Study of iron profile level in lupus nephritis

Background: Systemic lupus erythematosus [SLE] is a multi-factorial, chronic autoimmune disorder, characterized by dysfunction of T and B lymphocytes. It affects various vital organ systems, and 70% to 90% of SLE patients are females. Lupus nephritis [LN] is one of the common complications in patients with SLE and influences overall outcome of these patients. About two-thirds of patients with SLE have renal disease at some stage which is a leading cause of mortality in these patient .Iron is critical in nearly all cell functions and the ability of a cell, tissue and organism to procure this metal is obligatory for survival. Iron is necessary for normal immune function, and relative iron deficiency is associated with mild immunosuppression. Concentrations of this metal in excess of those required for function can present both an oxidative stress and elevate risks for infection. As a result, the human has evolved to have a complex mechanism of regulating iron and limiting its availability. Ferritin levels correlate with disease activity in patients with SLE and developing of lupus nephritis

Objective: To correlate between Iron profile and SLE activity and developing lupus nephritis

Materials and Methods: A prospective study was conducted on 75 adult persons: 25 Patients with SLE with proteinuria, patients with SLE without proteinuria, 25person have no SLE [control group].These person were Admitted at internal medicine department and outpatient clinic of Al-Hussein university hospital, Cairo, Egypt. SLE patients were diagnosed according to the American College of Rheumatology [ACR] criteria, Lupus Activity assessment by C3 and C4, Lupus nephritis assessment using Albumin /creatinine ratio. Iron profile was measured and included: serum iron, serum TIBC, transferrin saturation and Serum ferritin levels were tested by ELISA

Results: There were no significant statistical difference between groups as regard age or sex however, There were significant difference between groups as regard S.iron, S. ferritin, TIBC and TSAT, Between group analysis results showed significantly lower s.iron and TSAT level of SLE patients with and without proteinuria in comparison with control group. While S. ferritin is significantly high in SLE patients with proteinuria in comparison with SLE patients without proteinuria and control group. And this data go with activity markers of SLE

Conclusions: 1] Hyperferritinemia is a useful marker in assessment of disease activity and severity of Albuminuria in SLE patients complicated by lupus nephritis, treatment of hyperferritinemia can result in decreased Albuminuria and delayed renal damage. 2] Iron homoeostasis is important in normal immune function and Iron disturbance can result in mild immunosuppression

diagnostic efficiency of ultrasound and mammography in the evaluation of breast masses correlated with histopathology

To evaluate the role of mammosonography and mammography and histopathological correlation in assessment of the breast masses. We had studied a totally forty female patients with breast complaint either breast lump [36 cases] or other breast symptoms [fever, pain and discharges] 14 cases. All patients attended to radio-diagnosis departments of Sayed Galal hospital. Mammography and mammosonography were done in all cases to evaluate the specificity and sensitivity of both technique in correlation to the histopathological results [either fine needle, core biopsy or excision biopsy]. Forty patients with breast lesion were examined, 25 patients were benign [16 cases fibroadenoma 64%, 4 cases abscess 16%, 2 cases simple cyst 8%, 2 cases galactocele 8%, and 1 case duct ectasia 4%] and 15 patients were malignant, 13% cases infiltrating ductal carcinoma represent 86.6%, 1 case infiltrating lobular 6.6% and 1 case medullary type represents 6.6%. Combined use of mammography and sonomammography has a valuable role in diagnosis and management of breast lesion and can differentiate between benign and malignant lesions, however histopathology and its role can significantly reduce the need for surgery in breast lump

Radiological modalities versus histopathological finding in chronic small bowel diseases

The small intestine is one of the most difficult areas to study radiographically in the gastrointestinal tract, yet satisfactory investigations are needed to give the maximum definition of every inch of the intestine. Barium radiology remains the method of choice for diagnosis and evaluation of many small intestinal disorders. The other radiological modalities are helpful in diagnosis of chronic small bowel disorder and also detecting the associated pathology and the complications in the different organs. Aim of the work: To evaluate the accuracy of the different radiological modalities in diagnosis of different chronic small bowel diseases. This study was conducted on 50 patients referred from the inpatients departments and outpatients' clinic of medicine and surgery to the radiology department of Bab El Sharia University hospital. They were 30 males and 20 females, their age ranged between 22 and 50 years. The predominant clinical presentations were diarrhea [40 cases], loss of body weight [34 cases], abdominal colic [42 cases], distension [18 cases], fever [6 cases] and bleeding per rectum [1 case]. The cases were submitted to the following: Full clinical examination, Basic laboratory investigations and radiological studies. 38 patients of our conducted study were pathologically proven [76%]. Two cases [4%] were suspected to have small intestinal loops infiltration by an invasive ovarian carcinoma using another modality, while barium study decline this [our results was confirmed operatively]. On the other hand, there were four cases [8%] of post radiotherapy enteric changes having no definite criteria by barium study, and was diagnosed by previous clinical data of receiving radio-therapeutic treatment. Our study was non specific in two cases [4%]. Our study was negative in one patient suffering from obscure rectal bleeding proved by angiography to have a ceacal vascular malformation. Then we classified our population for more detailed analysis according to the type of abnormality into: Post therapeutic complications [6 case], inflammatory diseases [18 cases], neoplastic disorders [6 cases], obstructive disorders [4 cases] and others [6 cases]. Barium study is a highly sensitive imaging tool for detecting small bowel disorder. However other radiological modalities with correlation with the histopathological finding are helpful in the diagnosis and detection of complications of different chronic small bowel diseases

Evaluation of tuberculosis versus pyogenic [infectious] arthritis by using MRI imaging

To assess magnetic resonance [MR] imaging features in differentiating tuberculous arthritis from pyogenic arthritis. Findings in 29 patients with tuberculous arthritis were compared with those of 13 patients with pyogenic arthritis. Bone erosion, marrow signal intensity, synovial lesion signal intensity, boundaries [smooth or irregular] for extraarticular extension of infection, and abscess rim enhancement [thin and smooth or thick and irregular] were analyzed. Revealed that bone erosion was more common in patients with tuberculous arthritis [24 [83%] of 29] than in those with pyogenic arthritis [six [46%] of 13] [P = 0.026], while subchondral marrow signal intensity abnormality was seen more frequently in patients with pyogenic arthritis [12 [92%] of 13] than in those with tuberculous arthritis [17 [59%] of 29] [P = 0.036]. On T2-weighted images, there was no significant difference between the synovial lesion signal intensities of tuberculous arthritis and pyogenic arthritis. Lesions in 16 [70%] of 23 patients with tuberculous arthritis and two [17%] of 12 patients with pyogenic arthritis had smooth extraarticular boundaries, while those in seven [30%] of 23 patients with tuberculous arthritis and 10 [83%] of 12 patients with pyogenic arthritis had irregular boundaries [P = .005]. Tuberculous abscesses [16 [100%] of 16] had thin and smooth rim enhancement, while most pyogenic abscesses [five [7 1%] of seven] had thick and irregular rims[P .001].MR imaging of bone abnormalities Tnalities, extraarticular lesions, and associated abscesses provides useful information in the differentiation of tuberculous arthritis and pyogenic arthritis