Study design and procedures
hypocomplementaemia, seizures, fever, hematuria, myositis, lupus headache, vasculitis, rash, psychosis, lupus, pyuria, leukopenia, hemolytic, proteinuria, arthritis, visual impairment, pleurisy, mucocutaneous, lupus disease, alopecia
MUCOSAL ULCERATION, LEUKOPENIA, LUPUS, VASCULITIS, ALOPECIA, THROMBOCYTOPENIA, ARTHRITIS, HEMATURIA, PERICARDITIS, PLEURISY, LUPUS, ORGANIC BRAIN SYNDROME, MYOSITIS, EVENTS, CRANIAL NEUROPATHY, DISEASE
All patients were routinely examined and periodically tested at baseline. These tests included cell blood count, kidney and renal function, urine analysis, and laboratory tests like anti-dsDNA, anti-nuclear antibody (ANA) titer, serum complement C3 and C4 concentrations, total hemolytic activity (CH50), and proteinuria, performed in the reference laboratory of Imam Khomeini Hospital. Then, the patients were randomly divided into 40 cases receiving NAC and 40 control subjects. The case group received NAC (manufactured by Osveh Pharmaceutical Company, 600-mg effervescent tablets) at a dose of 1800 mg daily three times per day in an 8-h interval basis for 3 months. The control group continued to use the same standard lupus medication regimen. The activity of lupus disease before and after treatment was measured according to the British Isles Lupus Assessment Group (BILAG) scoring system that evaluates neurological, musculoskeletal, renal, mucocutaneous, general, cardiorespiratory, vascular, and hematological manifestations (indicating score 0 as non-involvement and score 4 as the highest involvement rate) (47) as well as based on SLE Disease Activity Index (SLEDAI) score (48). SLEDAI index determines the risk of seizures, psychosis, organic brain syndrome, visual impairment, cranial neuropathy, lupus headache, vasculitis, cerebrovascular events (CVA) score 8, arthritis, myositis, urinary casts, hematuria, proteinuria, pyuria score 4, new rash, alopecia, mucosal ulceration, pleurisy, pericarditis, hypocomplementaemia, increased DNA binding score two and fever, thrombocytopenia, and leukopenia with score 1. All patients were told to avoid any change in the drug pattern and other nutritional or behavioral habits. It should be noted that a daily allowance dose of multivitamins containing 500 mg of vitamin C and 30 international unit (IU) of vitamin E was performed in all patients. Demographic data, laboratory findings, BILAG score, and SLEDAI score were recorded in pre-designed forms.