Assessment of anticardiolipin antibodies, circulating lupus anticoagulant, protein C, protein S, antithrombin III and activated protein C resistance and their relation to thomboembolic and other clinical manifestations in Behcet's disease

Venous and arterial thrombosis occurs in patients with Behcet's disease and is associated with significant morbidity and mortality. Studies on a possible association between the occurrence of thrombosis and thrombophilia in patients with this disease have been controversial. The objective of this study was to assess the frequency and clinical relevance of anticardiolipin antibodies [aCL] and other thrombophilic factors and their relationship to thromboembolic and clinical manifestations in Behcet's disease [BD]. IgG, IgM and IgA anticardiolipin antibodies [aCL] isotypes, presence of circulating lupus anticoagulant [LAC], protein C, protein S, antithrombin III and activated protein C resistance were investigated in 25 patients with BD and 25 patients with various rheumatic diseases not known to be associated with venous or arterial thromboembolic phenomena served as controls. Twelve of the patients with BD [48%] had either deep vein thrombosis [8 patients], arterial thromboembolic phenomena [4 patients], or both [2 patients]. The IgA aCL elevated in14 [56%] patients with BD compared with one [4%] patient in the control group [P<0.01]. IgG aCL levels were elevated in 13 [52%] patients with Behcet's disease [BD] compared with one [4%] patient in the control group [P<0.01].Also patients with BD do not have decreased protein S, or antithrombin III activity, activated protein C resistance, circulating lupus anticoagulant [LAC], or elevated LgM aCL. No significant differences were found between any variable in both groups. No association between elevated IgMaCL levels and venous or arterial thrombosis and no statistical correlation was found between any factor and clinical manifestations of the disease. A significant number of patients have elevated levels of IgA and IgG aCL but they are not associated with venous or arterial thrombosis. These results do not suggest a primary role for aCL in BD and do not support the role of coagulation abnormalities in the pathogenesis of thromboembolic complications of Behcet's disease but suggest vascular inflammation as the main pathogenetic event in the vascular lesions in Behcet's disease

Functional endoscopic sinus surgery [FESS] in patients with hyperreactive airway disease

This Study was conducted as prospective study on 36 asthmatics with evidence of chronic rhinosinusitis. The aim of this study is to study the effect of chronic sinusitis and polypoidal sino-pathy on the lower airways and to elucidate the effect of functional endoscopic sinus surgery [FESS] on the hyperreactive airway disease and asthma associated with chronic sinusitis. The results of this Study 3 months and 6 months postoperativley showed a significant improvement of all major nasal symptoms [P<0.05] [Table 1] except for hyposmia which did not show the same improvement [P>0.05]. In both allergic and non allergic patients 3 months and 6 months postoperatively, there was a significant improvement in the mean asthma symptoms [P<0.05] [Table 2 and Fig. 1], asthma exacerbation [P<0.05] [Table 3, 4]. We concluded that, sinus disease is an aggravating and exacerbating factor in asthma rather than an inducer of asthma and this was proved by improvement of severe asthma markedly after elimination of the offending sinusitis by FESS and by observation of airway hyperresponsiveness in non asthmatic subjects with chronic sinusitis, and by the observation of improvement of airway hyperresponsiveness after FESS due to relief of nasal symptoms and sinus lesions

Study of Interleukin-16 in Bronchoalveolar lavage of Smokers with and without chronic bronchitis

The study included 30 subjects [10 case of healthy smokers with no chest symptoms, 10 cases of smokers with chronic bronchitis and ten healthy non smokers as control group]. The result of this study showed highly significant statistical increase in the level of IL- 16 in BAL and serum of smokers with or without chronic bronchitis compared to control group [P < 0.001, P < 0.0001 respectively] but no significant statistical difference in its level in BAL and serum of smokers with and without chronic bronchitis [P < 0.05, P > 0.05 respectively]. Also, there was no significant correlation between serum and BAL IL- 16 level in non smokers and smokers without chronic bronchitis [P< 0.05] but there was a significant correlation between them in smokers with chronic bronchitis [P< 0.05]. We concluded that, BAL and serum IL- 16 levels are significantly higher in smokers, [even if they are asymptomatic] than in non smokers, this fact must make us to focus on the danger of smoking in the community