Background: Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease. Conflicting reports are available about the association between human parvovirus B19 (B19) infection and RA. Most studies were done in European and Asian countries, but only few studies were performed in Africa. Objectives: This study aimed to investigate the seroprevalence of parvovirus B19 infection in RA patients compared with healthy controls and to search for possible association of B19 viremia with disease activity and severity. Methodology: This case-control study was conducted on 50 RA patients who fulfilled the 2010 American College of Rheumatology/European League against Rheumatism classification criteria for rheumatoid arthritis and 30 matched healthy controls. All participants were examined for parvovirus B19 infection by serological detection of anti-B19 IgM and IgG by ELISA and B19 DNA by nested PCR. Results: Parvovirus B19 DNA was detected in 17 (34%) of patients While controls were (6.7%) with a significant difference (0.005). There was significant difference between patients and controls (P=0.007) regarding IgG anti-B19 antibody but not anti-B19 IgM (P =0.59). There was a significant association between B19 viremia and all activity parameters. B19 positive patients had higher levels of ESR and CRP, higher DAS28 scores and more affected joints than B19 negative patients with statistically significant differences. B19 positive patients had significantly higher levels of RF and anti-CCP. Furthermore, B19 positive patients were more likely to have joint erosion. Conclusion: This study revealed that parvovirus B19 infection may play a role in the aetiopathogenesis of RA.
Background: Hyperuricemia is a common risk factor for conditions associated with oxidative stress. Alternatively, there is increasing evidence that normal serum uric acid (UA) plays a protective role as an antioxidant. Osteoporosis was commonly attributed to oxidative stress and is a common complication of rheumatoid arthritis (RA). Objectives: To study the relationship between serum UA and bone mineral density in male patients with rheumatoid arthritis. Patients and methods: Fifty RA male patients were included in this study. Age, disease duration, and type of medication were recorded. Clinical examination for tender and swollen joints was done and disease activity score 28 was calculated. Body mass index, random blood glucose, erythrocyte sedimentation rate, C-reactive protein, serum UA, rheumatoid factor and anti-CCP were measured. Bone mineral density was measured using dual-energy X-ray absorptiometry at the lumbar spine, hip and radius. Results: A highly significant positive correlation between serum UA and T scores in the lumbar spine and hip. However, serum UA was negatively correlated with disease activity, ESR and CRP (P < 0.001). There was significant (P < 0.001) association between serum UA and different therapeutic agents (levels of serum UA were higher in patients taking combined biological and conventional disease modifying anti-rheumatic drugs (DMARDs) than those who were taking biological or conventional DMARDs alone.
Conclusion:High normal serum UA level is protective against osteoporosis at both the lumbar spine and hip in male rheumatoid arthritis patients. Also, serum UA level is negatively correlated with RA disease activity and acute phase reactants in male patients with RA.
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