Evaluation of serum interleukin-34, as a marker of disease activity in systemic lupus erythematosus and rheumatoid arthritis patients

Aim of the work: To evaluate the role of IL-34 in the pathogenesis of SLE and RA and to assess its role as a biomarker of disease activity. Subjects and methods: This study was carried out on 29 patients with SLE, 29 patients with RA, and 29 healthy control subjects. SLE disease activity was measured by systemic lupus erythematosus disease activity index (SLEDAI). RA disease activity was measured by 28-joint disease activity score (DAS-28). Serum IL-34 was measured by enzyme-linked immunosorbent assay (ELISA) . Results: There was highly significant elevation in IL-34 level in SLE and RA when compared to control group (p<0.001). IL34 level did not differ significantly between SLE and RA groups (p˃ 0.05). There was a significant positive correlation between IL-34 level and SLEDAI in SLE patients as well DAS 28 score in RA patients. The highest level was detected in patients with high disease activity. There was statistically significant correlation between IL-34 levels and ESR, CRP, and anti-ds DNA antibodies but inversely correlated with C3 in SLE patients. There was also statistically significant correlation between IL-34 levels and ESR, CRP RF, and anti CCP antibodies in RA patients. Conclusion: IL-34 could be useful marker for disease activity in SLE and RA

Vitamin d status in children with acute lymphoblastic leukemia

Background: Skeletal morbidities are a common initial presentation and outcome in acute lymphoblastic leukemia(ALL). Vitamin D plays a vital role in the physiological regulation of calcium and phosphate transport and bone mineralization. Also high (25(OH)) level and high vitamin d intake at the time of diagnosis and initiation of anticancer treatment were associated with improved outcome. Methods: Twenty five ALL patients admitted to hematology and oncology unit, children hospital Zagazig University in one-year .vitamin D (25 (OH)) level was assessed in all patients at diagnosis. Patients were classified into deficient vitamin D (0-20)ng/ml , insufficient vitamin D (20-30)ng/ml and sufficient vitamin D (30-50)ng/ml. Statistical analysis was done to determine relation between different groups and ALL patients characteristics. Results: Vitamin D deficient in 24% of patients, vitamin D insufficient in 48% of patients, and vitamin D sufficient in 28% of patients. There was high statistical difference between different groups regarding bone pain and sex. Conclusions: A non-sufficient level in childhood all (deficiency and insufficiency) is common in childhood ALL and this is related to bone pain as initial clinical presentation. Vitamin D is related to presentation and prognosis of ALL in children

Study of non-organ specific antibodies in children with genotype 4 chronic hepatitis C

Adult studies established a relationship between hepatitis C virus [HCV] infection and the presence of non-organ specific antibodies [NOSAs]. Most studies were carried out on genotypes 1 and 2. Only a few studies addressed that issue in pediatrics. No studies have been carried out on autoimmunity and genotype 4 in children. We aim to investigate NOSAs in 80 Egyptian children with chronic HCV infection along with studying the underlying genotype of HCV, and correlating autoimmunity with the epidemiological, clinical, biochemical, and virological features. HCV RNA was assayed by the polymerase chain reaction and viral genotypes were determined. NOSAs were measured and liver biopsies were taken for histopathological examination. Genotype 4 was the only detected genotype in the included 80 patients. Anti-smooth muscle antibodies [ASMA] were the only detected antibodies in 32 [40%] patients, always with V specificity [vessels only] at titers ranging from 1:20 and 1:160. Anti nuclear antibodies [ANA] and liver-kidney microsomal antibodies 1 [LKMA 1] were not detected in any of our patients. Epidemiologic and clinical features did not significantly differ between autoantibody positive and negative patients. Among biochemical features, significantly high levels of total bilirubin, albumin, immunoglobulins, alkaline phosphatase, and gamma glutamyl transpeptidase were found in the antibody positive group. Genotype 4 HCV is the prevailing genotype in Egyptian children with chronic HCV infection. A consistent proportion of these children with chronic HCV infection circulate non-organ specific autoantibodies. The prevalence of ASMA and the absence of ANA and LKMA 1 might be related to the unique situation in Egypt with unique prevalence of genotype 4. More studies are warranted on larger pediatric population to validate these findings.