Plasma factor VII and histidine-rich glycoprotein as a potential markers in pre eclampsia

Background: Preeclampsia [PE] is a complex and serious multi-system disorder of pregnancy with a worldwide incidence of 5-7% and contributes significantly to maternal and perinatal morbidity and mortality. Normal pregnancy is associated with a local hypercoagulable state that becomes more profound in PE. Histidine-rich glycoprotein [HRG] is a protein interacting with angiogenesis, coagulation, and inflammatory responses, processes known to be altered in preeclamptic pregnancies

Aim of the work: Is to analyze changes in the circulating levels of plasma factor VII [Plasma F VII] and HRG in women developing PE and to evaluate them as markers for early diagnosis of PE

Subjects and Methods: This study was carried out on 80 pregnant women after 20 weeks of gestation. The subjects were divided into: Group I [G1]: 40 cases with preeclampsia; Group II [G2]: 40 normal pregnant women who were matched for age and gestational period. Plasma FVII and HRG were measured by ELISA

Results: Plasma FVII levels were significantly higher in G1 [206.22 +/- 46.25 ng/ml] as compared to G2 [97.46 +/- 21.95 ng/ml] [p<0.001]. Significant positive correlation of plasma FVII with fibrinogen and significant negative correlation with platelet count and HRG were detected. At cut off 125.75 ng/ml plasma FVII levels shows high sensitivity and specificity [95%]. HRG levels were significantly lower in G1 [37.1 +/- 7.52 pg/ml] as compared with G2 [79.87+/-24.15 pg/ml] [p<0.001]. HRG shows significant positive correlation with platelet count and significant negative correlation with each of fibrinogen and plasma FVII. At cut off 46.45 pg/ml. HRG shows high sensitivity [92.5%] and specificity [87.5%]

Conclusion: Plasma FVII and HRG can be used as early marker for detection of PE

Serum neopterin level in children with juvenile idiopathic arthritis

Background: Juvenile idiopathic arthritis [JIA] is generally considered a clinical syndrome involving several disease subsets, with a number of inflammatory flows, leading to an eventual common pathway in which persistent synovial inflammation and associated damage to articular cartilage and underlying bone are present. Neoptrin is a reliable marker in the assessment of the rate of IFN-gamma production. Levels of neoptrin increase in direct proportion with the level of interferon. Measurement of neopterin level is useful because of its relative stability also it is a prognostic indicator for cell-mediated immunity

Aims: This study aims to assess serum level of neopterin in patients with Juvenile Idiopathic Arthritis [JIA] in relation to the disease activity, severity and response to conventional and biological therapy

Methodology: The study was conducted on 30 patients [Group A] previously diagnosed as SoJIA, they were divided into two subgroups according to their therapy into Group AI on biological therapy [15 patients] and Group AII on conventional therapy [15 patients]. These in addition to 20 healthy controls [Group B]

Results: Basic clinical evaluation and laboratory investigations were done. We found that JIA patients had significantly higher levels of serum neopterin than healthy controls. We also found a highly significant difference between neopterin levels in the activity and remission states among all patients [Group AI and Group AII]

Conclusion: We concluded that serum neopterin is a useful marker for cellular immune activation and also indicative of the activity of JIA. Our findings are supported by positive correlations between serum neopterin levels and other markers of activity as TLC, PLT counts, ESR, and CRP. We also concluded that serum neopterin is a sensitive and accurate predictor of disease activity where sensitivity of that test was 93.3% and accuracy was 72.5%

Recommendations: Investigating the serum neopterin measurement in other autoimmune collagen diseases. Assessment the influence of biological therapy on neopterin levels in relation to disease progression

Prognostic impact of factor V leiden in systemic lupus erythematosus pediatric patients

Objective: This research aimed to study the presence of factor V gene G1691A mutation [Factor V Leiden] in SLE pediatric patients with and without complications and to investigate the association between the presence of Factor V Leiden and lupus complications mainly lupus nephiritis in these patients

Subjects and Methods: This study was conducted on 50 Egyptian pediatric patients [48 females and 2 males] who were all diagnosed as SLE according to the American College of Rheumatology criteria. They were enrolled from the Immunological Clinics at Ain shams University Pediatric Hospital and were divided into two groups: Group 1 [control group] of matched age and sex: Including 25 newly diagnosed uncomplicated SLE patients e.g.: arthritis, musculoskeletal and cutaneous lupus. Group 2 [patients group]: Including 25 SLE complicated patient e.g.: nephritis, neurolupus, thrombotic manifestation, cardities and antiphospholipid antibody syndrome. The complications observed in patient group was further classified into lupus nephritis alone or lupus nephritis with other complications [21 patients] or patients with complications other than lupus nephritis [4 patients]

Results: All patients included in this study were subjected after taking their parents' consent to full history taking laying stress on history of complications mainly lupus nephritis. In addition, laboratory investigations which include CBC, tests for confirmation of SLE as ANA, anti dsDNA, C3, lupus anticoagulant, anticardiolipin IgG and IgM and renal function tests as serum creatinine and 24 hrs urinary proteinsm were done. The Factor V gene mutation was determined by the method of PCR-based DNA analysis in both control and patient groups. In control group, there was 1 out of 25 patients having the Factor V Leiden mutation; who had a heterozygous pattern. The prevalence of Factor V Leiden in patients group showed 2 out of 25 patients, both of them had a heterozygous pattern of the gene mutation

Conclusion: This study couldn't demonstrate any correlation between the presence of Factor V Leiden mutation and the presence of complications in SLE patients as there was no statistical significant difference [P >0.05]

Some markers of oxidative stress and antioxidant status in patients with psoriasis

Psoriasis is a common, chronic inflammatory skin disease with unknown etiology. It has been suggested that increased reactive oxygen species [ROS] production and deficient function of antioxidant systems activities may be involved in the pathogenesis of the disease. The goal of this study was to determine the role of lipid peroxidation, assess the antioxidant activity in psoriasis patients and to correlate it with severity of the disease. In this study malondialdehyde [MDA], super oxide dismutase [SOD] enzyme activity, and total antioxidant oxidative capacity [AOC%], Vit E and beta carotene levels in 24 patients with psoriasis were investigated and compared with those of 12 control subjects. Clinical severity of the disease was determined according to the Psoriasis Area Severity Index [PASI] scores in patients. Our results showed that MDA as a marker of oxidative stress was significantly higher in psoriatic patients, while AOC%, SOD, Vit E and beta carotene as markers of antioxidant status were significantly lower in psoriatic patients compared to control. However, there was no correlation between PASI score and plasma AOC% and erythrocyte SOD levels. In conclusion our results may provide some evidence for the role of ROS production associated with decrease antioxidant potential in psoriasis

Clinical and biochemical changes in Egyptian patients with Sjogren Larsson syndrome

The Sjogren-Larsson syndrome [SLS] is an inborn error of lipid metabolism, characterized clinically by congenital ichthyosis, mental retardation and spasticity. It is a rare autosomal recessive condition resulting from fatty aldehyde dehydrogenase deficiency, which is involved in lipid synthesis and catabolism. This study included nine patients with SJL, their ages ranged from 2.6 to 12 years [6.4 +/- 2.2]. All the patients were subjected to full clinical examination and biochemical investigations including the estimation of the level of fatty aldehyde dehydrogenase in leucocytes and total cholesterol, triglycerides, low-density lipoproteins [LDL], high-density lipoproteins [HDL], low-density lipoprotein oxidizability and 5-lipooxygenase in plasma. Neurophysiologic examinations including magnetic resonance image [MRI], electro encephalogram [EEG], and visual evoked potential [VEP] were done. The study aims to outline the clinical signs and symptoms together with the biochemical characteristics of SLS. Our findings provide evidence for defective 5-lipoxygenase degradation, fatty aldehyde dehydrogenase deficiency, while lipid profile and low density lipoproteins oxidizability were significantly increased in SLS patients. These findings suggest that fatty aldehyde dehydrogenase plays a major role in detoxification and in the turn over of fatty aldehydes and lipids and offer non-invasive diagnostic tools. Moreover, they provide a powerful rationale for therapeutic trials aimed at inhibiting 5-lipoxygenase synthesis

value of transfferrin receptors assay and erythrocyte zinc protoporphrin in diagnosis of iron deficiency in hemodialysis patients.

This study aimed to evaluate the clinical usefulness of serum transferrin receptor and erythrocytes zinc protoporphyrin as possible markers of iron deficiency anemia in dialysis patients. This cross sectional study included 50 patients undergoing regular hemodialysis treatment, three times weekly. None of these patients received intravenous iron therapy, blood transfusion or recombinant human erythropoietin [rHuEpo] within three months before the study. Patients who had factors affecting serum ferritin and transferrin receptor [TR] levels as well as other causes of iron deficiency anemia were excluded. All patients were subjected to complete blood count [including hemoglobin concentration, hematocrit and MCV] and routine biochemical profile including blood urea and serum creatinine, sodium, potassium, calcium, phosphorus and albumin. Iron studies included serum transferrin, serum iron, total iron binding capacity [TIBC], serum ferritin, transferrin saturation index, erythrocyte zinc protoporphyrin and serum transferrin receptors. Iron status was evaluated by bone marrow examination by a biopsy from the posterior iliac crest or sternal bone marrow aspiration. Sections were examined for iron with Prussian blue stain and graded according to scale described by Ho-Yen. The study concluded that TR is more sensitive than s. ferritin as an indicator of iron deficiency, while s. ferritin is more specific screening test for iron store deficiency. ZPP also gives low sensitivity and specificity as an indicator of iron store deficiency. It may be predicted that these measurements are likely to replace the conventional parameters. They would be especially used in the outpatient clinics, where bone marrow examination is either not available or regarded as an invasive mean