Study of serum hepcidin and reticulocyte hemoglobin content in juvenile rheumatoid arthritis patients

Objective: Juvenile Rheumatoid Arthritis [JRA] is frequently associated with different types of anemia. The effect of anemia and disease activity, on two iron status parameters; serum hepcidin and reticulocyte hemoglobin content [CHr], was investigated in JRA patients

Methods: Blood samples were obtained from 43 JRA patients and 20 ages and sex matched healthy children as control. Laboratory parameters of anemia and disease activity as well as serum hepcidin and CHr were compared between patients and control Possible correlations of hepcidin and CHr with anemia and disease activity parameters were studied

Results: All studied parameters except TIBC, serum ferritin and hepcidin showed significant differences between patients and control. Significant correlations were found between CHr and all anemia parameters except TIBC and serum ferritin while hepcidin was only correlated to serum ferritin. Both hepcidin and CHr were significantly correlated to CRP, white blood cell and neutrophil counts. Moreover, hepcidin was significantly correlated to tender joint count while CHr was significantly correlated to platelet count and swollen joint count

Conclusion: In JRA patients, serum hepcidin was primarily affected by the acute phase state rather than anemia while CHr was affected by them both with a slight predominance of anemia over inflammation

Protein C and soluble thrombomodulin in relation to tumor necrosis factor-alpha in critically ill septic patients and their correlation with sofa score

The objective of this study was to investigate the influence of sepsis on protein C [PC] activity and soluble thrombomodulin [s-TM] in relation to tumor necrosis factor-alpha [TNF-alpha]. Also, to orrelate these parameters with the SOFA score and serum lactate concentration as predictors of morbidity and mortality in septic patients. Thirty two adult patients [17 with sepsis and 15 with severe sepsis] in the intensive care unit [ICU], as well as 10 healthy age- and sex- matched controls were accrued to the study. The results showed that the baseline values of PC activity were significantly lower in both groups of septic patients compared to the controls, whereas, the serum levels of s-TM, TNF-alpha and lactate were significantly higher in the former compared to the latter. Moreover, survivors in both patient groups had higher PC activity and lower serum levels of s-TM, TNF-alpha and lactate compared to non survivors, both on day [1] and day [3] of ICU admission with variable statistical significance reflecting the heterogeneity of sepsis and the well-known individual patient variation. In addition, day [3] samples showed significant increase in PC activity and reduction in serum levels of s-TM, TNF-alpha, lactate and SOFA scores in survivors and the reverse in non survivors compared to baseline levels. Also, baseline PC activity was correlated negatively with SOFA score but not with serum TNF-alpha in both groups of septic patients. It was also negatively correlated with serum TM and lactate in sepsis but not in severe sepsis

Prognostic value of serum leptin in patients with acute myefogenous leukemia

Aim: Leptin is a hormone secreted by adipocytes that regulates body weight and energy expenditure. Leptin receptors can be expressed by acute myelogenous leukemia [AML] cells and leptin may affect leukemic hematopoiesis. In addition, leptin may function as a stress-related hormone and may contribute to the anorexia and wasting syndrome of cancer and infections. The present work aimed at estimating the serum leptin level in patients with AML at presentation and after induction chemotherapy in order to extrapolate its possible alteration with infection in these patients and its role in influencing hematopoietic recovery following chemotherapy. Subjects and Thirteen newly diagnosed AML patients, 7 males and 6 females [mean age: 40.54 +/- 13.5 years] and ten healthy age- and sex-matched controls were enrolled in the study. Serum leptin was estimated by the ELLSA technique. In AML patients, the pretreatment mean serum leptin [15.8 +/- 19.8 ng/ml] did not differ significantly from the controls [8.25 +/- 7.25 ng/ml]. Post-chemotherapy, the mean serum leptin level [12.1 +/- 14 ng/ml] decreased compared to the pre-therapy level. However, this decrease was not statistically significant. A significant positive correlation was found between serum leptin and body mass index [BMI], both at presentation [r=0.777, P=0.002] and post-chemotherapy [r=0.557: P=0.048], and serum leptin was significantly higher in female as compared to male patients before and after chemotherapy [P=0.001 and P=0.024, respectively]. No significant correlation was found between serum leptin and any of the studied parameters [hemoglobin, total leukocytic count, platelet count, bone marrow blast percent, absolute neutrophilic count and days to hematopoietic recovery]. Also, no significant difference was found between patients who achieved complete remission [n=6] and those who achieved partial remission [n=5] regarding the serum leptin both before and after therapy. Comparing the mean serum leptin levels in patients who developed chemotherapy-induced neutropenic sepsis [n=11] and those who did not develop sepsis [n=2], the level was significantly higher in the former than in the latter, both before [P-0.005] and after [P=0.012] chemotherapy. Conclusions: The findings of the present study support the hypothesis that leptin is a stress-related hormone involved in the host defense of acute inflammation and may be important for survival. However, further studies are warranted to clarify the potential diagnostic, prognostic and therapeutic roles of leptin in patients with AML