Background Tuberculous pleurisy and malignancy are two of the most common causes of pleural effusion. IL-33 is expressed in the epithelial lining and endothelial cells and is released after cell damage; it is proposed to have an essential role in sensing damage in various infectious and inflammatory diseases. This work aimed to determine the diagnostic role of IL-33 in pleural effusions. Methods One hundred seventeen patients with pleural effusions of different etiologies had a quantitative measurement of IL-33 in their pleural effusion and serum samples by ELISA technique. Results The concentrations of IL-33 (mean ± SD) in tuberculous pleural effusion (TPE) group (22.5 ± 0.90 ng/l) were significantly higher than that of malignant pleural effusion (MPE) group (14.6 ± 2.35 ng/l; P <  0.001). There is no significant difference between the serum levels of IL-33 in (TPE) group and (MPE) group ( P >  0.05). The concentrations of IL-33 in the pleural effusions were significantly correlated to that of the serum concentrations in each group (TPE: r = 0.848, P = < 0.001; MPE: r = 0.881, < 0.001) and pleural ADA in patients with tuberculous pleural effusions, ( r = 0.38, P <  0.001). The cut-off value of pleural IL33 for (TPE) was 19.16 ng/l, with a sensitivity of 91.7%, a specificity of 96.4%. The cutoff point of a pleural/ serum IL-33 ratio for the diagnosis of TPE was > 1.4 with a sensitivity of 91.7% and specificity of 100% while for the determination of (MPE) was < 0.9 with a sensitivity of 83.3% and specificity of 96.4%. Conclusion IL-33 level may serve as a novel biomarker to differentiate pleural effusions, especially tuberculous from malignant effusions.

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Introduction:The risk of mortality for pediatric patients with severe chronic kidney disease (CKD) is 30fold higher than that for healthy patients of the same age. The main cause of death is cardiovascular disease (CVD), accounting for 25-50 % of deaths in children and young adults with childhood onset CKD. Aim of the study:To study serum hepcidin level and its role in anemia and cardiovascular dysfunction in children with CKD, either on hemodialysis (HD) or on conservative therapy. Methods: Serum samples were obtained from 20 healthy individuals and from 30 patients with CKD on regular dialysis (group I) and 20 patients with chronic kidney diseases on conservative therapy (group II).The levels of hemoglobin , serum ferritin, s. iron , TIBC, serum hepcidin, and echo parameters in form of fractional shortening (FS),l eft ventricular mass index (LVMI) and trans mitral to mitral annular early diastolic velocity ratio (E/Ea') ratio were determined and the correlation between them was studied. Results: There is a significant increase in the serum hepcidin levels in group I and group II than the control group. There was significant correlation between hepcidin and serum ferritin, s. iron, transferrin saturation, FS, LVMI, E/Ea' while there was a negative correlation between serum hepcidin and both hemoglobin and TIBC. Conclusion: Hepcidin level is a good biomarker for anemia and cardiac dysfunction in patients with chronic kidney disease.

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