Platelet count, mean platelet volume and aggregation as markers of disease activity in rheumatoid arthritis

Rheumatoid arthritis [RA] is a chronic inflammatory disorder that affects small joints of hands and feet. Different forms of hematological disorders are associated with RA as anemia, neutropenia, thrombocytosis, thrombocytopenia, eosinophilia, and hematological malignancies. To correlate the value of mean platelet volume [MPV], platelet count and platelet hyperactivity with Disease Activity Score [DAS 28 score] and their reflection on cardiovascular system in RA. 50 newly diagnosed RA patients were attending the Clinical Rheumatology Unit during the year 2012 with twenty five control helthy subjects randomly selected. For all, CBC, including platelet count, MPV, platelet aggregation using ADP, echocardiography in addition to ECG, ESR, and CRP were done. MPV, Platelet count, CRP and ESR were, significantly higher in RA patients than controls, while Platelet aggregation, hemoglobin level, mean diastolic function and ejection fraction[EF] were significantly lower in RA patients than control group. Significant positive correlations were detected between DAS 28 score and both MPV and platelet count, while significant negative correlations were found with both hemoglobin and EF. Significant increase of the platelet aggregation in sero-negative compared to sero-positive rheumatoid arthritis patients was detected. Platelet count and MPV are inexpensive tests, may be useful for a rapid assessment of disease activity in patients with RA

Early detection of factor VIII inhibitors in hemophilia a patients with different treatment modalities

Hemophilia care in underdeveloped and developing countries is extremely inadequate and in some instances, completely absent. Persons with hemophilia battle the complications of both the disease and its treatment. One of the most serious of these problems is the development of the inhibitors. The development of the inhibitors influences their quality of life. This work was designed to: 1- elucidate the inhibitors status 2-to study the relation of factor VIII inhibitors and modes of therapy and duration of treatment 3- to clarify the cause of bleeding, is it related to insufficient treatment or development of inhibitors 4- to study the effect of the severity of hemophilia in the frequency of factor VIII inhibitors and their correlation with factor VIII level. The study included 63 hemophilic patients under different treatment modalities and were classified to four groups according to the types of treatment; they were group [I] included [7] patients with no previous anti hemophilic treatment and were considered as a control group, group [II] included [12] patients who were on treatment with fresh frozen plasma, group [III] consists of [16] patients who were under treatment with cryoprecipitate and group [IV] was [28] patients who were under treatment with concentrated factor VIII.To all groups of patients complete blood count, prothrombin time and prothrombin concentration, activated partial thromboplastin time, factor IX, von willebrand factor, factor VIII levels and factor VIII inhibitor levels were performed. Development of inhibitors was obvious in severe hemophilic patients especially in those who were receiving on demand factor VIII concentrate therapy