Evaluation of Serum Adenosine Deaminase Changes Before and After Treatment in Patients with Systemic Lupus Erythematosus, Henoch-Schonlein Purpura and Juvenile Idiopathic Arthritis

Abstract

Background: Adenosine deaminase (ADA) is a purine metabolism enzyme that can be used as an indicator of cellular immunity for monitoring of inflammatory diseases. The aim of this study was to investigate the changes of serum adenosine deaminase before and after treatment in patients with systemic lupus erythematosus (SLE), Henoch-Schonlein purpura (HSP) and juvenile idiopathic Arthritis ( JIA). Methods: The study comprised 103 patients with JIA, 17 with SLE and 30 HSP. The serum ADA was measured of all patients before and after treatment or remission. Serum ADA was measured by an ultraviolet kinetic method with NADH as substrate. Normal value for serum ADA level was less than 15 IU/L. Results: Positive serum ADA was found in 38 patients with JIA (38.9%), 9 patients (52.9%) with SLE and 6 patients (20%) with HSP. During the disease activity (before treatment), the mean serum ADA in patients with JRA was 15.1±10.9 IU/l, vs. 12.6±4.5 IU/l in patients with HSP and 18.8±11.95 IU/l in patients with SLE (P=0.097). There was no significant differences in changes of ADA levels between disease activity and after control (p= 0.1) in SLE. In patients with JIA, there was significant differences in changes of ADA levels between disease activity and control (p= 0.01). There was no significant differences in changes of ADA levels between disease activity and control (p= 0.2) in HSP. Conclusion: Determination of ADA serum levels is as noninvasive method, reliable and easy for diagnosis of JIA and can be used as alternative parameters representing disease activity in SLE patients.