Anti-C1q and anti-dsDNA antibodies in systemic lupus erythematosus: Relationship with disease activity and renal involvement in Sharkia governorate, Egypt

Renal involvement is one of the main determinants of poor prognosis of systemic lupus erythematosus [SLE]. Kidney biopsy is an invasive procedure and accompanied by potential risks. Thus defining a reliable biomarker of kidney involvement in SLE is highly desirable. To assess the role of anti-C1q Ab in combination with anti-dsDNA Ab in detection of SLE disease activity and renal involvement [lupus nephritis]. Anti-C1q Ab and anti-dsDNA antibodies were determined in 60 randomly selected adult SLE patients one of them refused the biopsy and those who completed the study were 59. The control group included 25 age and sex matched volunteers. According to lupus nephritis [LN] and SLEDAI score, patients were divided into four groups: group 1, 11 patients had active disease with LN; group 2, 20 patients had inactive disease with LN; Group3, six patients had active disease without LN; group 4, 22 patients had inactive disease without LN. A significant association of active lupus nephritis detection and the presence of either one or both of the studied antibodies [anti-C1q Ab or anti-dsDNA]. None of the patients of group 1 had anti-C1q Ab only, and none was negative for anti-C1q Ab and anti-dsDNA Ab together. Levels of anti-C1q Ab and anti-dsDNA Ab were significantly higher in more active LN than less active LN. Anti-dsDNA and anti-C1q antibodies sensitivity and specificity for detection of more active LN was 85.0% and 64.0% and 70.0% and 55.0%, respectively, and 75.0% and 91.0% for both. Both antibodies had a positive correlation with SLEDAI score and proteinuria and a negative correlation with C3 reduction. A high significant positive correlation was detected between anti-C1q Ab and anti-dsDNA Ab. Anti-C1q Ab, in combination with anti-dsDNA Ab may serve as potential reliable and none invasive markers of SLE disease activity and renal involvement to avoid unnecessary renal biopsies

Evaluation of gastric function in rheumatoid disease

The present study was designed to study gastric secretory function through analysis of the interrelation between plasma gastrin, gastric acid secretion and gastric microflora in patients with rheumatoid arthritis. The study included 70 patients with rheumatoid arthritis, divided into three groups according to the line of treatment. All patients were subjected to full clinical and laboratory investigations, Gastrin hormone assay in serum, microbiological investigations included estimation of basal gastric acid secretion, maximal and peak acid secretion after stimulation by pentagastrin and culture of saliva and gastric juice samples before and after stimulation by pentagastrin.The results showed that plasma gastrin levels correlate inversely with the acid secretory state and patients with basal achlorhydria or very low gastric acidity had microorganisms in their stomach where the patients with acid secretion in the basal gastric samples had a negative bacterial culture

Electromyography and nerve conduction velocity study in diabetic patients without clinical signs of peripheral neuropathy

The aim of the present study was to evaluate the functional state of peripheral nerve [motor and sensory] conduction velocity before the occurrence of subjective or objective manifestations of peripheral neuropathy in diabetic patients. Clinical and laboratory findings and electrophysiological studies were assessed in forty diabetic patients as well as to healthy subjects. They were classified into three groups: Group I: Insulin required diabetes mellitus [IRDM] [20]. Group] II: Non Insulin dependent diabetes mellitus [NIDDM] and Group III Control [10] healthy subjects. All patients of both groups had no clinical symptoms or signs suggesting peripheral neuropathy. The laboratory tests included estimation of the levels of the fasting blood glucose, 2 hours postprandial and glycosylated haemoglobin. The electrophysiological procedures done were estimation of MNCV of the median and the common peroneal nerves and SNCV of the median and sural nerve. The electromyographic examination revealed polyphasic changes in 5% of the cases in group I, while in group II it was present in 20% of cases. The mean value of the MNCV of both median and common peroneal nerves were significantly lower in both studied groups as compared with the healthy control. The mean value of SNCV of both median and sural nerves were significantly lower in both studied groups as compared with healthy control. The pathogenetic mechanism of diabetic neuropathy remains unclear since many factors have been implicated. The theory of metabolic derangements associated with diabetes mellitus as a cause of abnormal conduction velocity has received a substantial support. It can be finally concluded that the results of EMG, MNCV and SNCV measurements in our diabetic patients without clinical symptoms or signs seem to be mandatory for the detection of early cases of subclinical neuropathy

Assessment of inflammation in the rheumatoid knee joint: correlation between clinical, laboratory and thermographic methods

The present study was done to evaluate the role of thermography in assessment of inflammation in rheumatoid knee patient. Also, a trial to find a correlation between thermographic index and disease activity. The subjects of this study included thirty patients suffering of rheumatoid arthritis [24 females and 6 males]. They are selected from the outpatient clinic of Rheumatology and Rehabilitation Department at Zagazig University Hospital, and diagnosed according to American Rheumation Association, revised criteria [Arnett et al., 1988]. Their ages ranged from 23 - 55 years, with a mean [37.7 +/- 11.28] years and the disease duration ranged from 7 months - 8 years with mean [3.4 +/- 1.3 years]. All of these patients suffer from active synovitis of one or both knee. Ten healthy individuals [4 males and 6 females], were chosen as control for thermography. From the study we found abnormal thermal pattern in the knee of rheumatoid patients as they were in activity. Also, we found a highly significant correlation between thermographic index and mean disease activity grades [Mallya score [P < 0.001]. Thermography was found to be an objective method for measuring the degree of inflammation in different joints of RA. It was simple, sensetive, safe, reproducible and capable of monitoring changes in disease activity over time

Knee function after intra-articular steroid injection

Intra-articular injection of cortico-steroids have been employed in the treatment of rheumatoid arthritis [R.A.] for a long time. Thirty patients with R.A. were included in this study. Synovitis with effusion of the knee joint was the major symptomatic problem with no response to NSAID and second line drugs. Under aseptic condition, aspiration was done, then 40 mg triamcinolone acetonide injected to the knee joint. There was improvement of pain, tenderness, mid-knee circumference, stride length and walking time. This improvement was found highly significant between pre-treatment and 2 and 6 weeks post treatment [P<0.001]

Study of shoulder injuries in athletes

227 male players sharing in different types of sports were examined as regards the shoulder girdle region, the types of injuries and duration of sport participation. It was found that the incidence of shoulder injuries in all players examined was [22.47%] and shoulder affection was common among weight lifters and wrestlers. It was also found that the commonest injuries encountered frequently among players were, respectively, rotator cuff lesion [19.60%], impingement syndrome [15.68%], anterior subluxation of the glenohumeral joint [13.7%], then anterior dislocation, bicipital tendinitis and pectorolis major lesion all had the some percentage [9.80%]