Nailfold capillary density as a possible indicator of pulmonary capillary loss in systemic lupus erythematosus

Nailfold capillaries are involved in the disease process in systemic lupus erythematosus [SLE]. The same pathology is also observed in alveolar capillaries. To correlate the nailfold capillary density with pulmonary KCO function tests and therefore with pulmonary capillary loss in SLE patients. We studied 25 systemic lupus erythematosus patients [22 females and 4 males] and 10 healthy age and sex matched volunteers as a control group. Nailfold capillary density abnormalities were studied using a Leica light microscope under immersion oil at a magnification of x200. Pulmonary KCO function tests were performed within 6 months of measuring nailfold capillary density. The pulmonary diffusing capacity [DLCO] was calculated using the single breath method. Pulmonary diffusing coefficient [KCO] was also calculated and expressed as a percentage of the predicted value. KCO was used as a measure of alveolar wall capillary density. There was a significant difference in nailfold capillary density between systemic lupus patients and controls. There was a non-significant difference in pulmonary KCO function tests between the two groups. There was a significant relation between nailfold capillary density and pulmonary KCO function tests in SLE patients. We used three methods in determining the nailfold capillary density. The nearest value method showed highly significant difference with pulmonary KCO test [p<0.001]. The other two methods [reproducible and highest nailfold capillary density values] showed significant differences [p<0.01 and p<0.05 respectively]. There were significant differences between nailfold capillary density and laboratory findings, arthritis, photosensitivity, malar flush and oral ulcers. Nailfold capillary density is a simple method that can determine alveolar capillary density in SLE

role of bacterial antigens in reactive arthritis

The study was performed on 40 reactive arthritis patients and 20 healthy controls. Clinical and laboratory evaluation was used to elaborate the bacterial antigens role in the pathogenesis of reactive, arthritis. Serum samples were collected for rheumatoid factor, tissue typing and Widal test. Stool samples were collected for culture. Urogenital swabs were taken for culture and polymerase chain reaction [PCR] for chlamydia-DNA. There was preceding infection of the urogenital tract through positive urogenital swab cultures of mycoplasma in 8 patients [20%], positive PCR for chlamydia-DNA in 19 patients [47.5%] and previous gastro-intestinal infection through positive compylobacter culture in 10 patients [25%], shigella in 5 patients [12.5%] and salmonella in 10 patients [25%]. There was some patients had combined infection with different types of organism. There was a role of bacterial antigens in the pathogenesis of reactive arthritis, which affect gastero-intestinal tract such as salmonella and urogenital tract such as chlamydia trachomatis

Clinical and laboratory parameters that affect serum and synovial Fluid interleukin-6 level in rheumatoid arthritis patients

This study was conducted on thirty Rheumatoid Arthritis [RA] patients, 21 females and 9 males, with a mean age of 37 +/- 12.5 years; ten primary osteoarthritis [OA] patients, 7 females and 3 males whose mean age was 51 +/- 10.3 years; and ten apparently healthy volunteers, 8 females and 2 males whose mean age was 38 +/- 12.3. RA patients were subjected to: erythrocyte sedimentation rate, full blood picture antinuclear antibodies, rheumatoid factor and C-reactive protein. Measurement of serum IL-6 was done for all 3 groups, RA, OA and controls and synovial IL-6 levels for RA and OA patients. The results showed a non-significant difference in the level of serum and synovial fluid IL-6 in patients with disease duration below 10 years [200 +/- 127 pg/ml] and those with disease duration above 10 years [189.7 +/- 11.6 pg/ml]. Again there were non-significant differences in the serum and synovial fluid levels of IL-6 in RA patients treated with NSAIDs, immunosuppression [Methotrexate,] a combination of Methotrexate and chloroquine phosphate Na aurothiomalate, or corticosteroids. There was a significant correlation between both serum and synovial fluid IL-6 levels and the mean disease activity grades of RA. Also we found a significant correlation between serum and synovial fluid IL-6 levels and R.F [p <0.05]. But there was no significant correlation between serum and synovial fluid IL-6 and ANA. We concluded that serum IL-6 level can be considered as a parameter of rheumatoid disease activity and it might play a role in the pathogenesis of rheumatoid disease