Anti-cyclic citrullinated peptide [anti-CCP] antibodies in juvenile rheumatoid arthritis children

To determine if anti-cyclic citrullinated peptide antibodies [Anti-CCP] can be detected in sera of with juvenile rheumatoid arthritis [JRA] patients and to study its clinical significance. Serum anti-CCP antibodies were measured with ELISA technique in 20 JRA patients. Thirty adult RA patients and 20 apparently healthy children were also included in the study. Correlations between anti-CCP, disease characteristics, medication and radiological damage were also determined in JRA patients. Anti-CCP was positive in 10% [2/20] of JRA patients and in about 67% [20/30] of adult RA patients while it was not detected in healthy children. The two JRA patients were girls with seropositive [IgM-RF] polyarticular subtype. There was a statistically significant difference in radiological damage and rheumatoid factor seropositivity between anti-CCP positive and negative JRA patients. On the other hand, disease duration, antinuclear antibody positivity and medication did not differ statistically between the previous two groups. Anti-CCP antibodies can be detected in the sera of JRA patients but less frequently present than adults with RA. Anti-CCP antibodies are exclusively present in the subset of seropositive polyarticular JRA

Evidence of cerebral hypoperfusion with [99m]tc HMPAO SPECT in Egyptian scleroderma patients

The aim of this study was to investigate regional cerebral blood flow [rCBF] with 99mTc-hexamethyl-propylenamine oxine [HMPAO] single photon emission computed tomography [SPECT] in a group of 22 patients affected with systemic sclerosis [SSc]. The SPECT findings were correlated with clinical data and MRI whenever possible. The study was conducted on 22 Egyptian SSc patients in comparison to ten healthy age-matched controls. Subjects affected with concomitant diseases that might interfere with the interpretation of the SPECT results were excluded. SPECT findings were correlated with clinical data, magnetic resonance imaging [MRI] of the brain and magnetic resonance angiography if available. Twelve SSc patients [54.5%] showed cerebral hypoperfusion, focal in 8 [66.7%] patients and diffuse hypoperfusion in 4 [33.3%] patients at the SPECT analysis. MRI was available in 15 patients and was shown to be altered in five of them [33.3%]. Magnetic resonance angiography [MRA] was normal in those five patients except one. No significant differences were found between the group of SSc patients showing hypoperfusion and those showing a normal SPECT scan regarding age, the duration of disease and damage of other organs typically involved in the disease. Focal or diffuse cerebral hypoperfusion was found with SPECT in more than half of the neurologically asymptomatic SSc patients. SPECT was more sensitive in reflecting changes of cerebral blood flow than MRI. The hypoperfusion was not linked to ageing and possibly reflects the cerebral location of the microangiopathic process characterizing the disease