Rheumatology Research Journal
Volume:3 Issue: 3, Summer 2018

Hypertrophic osteoarthropathy manifests as digital clubbing, subperiosteal new bone formation in tubular bone and diffuse skin hypertrophy. It could be either primary or secondary. We report a 31-year-old man presenting with digital clubbing and diffuse skin thickening which started at puberty. X-rays showed subperiosteal new bone formation. All examinations for secondary causes were negative.

Behcet’s disease (BD) is a multi-system, progressive disease which usually presents with oral aphthous and genital ulcers. It may involve other organs such as the eyes, joints, nervous and vascular systems. Although the origin of BD is unknown, it is proposed that immunological, viral, and toxic factors are responsible. The current study evaluated the oxidant/antioxidant balance (redox index) in Behcet’s disease and its correlation with disease activity. Thirty BD patients were enrolled in the study based on International Study Group (ISG 1992) criteria. An age- and gender-matched control group was selected from healthy hospital staff. In this study, 3, 3, 5, 5 tetramethylbenzene (TMB) was used to determine oxidant/antioxidant balance. In the first enzymatic reaction, TBM was oxidized to a colorful cation. In the second chemical reaction, the colorful cation was regenerated to a colorless substance. In such way, the redox index was achieved. The redox index was significantly higher in the BD group than in the healthy group (P=0.0140). The mean redox index varied significantly in different levels of disease activity and was higher in patients with a severe case in comparison with those with a moderate form (P=0.038). There was a positive correlation between disease activity and redox index (r=0.450; P=0.013). A positive correlation was observed between the redox index and the WBC count in patients (P=0.033). The findings of this study demonstrate the presence of oxidative stress in BD, and the severity of BD has a moderately positive correlation with the redox index.

Cardiovascular diseases are the most common causes of death in patients diagnosed with rheumatoid arthritis (RA). The high prevalence of cardiovascular disease is independent of known risk factors in RA patients. The present study aimed to estimate the left ventricular diastolic function in patients suffering from RA using conventional Doppler and tissue Doppler echocardiographic imaging (TDI). This descriptive, cross-sectional study was conducted on 40 patients who had an established diagnosis of RA for over five years (2, 7, 9) and referred to the Rheumatology Department and Clinic of Ghaem Hospital, affiliated with Mashhad University of Medical Sciences. Patients with normal electrocardiography, chest examination, and chest radiography were subjected to M-mode, two-dimensional Doppler echocardiography. Data analysis was performed with the SPSS statistical software package (version 11.5). A p-value less than 0.05 was considered statistically significant. According to the results, mitral and tricuspid insufficiencies were the most common valvular diseases (72.5% and 52%, respectively). In 70% of the patients, diastolic function was normal. A significant relationship was observed between systolic function and diastolic abnormality (P=0.001). Pulmonary hypertension was detected in 40% of patients. Nevertheless, no significant relationship was observed between E and Em or between A and Am (P=0.432, P=0.844, respectively). The Mann-Whitney U test revealed a statistical difference between the two groups in terms of EF, which was significantly lower in the diastolic dysfunction group (P=0.047). A wide and frequent variety of cardiac diseases, especially mitral, aortic, and tricuspid regurgitation, may be found in RA patients. It can be concluded that active RA patients have a significantly high incidence of diastolic dysfunction in the absence of clinical evidence of heart disease

Systemic lupus erythematosus (SLE) is a multi-systemic disorder with various clinical manifestations. Lupus is a multifactorial autoimmune disease resulting from complex gene-environment interactions. IL-17 is a pro-inflammatory cytokine secreted by Th-17 cells, and IL-17A and IL-17F are two predominant members of this family. The present study assessed the association of IL-17F (rs763780) gene polymorphism with SLE. A total of 102 SLE patients and 141 healthy subjects were enrolled in this case-control study. Genotyping was done using the PCR-RFLP technique. The results were analyzed using SPSS software. Results showed a borderline relationship between the heterozygote genotype (AG) and a reduced risk of SLE (OR: 0.31, 95% CI: 0.09-1.0, P=0.05). The A allele was also shown as having a protective effect on SLE susceptibility (OR: 0.68, 95% CI: 0.46-1.0, P=0.05). No association was observed between the genotypes of the IL-17F gene polymorphism and the risk of SLE (P>0.05). In conclusion, it seems that the IL-17A gene may be involved in the pathogenesis of SLE.

Systemic lupus erythematosus (SLE) is considered one of the risk factors for cervical cytological abnormalities and high-risk HPV infection. However, there is a scarcity of data about the prevalence of high-risk HPV infection in patients with lupus. In order to define strategies for cancer prevention, we aimed to determine the prevalence of HPV infections in women with SLE compared to a control group. Fifty patients with SLE from the SLE clinic in Hafez Hospital, Shiraz University of Medical Sciences, were compared to 50 healthy married control women. In both groups, routine Pap smears were obtained, and the endocervical side of the spatula was sent for HPV DNA analysis. The case and control groups were compared for the presence and type of HPV infection as well as the relation between its presence with immunosuppressant use and disease activity. HPV infection was detected in 4% (2.50) of lupus patients, but it was not seen in the control group. HPV typing identified types 16 and 18 in these two patients. No relationship between HPV infection and immunosuppressant use or activity of disease was seen in the current study. There was no statistically significant difference in HPV prevalence between patients and the control group (P=0.495). Results of this study showed that SLE and the use of immunosuppressants in patients with lupus were not risks for high-risk HPV infection or cervical dysplasia in our area compared to the normal population, but further studies on more patients receiving immunosuppressants and biologics are recommended.

Sarcoidosis a systemic granulomatous disorder of unknown etiology with varying clinical pictures. HLA genes, especially HLA-DRB1, have been shown to be candidates for the etiology of sarcoidosis. This study examined the association between the polymorphism of HLA-DRB1 alleles and sarcoidosis in Iranian subjects. The study population included 58 patients with sarcoidosis and 68 healthy controls. Genomic DNA was extracted, and the polymorphisms of the HLA-DRB1 alleles were determined using a polymerase chain reaction with sequence-specific primer (PCR-SSP). The frequency of HLA-DRB1*07 was higher in sarcoidosis patients (25.8%) than in controls (15.3%); however no significant difference was observed between the two groups (P>0.05). The frequency of HLA-DRB1*11 was higher in the control group (31.9%) than in cases (22.4%), but no significant difference was detected between the groups (P>0.05). The results of the present study showed that there is no association between HLA-DRB1 alleles and susceptibility to sarcoidosis in Mashhad, Northeast Iran. Further studies with large sample sizes are required in order to clarify this issue.