Nail fold capillaroscopic findings in iranian patients with systemic lupus erythematosus

Background: Systemic Lupus Erythematosus is a progressive autoimmune disease with a wide range of morphological and functional changes in microscopic examination of small blood vessels. Identification of vascular diseases at early stage, plays an essential role in the prevention of its' vascular complications. Nailfold capillaroscopy [NFC] is a non-invasive, easy, painless, and accurate method for evaluation of microcirculation and could be used for this purpose. The vast majority of studies on capillaroscopy in lupus patients have shown that changes are not specified to lupus -unlike Systemic Sclerosis- and are more likely to overlap with other diseases. Therefore, it was decided to check capillaroscopic changes and evaluate morphological changes and capillary structure in terms of quality and quantity in lupus patients

Materials and Methods: Nail fold capillaroscopic findings of 114 patients aged 19-75 years old were reviewed in this study. The results were categorized as: a] normal, b] non-specific morphological abnormalities, and c] Scleroderma-like pattern. Results were analyzed qualitatively and quantitatively using SPSS 21 software. "Chi square" test was used to analyze the relationships between variables [P<0.05 was considered significant]

Results: Our results show that Lupus -independent of any other microvascular risk factor can significantly affect the morphology and structure of blood circulation and these changes are shown with detail by nail fold capillaroscopy

Conclusion: Most of the findings are in line with similar studies performed by other investigators in this field. However, no specific pattern was recognized and microbleeding was higher in our patients with scleroderma-like pattern of involvement

[Metastasis of clear cell renal carcinoma to the maxillary gingiva in a 75-year old man: a case report]

About 1% of all oral cancers are metastases of primary tumors elsewhere in the body and could be located in the soft tissue as well as in the jaw bones. Among all the primary tumors that arise below the level of the clavicle, renal cell carcinoma [RCC] is the third most common neoplasm according to metastasis in the head and neck region. Majority of the reported cases involve the jaw bones rather than the soft tissues. Here one case of metastatic RCC to the maxillary gingival is reported. The Patient was a 75 year-old man who chiefly complained about swelling in his anterior region of the maxillary gingival. Excisional Biopsy was performed. Metastatic clear cell Renal cell carcinoma [CCRCC] was diagnosed by microscopic examination by demonstrating islands of cells separated from each other by thin fibrovascular septa, with stroma containing numerous sinusoid like vessels and immunohistochemistry [IHC] Staining [S-100, vimentin, EMA,CEA, CD 10, CK7, TTF-1 and PSA]. CT scan confirmed tumor in the right kidney. Nephrectomy and chemotherapy were performed but patient died 9 months after treatment as a result of metastases to brain and lung. CCRCC arise from renal tubular epithelium. Microscopically differential diagnosis for jaw tumors with clear cells includes a broad spectrum of tumors such as odontogenic tumors, salivary gland tumors and metastatic tumors. Generally, an immunohistochemistry panel consisting of S-100, vimentin, EMA. CEA, CD10.CK7, TTF-1 and PSA is useful to diagnose CCRCC from other clear cell tumors. Although IHC aids us in diagnosis, other paraclinical procedures like imaging should be done, to confirm the diagnosis

[ study of the hyperuricemia in obese children and correlation between hyperuricemia and factors related to the obesity]

Recently obesity in pediatric population is rising fast and its early onset complications [like those seen in adults] are keeping pace with it. It seems that a high level of urinary uric acid [UUA] could be the result of reproduction of uric acid in the body. On the other hand, it was shown to be the result of decreased urinary clearance of uric acid in some obese adults. Target of study is the mechanism of hyperuricemia in obese children and also the correlation between hyperuricemia and factors related to the obesity. We studied 75 severely obese children [42 boys and 33 girls] and compared them with 30 non-obese children [20 boys and 10 girls]. Serum leptin, lipid profile, liver tranaminases, uric acid and creatinine and also 24 hours urinary uric acid and creatinine were measured, and uric acid clearance was calculated in each case. Serum uric acid level [U.A] in obese children were significantly higher than those in control children, but urinary uric acid [UUA], uric acid clearance [CUA] and fractional excretion of uric acid [FEUA = CUA/CCR * 100] were lower in the obese children than those in controls. The low UUA in the obese children suggests that their hyperuricemia was not the result of over intake of food containing uric acid. There was a close correlation between uric acid and age/body weight and it becomes closer as they aged and gained weight. These results suggest that hyperuricemia in obese children is mainly attributable to impaired renal clearance of uric acid and not to overproduction in the body and it will higher age and body weight

Frequency of hepatitis C in patients with rheumatoid arthritis

Hepatitis C virus [HCV] infection has been explained as a disease that sometimes present with rheumatic manifestations indistinguishable from rheumatoid arthritis. This study has been performed to evaluate the frequency of hepatitis C virus infection in a group of patients with rheumatoid arthritis. In this study, during one year, serum samples collected from two hundred consecutive patients with rheumatoid arthritis in all affiliated hospitals of Shaheed Beheshti University, MC., were examined for anti-HCV antibody and HCV-RNA by ELISA and RT-PCR method, respectively. Using a questionnaire, the frequency of HCV infection, age and sex distribution, duration of rheumatoid arthritis, associated immune mediated disorders and risk factors for hepatitis C virus infection were assessed. A total of 200 patients [M/F=26/174] who were mainly aged 51-70 years were studied. The frequency of HCV was found to be 2% [95%CI: 0.6-7%]. All of the infected persons have had a low risk occupation in terms of exposure to the virus and none of them had HCV risk factors. No associated immune mediated disorder was found in HCV infected patients. Our results did not support any contribution of HCV infection in the pathogenesis of rheumatoid arthriti