Anemia in systemic lupus erythematosus [SLE] patients; types, simple diagnosis and role of erythropoietin [EPO]

Anemia is a common hematological abnormality in Systemic lupus erythematosus and can easily be categorized with simple laboratory tests; the aim of this study was to investigate types and causes of anemia in SLE patients and to evaluate the role of EPO in different types of SLE anemia. Patients and methods; forty three male and female patients with SLE were investigated for types and possible causes of anemia among the follow up patients of the rheumatology outpatient clinic of Sohag university hospital in one year, blood and urine samples were obtained for laboratory investigations, patients with hemoglobin level less than 14 gm/dl for male and 12.3 gm/dl for female were consider anemic and enrolled in the study. Thirty nine patients [90.7%- 1 male and 38 females] were anemic, with mean age of 31 +/- 10 years, the types and incidence of anemia were; iron deficiency anemia [IDA] n = 22 [56.4%], anemia of chronic disease [ACD] n = 12 [30.8%] and autoimmune hemolytic anemia [AIHA] n=5 [12.8%], mean levels of hemoglobin were 10.4 +/- 1.3, 9.6 +/- 1.1 and 7.7 +/- 0.8, in the three groups respectively, low levels of complement C3 and C4 were observed in AIHA, and ACD, but not in patients with IdA. Anti-dsDNA antibodies were seen in all patients with AIHA, and in 10 patients with IDA, CRP concentrations were not related to severity of anemia in the three groups, higher levels of serum creatinine and proteinuria were detected in the three was no difference in the mean levels of EPO among different groups. Anemia in SLE can be easily diagnosed by simple methods, IDA is very common among SLE patients in our community, Erythropoietin [EPO] may have no role in SLE anemia and the presence of Anti Erythropoietin antibodies [AEA] and its role can not be ruled out

Are patients with polycystic ovary syndrome at risk for cardiovascular disease?

Polycystic Ovary Syndrome [PCOS] is considered not only a reproductive endocrinopathy but also a metabolic disorder associated with long term health risks, including diabetes mellitus and coronary artery disease and it shares some or all components of syndrome X. To assess and evaluate cardiovascular risk factors in patients with PCOS and to compare the various systolic and diastolic function indices hetween PCOS patients and regularly cycling control women. 45 patients with PCOS [mean age 26.16 +/- 6.47 years and mean BMI 28.18"5.47 kg/m[2]] were recruited for this study, in addition to 30 healthy volunteer women with regular menstrual cycles, their age and body mass index [BMI] matched with the patients group. A thorough history and clinical examination were performed. Transvaginal sonography was performed using a transvaginal probe 5 MHZ. Hormonal assay for [serum luteinizing hormone [LH], follicle stimulating hormone [FSH], prolactin and total testosteronel, lipid profile [high and low density lipoproteins [HDL and LDL], triglyceride [TG] and total cholesterol [T Chol]], uric acid, homocysteine and two hours post prandial serum glucose [PPSG] levels were determined for all studied participants. M-mode, two dimension and Doppler echocardiography were performed for evaluation of systolic and diastolic function parameters. We have studied indices of cardiac flow in women with PCOS in relation to BMI, blood levels of reproductive hormones [LH, FSH. testosterone and prolactin]. lipid profile, uric acid, PPSG and homocsteine levels. The mean serum levels of LH, total testosterone, T Chol, TG, homocysteine, uric acid, PPSG, LH/FSH ratio and T Chol./HDL ratio were significantly higher in patients with PCOS group [p <0.001] than control group. Patients with PCOS had significantly lower peak mitral flow velocity in early diastole [PEV], ratio between peak mitral flow velocity in early diastole [E] and late diastole [A] [B/A ratio], Ejection fraction [EF] and fraction of shortening [FS] [p < 0.001] and significantly longer isovolumic relaxation time [IVRT] and E-velocity deceleration time [EVDT] [p <0.001]. Patients with PPSG> 140 mg/dl had significantly lower B/A ratio [p < 0.05] and those with BMI > 25 kg/m[2] had significantly longer IVRT [p <0.01]. Moreover, we found significant negative correlation between E/A ratio and both PPSG [r = -0.349] and LDL [r = -0.382] and significant positive correlation between IVRT and BMI [r = 0.415]. We conclude that both diastolic and systolic dysfunction are common findings in population with PCOS and this dysfunction together with the increased serum homocysteine concentration, dyslipidemia and impaired glucose tolerance may contribute to increased risk of cardiovascular disease in these patients