cross sectional study on bone mineral density in rheumatoid arthritis

Osteoporosis in women with rheumatoid arthritis [RA] is a subject of great interest. This study aims at the determination of the frequency of osteoporosis in RA patients and investigates the main clinical determinants of bone mineral density [BMD] in this disease. Subjects and The work included sixty female patients with RA fulfilling the American Rheumatism Association criteria [ARA], irrespective of their age or menopausal state. BMD was measured in patients at the wrist and lumbar spine. The results showed a significantly higher body mass index [BMI] in patients with normal BMD. Rheumatoid patients with osteoporosis had a longer disease duration than the other groups [P=0.012]. All postmenopausal patients and 67% of premenopausal patients had a low BMD. All patients with normal BMD were pre-menopausal. Health assessment questionnaire [HAQ] was higher in patients with low BMD and osteoporotic patients [P=0.031 and 0.018]. The same is detected for Ritchie articular index [P=0.024,0.022 and 0.036 for low BMD, osteopenia and osteoporosis, respectively] The visual analogue questionnaire [VAQ] was significantly higher in low BMD, osteopenia and osteoporosis compared to the normal BMD group [P=0.000 for all]. Serum calcium was significantly lower, while alkaline phosphatase and rheumatoid factor were higher in low BMD, osteopenia and osteoporosis patients than normal BMD. It is concluded that osteoporosis is a feature of rheumatoid arthritis; it is increased with BMI, longer disease duration, post-menopausal women and increase disease activity

Homocysteine and vascular events in lupus patients with and without raynaud's phenomenon

Aim: Homocysteine [Hcy] is now considered as an independent risk factor for cardiovascular diseases lupus patients with Raynaud's and without Raynaud's phenomenon [RP] are candidates for multiple vascular events due to several contributing factors. Hyperhomoysteinemia is among these factors. Subjects and The aim of this study is to examine the level of fasting homocysteine and anti-cardiolipin antibodies in a selected group of lupus patients with and without Raynaud's phenomenon, and find their relation to some vascular events. No significant difference in the serum levels of ESR, CRP, serum creatinine, anti-ds-DNA, C3, parameters of lipid profile, and the two isotypes of anticardiolipins [aCL] [IgG and IgM], when lupus patients with RP are compared with those with no RP. Homocysteine is significantly elevated in all lupus patients when compared to the control group, yet, there is no difference when lupus patients with RP are compared to those without RP. Conclusions: Our data do not support a cause and effect relationship between homocysteine and Raynaud's phenomon in lupus patients. Also, we are in favour of an essential role for lupus disease itself in the development of hyperhomocysteinemia. Whether nutritional supplementation with folic acid and vitamin B12 is advisable to ameliorate the vasomotor dysregulation in lupus patients with RP is still a matter of debate

Interleukin-8 [IL-8] production by activated neutrophils in rheumatoid disease

lnterleukin-8 [IL-8] produced by neutrophils was estimated before and after stimulation with lipopolysaccharide [LPS] in four groups of subjects:-a- 12 patients with active rheumatoid arthritis, b-8 patients with juvenile chronic arthritis [JCA], c-12 patients with osteoarthritis [OA] and d- 12 healthy controls. Neurorphil IL-8 production without stimulation by exogenous mitogen was significantly higher in different groups of patients than in the control group. The contrary was detected when neutrophils were stimulated by LPS. On the other hand, significantly higher levels of IL-8 were produced by neutrophils [with or without stimulation] from patients with active RA than from active JCA and OA. This may suggest that the higher levels of IL-8 released from neutrophils may be, at least in part, responsible for the different behaviour of RA with respect to JCA and OA. Further studies are needed to elucidate the role [if any] played by IL-8 in the pathogenesis of OA

Evaluation of some biochemical and radiological changes in bone metabolism during corticosteroid therapy

Osteoporosis is considered as a major outcome of corticosteroid administration. The evaluation of the degree of osteoporosis in patients on steroid therapy was examined by many studies. This work aimed at the assessment of bone turnover markers, as well as, quantitative computed tomography as measures for detection of osteoporosis in patients receiving corticosteroids. This has been achieved through the biochemical detection of bone turnover markers [total alkaline phosphatase [SAP], osteocalcin [OC], urinary excretion of hydroxyproline/creatinine [OHPr/Cr]] and QCT scanning of L[2]-L[4] Vertebrae. Our results demonstrated that 60% of patients on steroids had complaints related to osteoporosis. Concerning the biochemical parameters of bone turnover SAP tended to be higher in patients than in control. Also, OC is significantly reduced [P

Degenerative joint disease: a new cartilage marker

The aim of the present study was to quantity COMP level in serum of patients with newly developed and late OA in attempt to the prognostic value of its serum measurement as a new cartilage marker. The study was carried out on thirty patients with OA diagnosed according to ARA criteria subdivided into 2 groups [IA and IB] representing early and late OA, and twenty healthy normal individuals as controls [II]. group IA, IB and II were subject to clinical evaluation, routine investigations and determination of serum Ca, phosphorus. uric acid, RF, and X-ray of the affected joints. COMP level estimation in serum was done to all patients and controls Serum concentration of COMP ranged from 1.53-2.1 microg/ml, 2.18-2.65 microg/ml, and -2.65 3.02 microg/ml in the control group, group IA and IB respectively. COMP serum levels is significantly increased in GIA and IB than control [p < 0001]. Also, the comparison is significant between IA and IB patients [p < 0.001] For uric acid, Ca, and phosphorus no difference could be demonstrated between IA and IB. Serum level of COMP is significantly higher in late OA, than early cases, yet both groups are higher than control. The determination of serum COMP may be tried as indicative of therapy in OA cases especially when using chondroprotective therapeutic agents