Hematological profiles and Human Leukocyte Antigen-class II Alleles in Systemic Lupus Erythrematosus among Sudanese Patients

Abstract

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by autoantibody production that can result in damage to multiple organ systems. The present study aimed to investigate Human Leukocyte Antigen class II in Systemic lupus erythromatous (SLE) Sudanese patients, the Anti nuclear auto antibodies profile in patient, the antiphospholipid autoantibodies as well as hematological abnormalities. Eighty SLE patients and sixty matching ethnicity and sex healthy controls were enrolled in present study from Rheumatology Clinic at the National Ribat University Hospital, Medical Military Hospital and Private Clinic . Demographic data (name, sex, age and the tribe ) were obtained from patients and Blood samples were collected in EDTA containers to be used for HLA typing by using polymerase chain reaction (PCR) technique, Anti nuclear auto antibodies profile by using Immunoblott technique, antiphospholipid antibodies by using ELISA technique and measurement of hemoglobin, total white blood cells and platelets by using Sysmex . In present study there are 76 females and 4 males, female to male ratio was 19:1, Afro-asiatic tribes were the most affected with disease than Nilo-Saharan tribes ,The result of HLA class II, DR & DQ alleles were typed from DNA sample of all patients and controls, DRB1* 15 was carried by 23% of patients and 13% of control with p.value 0.01, DQB1* 05 was carried by 22% of patients and 13% of control with p.value 0.03, DRB1* 13was carried by1 2% of patients and29 % of control with p.value 0.001, DQB1* 06 was carried by 28% of patients and 43% of control with p.value 0.005. All patients were positive for ANA (100%), where as 73% were positive for anti smith antibody and 42% positive for dsDNA antibody. The results of antiphospholipid antibodies were 38% and 22% positive of SLE patients for anticardiolipin antibody and Anti-β2-glycoproteinI antibody respectively. Hematological abnormalities as following: anemic patients (<12g/dl) was 68%, leukopenic patients(<4.0×109/l) was 40% and the thrombocytopenic patients(<100×109/l) was 7%. From these results we conclude that: DRB1*15 and DQB1*05 alleles may be considered as risk alleles with relative risk 2.1 and 1.7 respectively. While DRB1*13 and DQB1*06 may be considered as protective alleles with relative risk 0.43 and 0.64 respectively. There are different levels of antiphospholipid antibodies in Sudanese patients, particularly, anticardiolipin antibodies were found more frequently than Anti-β2-glycoproteinI antibody antibodies. According to present study Anti ANA, anti-Sm and anti dsDNA may be considered as important serological markers for the diagnosis of Sudanese patients with SLE. The hematological abnormalities were not differing from other different diseases.