#5903 CLINICAL OUTCOME CORRELATION AMONG NEWLY DIAGNOSED LUPUS NEPHRITIS IN RELATION TO PERIPHERAL BLOOD LYMPHOCYTE SUBSET: A PROSPECTIVE STUDY

Abstract

Abstract Background and Aims Given the heterogeneity in presentation, treatment practices and the outcome of lupus nephritis, there is a need for new protocols to predict outcome and rationalize treatment. Aim To prospectively study the correlation between peripheral blood lymphocyte subset, inflammatory markers and clinical outcomes among newly diagnosed lupus nephritis patients. Method Lymphocyte subset typing by flow cytometry method done at diagnosis and end of 6 months. SLEDAI -2k score. Intensive phase of Immunosuppression individualized by treating physician. Urine protein excretion was used to assess the final treatment outcome. Statistical analyses done using SPSS software. Two-sided P value of < 0.05 was considered significant. Pearson correlation coefficient formula used for correlations. Logistic regression done to identify factors responsible for clinical remission achieved at six months. Inclusion: All newly diagnosed renal biopsy proven Class 3, class 4, Class 5 or a combination class of lupus nephritis patients seen at Kasturba Hospital and Medical College, Manipal. Exclusion: Patients with active/recent infection, active malignancy, those with prior explosion to immunosuppression. Outcome measures, 1. To detect correlation if any, between peripheral blood lymphocyte subset, serum inflammatory markers and disease activity score at presentation. 2. To determine correlation if any, between peripheral blood lymphocyte subset and clinical remission achieved following immunosuppressive regimens at the end of six months of initial intensive treatment phase. Results 22 patients were taken for study. Relationship between SLEDAI score, lymphocyte subset characters, and clinical outcome given in Table 1 and 2. There was good correlation between lymphocyte subset characters, inflammatory markers and SLEDAI score, indicating ability of lymphocyte subset characters to characterize the severity of lupus nephritis. We found significant difference in lymphocyte subset characters between baseline and at the end of 6 months treatment. But there was no significant correlation for remission attainment with lymphocyte subset characters and SLEDAI score. Conclusion 1. Correlation found between peripheral blood lymphocyte subset, serum inflammatory markers and disease activity score at presentation and 6 months of treatment of lupus nephritis. 2. Peripheral blood Lymphocyte subset analysis was not found useful in predicting clinical outcome in lupus nephritis at the end of 6 months of intensive treatment.