Safaa Sayed

Vitamin D status in rheumatoid arthritis patients: relation to clinical manifestations, disease activity, quality of life and fibromyalgia syndrome

To assess vitamin D levels in rheumatoid arthritis (RA) patients and to find their relation to clinical parameters, fibromyalgia syndrome (FMS), quality of life (QoL) and disease activity.

Cutaneous vasculitis in systemic lupus erythematosus patients: potential key players and implications:

Objectives The aim of the present work was to study the clinical characteristics of cutaneous vasculitis (CV) in systemic lupus erythematosus (SLE) patients and find possible potential key players in its development and implicated associations with the disease manifestations. Patients and methods Fifty adult female SLE patients underwent full history taking, thorough clinical examination and laboratory investigations. The SLE Disease Activity Index (SLEDAI) and accumulated damage using the Systemic Lupus International Collaborative Clinics/American College of Rheumatology Damage Index (SLICC/ACR DI) were assessed. Results The mean age of the patients was 29.1 ± 6.1 years and was significantly lower in those with CV (p = 0.018). The disease duration was 4.9 ± 3.7 years. CV was present in 30% of the patients. Musculoskeletal manifestations and hypocomplementemia were present in all patients with CV. The SLEDAI and SLICC/ACR DI tended to be higher in those with CV. Complement (C3 and C4) was significantly consumed in CV patients (p < 0.0001). Antiphospholipids were comparable between those with and without CV. Lupus nephritis, cardiovascular manifestations and Sjögren syndrome were significantly linked to the development of CV (p = 0.025, p = 0.023 and p < 0.0001, respectively). Both C3 and C4 showed a high sensitivity (93.3% and 86.7%) to detect CV in SLE at cut-off values below 81.4 mg/dl and 16.8 mg/dl, respectively. Conclusion CV is closely related to hypocomplementemia but not to antiphospholipids and is associated with lupus nephritis, musculoskeletal manifestations and Sjögren syndrome.

Methylene tetrahydrofolate reductase, transforming growth factor-β1 and lymphotoxin-α genes polymorphisms and susceptibility to rheumatoid arthritis

BACKGROUND Rheumatoid arthritis is a widely prevalent autoimmune disorder with suggested genetic predisposition. OBJECTIVES The aim of this study is to detect the pattern of genetic polymorphism of methylene tetrahydrofolate reductase (MTHFR C677 T and A1298 C), transforming growth factor-β1 (TGF-β1 T869 C) and lymphotoxin-α (LT-α A252G) in patients having rheumatoid arthritis and correlate these patterns to disease activity and serum levels of tumor necrosis factor-alpha (TNF-α), B-Cell Activating Factor (BAFF), and osteopontin. METHODS A total of 194 subjects, 90 controls and 104 patients with rheumatoid arthritis were genotyped for MTHFR C677 T and A1298 C, TGF-β1 T869 C and LT-α A252G polymorphisms using a methodology based on PCR-RFLP. Also serum levels of TNF-α, osteopontin and BAFF were measured by ELISA kits. RESULTS The CT genotype and T allele of MTHFR C677 T and GG genotype and G allele of LT-α A252G are associated with the risk of RA and with higher levels of the pro-inflammatory cytokine, TNF-α in patients with rheumatoid arthritis. CONCLUSION Our findings suggest that there is association between MTHFR C677 T and LT-α A252G genes polymorphisms and increased risk of RA in this sample of Egyptian population.

Polimorfismos dos genes metilenotetrahidrofolato redutase, fator de crescimento transformador β1 e linfotoxina‐α e susceptibilidade à artrite reumatoide

BACKGROUND Rheumatoid arthritis is a widely prevalent autoimmune disorder with suggested genetic predisposition. OBJECTIVES The aim of this study is to detect the pattern of genetic polymorphism of methylene tetrahydrofolate reductase (MTHFR C677T and A1298C), transforming growth factor-β1 (TGF-β1 T869C) and lymphotoxin-α (LT-α A252G) in patients having rheumatoid arthritis and correlate these patterns to disease activity and serum levels of tumor necrosis factor-alpha (TNF-α), B-Cell Activating Factor (BAFF), and osteopontin. METHODS A total of 194 subjects, 90 controls and 104 patients with rheumatoid arthritis were genotyped for MTHFR C677T and A1298C, TGF-β1 T869C and LT-α A252G polymorphisms using a methodology based on PCR-RFLP. Also serum levels of TNF-α, osteopontin and BAFF were measured by ELISA kits. RESULTS The CT genotype and T allele of MTHFR C677T and GG genotype and G allele of LT-α A252G are associated with the risk of RA and with higher levels of the pro-inflammatory cytokine, TNF-α in patients with rheumatoid arthritis. CONCLUSION Our findings suggest that there is association between MTHFR C677T and LT-α A252G genes polymorphisms and increased risk of RA in this sample of Egyptian population.

Subclinical Hypovitaminosis D and Osteoporosis in Breast Cancer Patients

Objective: This study was designed to detect 25-hydroxy vitamin D serum levels and bone mineral density (BMD) status in breast cancer patients, and to determine their relation to treatment and disease stages. Patients and methods: The study included 74 female patients with breast cancer and 52 healthy volunteers as the control group. Serum levels of 25-hydroxy vitamin D, calcium, phosphorus, and alkaline phosphatase were measured using ELISA kits, while dual energy x-ray absorptiometry (DXA) was performed to assess the BMD. Twelve patients received chemotherapy only; 12 received chemotherapy and hormonal therapy, 22 received chemotherapy and radiotherapy while 28 received chemotherapy, hormonal therapy and radiotherapy. Results: Serum levels of phosphorous and 25-hydroxy vitamin D were significantly lower (p =0.0001), and alkaline phosphatase was significantly increased (p =0.0001) in patients compared to the control. Hip, spine, and forearm DXA were significantly lower in patients than in controls (p =0.0001). The worst bone status was in those receiving both chemotherapy and hormonal therapy. The grade of tumor significantly correlated with the serum phosphorus level (p =0.048) and negatively with the serum 25hydroxyl vitamin D level (p =0.03) as well as with the DXA of hip (p =0.01) and spine (p =0.0001). Conclusion: Our study supports findings of increased incidence of hypovitaminosis D, osteoporosis and osteopenia in breast cancer patients. Hence, we throw light on the importance of offering calcium and vitamin D supplements to breast cancer patients. It is recommended that breast cancer patients have a DXA scan on a yearly basis.

Role of Power Doppler Ultrasonography in Detection of Subclinical Hyperuricemia in Patients with Non - Hodgkin's Lymphoma

Objective: This study aimed to detect incidence of subclinical arthritis in patients with NHL and the diagnostic ability of PDUS in detecting subclinical hyperuricemia. Methods: We studied 100 NHL patients (divided into 2 groups depending on the presence of the double contour (DC) sign detected by PDUS) and 100 controls in a cross sectional study. Demographic, clinical and serological data were evaluated. PDUS was done to all patients and controls. Results: There was a statistically significant difference between the two groups regarding the presence of subclinical hyperuricemia in group (1)(p=0.008) who had higher s. creatinine and gouty nephropathy (p=0.002 and p=0.001 respectively). Conclusion: PDUS can detect subclinical hyperuricemia and subsequent inflammatory arthritis in NHL patients; also it serves as a non-invasive, bedside tool.