Abstract
Aim: To assess the lipid profile in pediatric SLE (pSLE) patients in active disease state and compare it with inactive state. Methodology: It was an observational study carried out in the Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbagh, Dhaka-1000, Bangladesh from January 2013 to June 2014. A total 30 patients fulfilling the ACR 1997 criteria were enrolled in this study. Age and sex matched 15 controls were also included. Lipid profiles were measured at diagnosis, at 3 months follow up and at 9 months follow up. Results: At the time of diagnosis, pSLE patients’ mean triglyceride level and HDL cholesterol levels were significantly abnormal. At 3 three months follow up, when disease activity was high and patients were on high dose steroid therapy, there was increased total, LDL and HDL cholesterol level. At 9 months follow up when most of the patients had inactive disease and were on low dose steroid, all the lipids were within normal range. Comparison of active disease group with inactive disease group at 9 months found significant improvement of total cholesterol, triglycerides and HDL cholesterol levels. Conclusion: Control of SLE seems to be the most important factor in normalizing the lipids.
Highlights
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by multisystem inflammation and the presence of circulating autoantibodies directed against self-antigens, leading to inflammatory damage of many target organs including the skin, joints, kidneys, blood cells, blood vessels and the central nervous system [1]
Levels of total cholesterol and low density lipoprotein cholesterol (LDL) are mainly associated with the dose of prednisolone and high disease activity
Low level of high density lipoprotein cholesterol (HDL) cholesterol was associated with active SLE, whereas the dose of prednisolone was associated with increased levels of HDL cholesterol [5]
Summary
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by multisystem inflammation and the presence of circulating autoantibodies directed against self-antigens, leading to inflammatory damage of many target organs including the skin, joints, kidneys, blood cells, blood vessels and the central nervous system [1]. Lipid abnormalities in SLE patients may be due to disease process itself and due to drug treatment like steroids [1]. Lipid profile may be changed in different disease activity levels and in different prednisolone doses [5]. Levels of total cholesterol and LDL are mainly associated with the dose of prednisolone and high disease activity. Changes in HDL are usually associated with active SLE and a high dose of prednisolone [6]. A recent study showed that lupus nephritis was more common in those patients with abnormal total cholesterol (TC) and TG levels at diagnosis [7]. No study so far has been done regarding lipid profiles in pediatric systemic lupus erythematosus (pSLE) patients in Bangladesh
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