Plasma adrenomedullin level in systemic lupus erythematosus patients and its relation to disease activity and lupus nephritis

To study the plasma adrenomedullin [AM] level in systemic lupus erythematosus [SLE] patients and investigate its relation to disease activity and lap us nephritis. Taking, thorough clinical examination, laboratory investigations, disease activity assessment using SLE Disease Activity Index [SLEDAI] and plasma AM assay. Renal histopathology was done for the patients with overt renal involvement. Patients were divided into two subgroups: subgroup [1a] included patients with a history of renal involvement, and subgroup [1b] included patients without renal involvement. Ten age and sex-matched healthy subjects were included as a control group. SLE patients had highly significant higher plasma AM concentration than controls. In SLE patients, there was significant positive correlation between plasma AM concentration and each of SLEDAI and prednisolone dose. On the other hand, plasma AM concentration didn't show significant correlation with age, SLE disease duration, creatinine, proteinuria, C3 and C4. Subgroup [1a] had statistically significant higher plasma AM concentration and higher SLEDAI with increased proteinuria and creatinine than subgroup [1b]. SLE patients had higher plasma AM concentration than controls. SLE patients with a history of renal involvement had significant higher plasma AM concentration than those without renal involvement. These results suggest that AM has a role in the pathogenesis of SLE and lupus nephritis

Diagnostic role of anti-cyclic citrullinated peptide antibodies in rheumatoid arthritis and its relation to disease activity

To determine diagnostic value of anti-cyclic citrullinated peptide antibodies [anti-CCP] in rheumatoid arthritis [RA] patients, and its association with disease activity. Thirty RA female patients were included in this study. All patients were subjected to full history taking, thorough clinical examination, laboratory investigations, assessment of disease activity using Disease Activity Score 28 [DAS28] and anti-CCP assay. Ten age and sex-matched healthy subjects were included as a control group. Twenty one out of the 30 RA patients were anti-CCP positive while 9 were anti-CCP negative. All the 10 controls were anti-CCP negative. The sensitivity of the anti-CCP test for RA was 70% and the specificity was 100%. Twenty three RA patients were rheumatoid factor [RF] positive while 7 were RF negative. One out of the 10 healthy controls was RF positive. The sensitivity of the RF was 76.67% and the specificity was 90%. Nineteen out of the 21 anti-CCP positive patients' were RE positive while 4 out of the 9 anti-CCP negative patients were RE positive. The presence of either anti-CCP or RF increased testing sensitivity to 83.33%. There were statistically nonsignificant differences between the anti-CCP positive and negative patients regarding age, disease duration and DAS28. On the other baud, there were statistically significant differences between them regarding the frequency of RF, CRP and ESR. The anti-CCP antibodies had comparable sensitivity and higher specificity than the RF. The presence of either anti-CCP or RF increased testing sensitivity. It is suggested that anti-CCP antibodies assay has a useful role in the diagnosis of RA and might have an association with the disease activity