61(96.8) 6(9.5) - - -Blood urea 49(77.

8)62(98.4) -- - - 52(82.5

)Lipid profile

Total cholesterol 56(88.9)

62(98.4) - - - 57(90.5)

TG 55(87.3)

62(98.4) - - - 58(92.1)

LDL 56(88.9)

- - - - 57(90.5)

HDL 57(90.5)

- - - - 57(90.5)

Urine analysisAlbumin 15 60(95.2) 62(98.4)

62(98.4)

- 34(54)

Pus cells 11 61(96.8) 62(98.4)

62(98.4)

- 35(55.6)

RBCs 13 60(95.2) 61(96.8)

62(98.4)

63(100) 35(55.6)

Casts 25 62(98.4) 62(98.4)

-- - 35(55.6)

24h urinary ptn 36(57.1)

57(90.5) 60(95.2)

62(98.4)

63(100) 56(88.9)

Creatinine

clearance

22(34.

9)

59(93.7) 63(100) 62(98.4

)

63(100) 51(81)

Ptn/creatinine 46(73) 62(98.4) 63(100) - 63(100) 63(100)

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Hormonal TSH 59(93.

7)59(93.7) 59(93.7

)- - 62(98.4

)FT4 59(93.

7)59(93.7) 59(93.7

)- - -

Anti TPO titre - - 63(100) - - -ImmunologyANA Titre 0 0 0 0 - 0Anti DNA titre+VE 0 0 0 0 0 0C3 6(9.5) 59(93.7) 61(96.8

)61(96.8

)63(100) 44(69.8

)C4 27(42.

9)63(100) - - - 63(100)

Lupusanticoagulant

0 0 - - - 0

Anti cardiolipinIgM

43(68.3)

62(98.4) - - - 62(98.4)

Anti cardiolipinIgG

44(69.8)

- - - - -

HBsAg - - 63(100) 63(100) 63(100) -HCV Ab - - 63(100) 63(100) 63(100) -

Positive results immunology

Initial Relapse1

Relapse 2

Relapse 3

Relapse4

Current

n(%) n(%) n(%) n(%) n(%) n(%)ANA Titre +VE 54(85.7) 2(3.2) 1(1.6) 2(3.2) - 3(4.8)

Anti DNAtitre+VE

42(66.7) 4(6.4) 1(1.6) 2(3.2) 0 8(12.7)

Lupusanticoagulant+VE

6(9.5) 1(1.6) - - - 0

Table () Imaging results

Type of imaging/diagnosis

Number Percent

Chest XrayCardiomegaly 2 3.2Hepatomegaly 1 1.6

Pleural effusion 3 4.8Pericardial effusion 2 3.2

++ vascular marking 1 1.6Normal 7 11.1

ECHONormal 3 4.8

cardiac tamponade 2 3.2pericardial effusion 9 14.3

valvular disease 6 9.5

ventricular disease 3 4.8cardiomyopathy 1 1.6

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Pelvi abdominal USNormal 3 3.8

HSM 10 15.9Hepatomegaly 9 14.3

Ascitis 1 1.6DEXA scan

Osteoporosis 5 7.9Normal 12 19.0