Serum levels of hyaluronic acid [HA] and cartilage oligomeric matrix protein [COMP] as predictors of disease progression in rheumatoid arthritis

To measure the serum concentrations of specific cartilage and bone molecules reflecting tissue turnover to investigate disease activity. The study included 30 rheumatoid arthritis [RA] patients with age range 42 - 66 years. Sixteen patients had rapid erosive disease and fourteen had slow erosive, compared with 20 matched apparently healthy volunteers. All studied individuals were subjected to full history taking, clinical examination and laboratory investigations including measurement of serum levels of cartilage oligomeric matrix protein [COMP], hyaluronic acid [HA], high sensitive C- reactive protein [CRP], erythrocyte sedimentation rate [ESR] and RF concentration as well as measurement of activity of RA by disease activity score [DAS] 28 joint counts. The study showed a significantly higher values of COMP, HA, CRP and ESR in slow erosive [p<0.001] and rapid erosive [p<0.0001] RA patients when compared to controls. There were significantly higher values of COMP, HA, CRP and ESR in rapid erosive RA patients compared to slow erosive RA patients. A significant positive correlation between serum levels of COMP and HA and age, disease duration, Larsen score, DAS and CRP and ESR was found. Also there was a significant positive correlation between serum levels of COMP and HA [r = 0.674, p<0.01]. It could be concluded that the measurement of some serological biomarkers that reflect bone and cartilage destruction in RA patients, could be used to investigate disease activity and increase the knowledge of the basic pathophysiology of joint disease

Clinical and electrophysiological study of peripheral nerve functions in patients with chronic renal failure

To study the prevalence and the patterns of peripheral neuropathy in patients with chronic renal failure. The study was conducted on 40 patients with chronic renal failure [CRF] and 20 healthy subjects of matched age and sex [control group]. Patients were divided into 2 groups. Group]: those with chronic renal failure treated conservatively [n=20] and Group II. those with end stage renal disease treated by hemodialysis [n=20]. Patients were selected randomly. The presence of polyneuropathy and its severity was assessed in all participants hi clinical, neurological examination and the following electro-physiological methods: 1] motor nerve conduction of the median, ulnar, tibial and peroneal nerves, 2] sensory nerve conduction studies of the sural, ulnar and radial nerves 3] F-wave study of the median, ulnar, tibial and peroneal nerves; and 4] Soleus H-reflex. The prevalence of polyneuropathy in group 1 and group 2 were 60% and 65%, respectively [with no significant difference between them]. Polyneuropathy was evident clinically in 37.5% of CRF patients and subclinical neuropathy [diagnosed only on electrophysiological basis] was found in 25% of GRE patients. Electrophysiological abnormalities suggested that the pathology was mainly axonopathy as there was a significant reduction of the CMAP amplitudes. The pattern of uremic neuropathy was axonal, affecting sensory fibers more than motor ones. It seemed that the most sensitive tests in detecting uremic neuropathy would be the H reflex, sural sensory nerve conduction, the peroneal and tibial F wave studies and the median, peroneal and tibial motor conduction studies

Subclinical peripheral nerve involvement in rheumatoid arthritis patients

To study an electrophysiological investigation to find out the incidence and patterns of peripheral nerves involvements in rheumatoid arthritis and to correlate them with disease activity. This study was carried out on 30 patients with rheumatoid Arthritis classified to, Group I: 15 patients, [2males and 13 females, with evidence of disease activity, using disease activity score-DAS. Group II: 15 patients, [1 male and 14 females] with evidence of clinical remission, Control group: 12 healthy normal subjects, 2 males and 10 females. All patients undergo complete history raking, general, neurological examination, laboratory, radiological studies, electrophysiological studies were done for patients and control group on both sides of the body .a. motor nerve conduction studies to the following nerves [median nerve, ulnar nerve and common peroneal nerve] b. sensory nerve conduction studies to the following nerves: [median, ulnar and sural nerves]. There was significant delay in distal motor latency [DML] and distal sensory latency [DSL] with significant reduction in motor and sensory nerve conduction velocities in patients groups more than control group and in-group I more than group II [p<0.05]. There was significant positive correlation between DML, DSL and disease activity score [DAS] in group I [p<0.05] but in significant in group 2 [p>0.05] and significant negative correlation between MNCV. SNCV and DAS [p>0.05]. Rheumatoid neuropathy predominates in patients with evidence of disease activity. There is a positive correlation between distal latencies and disease activity score, and negative correlation between nerve conduction velocities and disease activity score

Evaluation of antinucleosome antibodies in systemic lupus erythematosus

Recent data suggest that the nucleosome plays a key role in the pathogenesis of systemic lupus erythematosus [SLE]. To determine the prevalence, sensitivity and specificity of antinucleosome antibodies [AnuA] in SLE patients and their association with disease activity, clinical and laboratory data. This study included three groups of 20 subjects each: group I [SLE patients], group II [rheumatoid arthritis [RA] patients], and group III [apparently healthy controls]. Serum AnuA, antinuclear antibodies [ANA], and anti-double stranded DNA [Anti-dsDNA] were measured with ELISA. Clinical activity of the disease was assessed with SLE Disease Activity Index [SLEDAI]. The highest prevalence of AnuA was found in group I [90%], significantly higher than that for group II [10%], and group HI [0%] [p<0.0001]. In group I, 55% were positive for AnuA, but not for anti-dsDNA. There was significantly higher prevalence of dermatological, joint, and renal disease in SLE patients with positive AnuA [p<0.01, p<0.001, p<0.01, respectively]. Moreover, AnuA correlated with disease activity [p<0.05] and had significantly higher sensitivity [90%] for the diagnosis of SLE. AnuA are of particular importance in the diagnosis of SLE, when anti-dsDNA is absent, AnuA correlates with disease activity, and most of the dermatological, joint, and renal disease manifestations, in patients with SLE. Moreover, AnuA are the most sensitive antibody marker, with an equal specificity, in the diagnosis of SLE, as compared with anti-dsDNA and ANA

Blink reflex alterations in recently diagnosed diabetic patients

To determine the frequency of blink reflex alterations and to examine the influence of hyperglycemia in inducing the alterations in recently diagnosed Type 2 diabetes mellitus patients. A cross-sectional study was carried out on patients having asymptomatic diabetes with a period of evolution under 10 years. In all 47 patients [26 women and 21 men], serum glycemia levels were determined and the latency onset of the blink reflex components were measured. The average patient age was 44.5 +/- 11.0 [mean +/- SD] years with a diabetes evolution period of 4.3 +/- 2.9 [mean +/- SD] years. After a fasting serum glucose test, the diabetic patients were catalogued as normoglycemic [126mg/dl] and subjected to a blink reflex test. The results obtained from the diabetic patients were compared with those from a non-diabetic control group. 14.8-31.9% of the diabetic patients showed alterations in blink reflex component latencies, The differences compared with the control group were significant [p<0.05]. Diabetes, as is well-known, can affect the central and peripheral nervous system and there does not appear to be a link between glycemic levels and blink reflex components. However, blink reflex alterations were present even in diabetic patients with a relatively short period of disease evolution

Correlation between cartilage defects as detected with MRI and x-ray spiking of tibial tubercles in osteoarthritis knees

To ascertain whether spiking of the tibial tubercles is associated with cartilage defects as detected by magnetic resonance imaging [MRI] in osteoarthritis [OA] of the knee joint patients. The study was performed on 76 knees of 47 patients with symptomatic tibiofemoral joint [TFJ] OA and 31 apparently normal knees of 16 volunteers as a control group. Angulation of the tip of the medial and lateral tubercles and the height of the tubercles above the tibial plateau were measured on a standard anteroposterior radiograph of the knee joint. Cartilage defects in the tibiofemoral joint were determined with MRI examination. The lengthening and sharpening of the angles of the tubercles were significantly more prominent in patients than controls. A strong association was found between angulation [if less than 70[0]] and especially the height [if more than 0.16] of the medial tibial spike and MRI-detected cartilage defects in the medial tibiofemoral compartment. The predictive value of the spiking of tibial tubercles for MRI-detected cartilage defects in TFJ was related to the degree and size of spiking. The presence of tibial spiking itself may not be a reliable sign of early OA