Psychiatric disturbances in rheumatoid arthritis

To study the pattern of psychiatric syndromes that may accompany Rheumatoid arthritis [RA] and their relationship to disease activity, severity, pain and disability. Also, to find out the impact of stressful life events on the same parameters of the disease. The study comprised forty RA patients and 20 apparently normal controls. They were subjected to thorough medical history taking, clinical examination, laboratory investigations, disease activity, spread severity index, functional assessment with the Health Assessment Questionnaire Score, the Social Readjustment Rating Scale [SRRS] and identification of psychiatric disorders using the International Classification of Diseases [ICD,-10] symptom checklist for mental disorders. The prevalence of psychiatric disorders was significantly higher in RA patients than in the control group [p<0.05]. Depressive disorders were the most prevalent of these disorders. The Social Readjustment Rating Scale was significantly higher in RA patients than in the control group [p<0.001]. Also RA patients with psychiatric disorders were found to have higher SRRS than those not suffering from psychiatric disorders [p<0.05]. The stressful life events were found to have a strong impact on disease activity and pain in RA patients. Depression was the most common psychological disturbance associated with RA. This study highlights the role that the rheumatologist can play in the early detection of psychiatric disorders and psychiatric consultation in the proper time. In addition, it should be emphasized that the psychosocial effects of RA should always be put in mind and treated as a part of the illness

Membrane cofactor protein as a marker of activity in systemic lupus erythematosus

1] Measure the percentage of membrane cofactor protein [MCP, CD46] expression on mononuclear cells. 2] Evaluate its role in the pathogenesis of systemic lupus erythematosus [SLE]. 3] Correlate it with disease activity or activated complement system. Thirty Egyptian SLE patients [27 females and 3 males] were enrolled in this study. All of them were subjected to thorough clinical examination and laboratory tests including complete blood picture, ESR, serum C3 and C4, serum creatinine, in addition to complete urine analysis and estimation of the percentage of MCP expression on monocuclear cells using flowcytometry. Ten normal healthy subjects were included as a control group. They were matched for age and sex with SLE patients. The percentage of MCP expression differentiated lupus patients from the control subjects and the difference was statistically highly significant [p<0.0001]. Moreover, MCP expression correlated with SLE disease activity scores [r=0.82], and with the parameters of renal damage such as serum creatinine [r=0.33] and serum C3 [r=-0.55]. This might implicate its role as an important indicator for active evolution of SLE as well as in the pathogenesis of lupus nephritis. This study suggests a role of MCP as a useful marker in evaluating SLE activity and a possible therapeutic implicator as a complement inhibitor in SLE patients