Distinguishing patients with active systemic lupus erythematosus (SLE) from those with inactive disease has always been considered a great challenge. Identifying new sensitive markers of activity will be of great value in the clinical management of the disease. Thus the aim of the current study was to investigate the relationship between serum neopterin levels and various parameters of disease activity currently used, in addition, to investigate serum neopterin levels in different patterns of organ disease involvement and during the administration of different therapy regimens used in the management of SLE. The study was conducted on 75 female subjects; 26 patients with active SLE, 24 SLE patients in remission and 25 healthy controls. Patients with SLE were fulfilled four or more of the American Rheumatism Association (ARA) criteria, and disease activity was scored using the British Isles Lupus Assessment Group (BILAG) index. Erythrocyte sedimentation rate (ESR), serum urea, serum creatinine, liver function tests, plasma complements C3 and C4, C3 degradation products (C3dg), anti-double stranded DNA antibodies (anti-dsDNA) and serum neopterin were measured in all groups. Serum neopterin was significantly elevated in the active group as compared to the remission group. Both groups of SLE showed higher levels of neopterin when compared to the control group. Serum neopterin level showed higher sensitivity than other SLE markers (80%) and second highest specificity after anti-dsDNA antibodies (73%). Also, a highly significant positive correlation was found between serum neopterin levels and each of plasma C3dg, anti-dsDNA antibodies, and ESR. Meanwhile, a highly significant negative correlation was detected between serum neopterin levels and both plasma C3 and C4 levels. As regarding various treatment regimens used in the management of active SLE, the current study demonstrated decrease in serum neopterin levels in patients receiving combined treatment of both prednisolone and cytotoxic drugs than those receiving either treatment alone. A significant difference in serum neopterin levels was observed in patients with multiple organ affection in comparison to those with single organ affection regardless the type of organ affected. The present results suggest that the estimation of serum neopterin levels seems beneficial in the assessment of disease activity and progress in SLE patients as well as the assessment of the efficacy of various treatment regimens being used.
The objective of this article is to construct infants growth curves of weight-forage and length-forage for Alexandria infants, (0-2 years) and to compare the WHO Child Growth Standards (2006) and the current constructed curves. The study was carried out through a cross sectional approach, at maternal and child health centers (MCH) in Alexandria (Egypt), it included sample of infants aged less than two years (1-24 months). Data was presented graphically by Z-scores and percentiles. The results showed that, the mean weight for age of infants included in the WHO standards was below the present median during early months of infancy. Based on the-2SD cutoff point, the prevalence of underweight was higher during the twenty four months for both girls and boys based on the present curves. The average length of infants included in the present study was above the WHO standards median during the first half of infancy. Moreover, for all age groups, stunting rates (i.e., <-2SD) were higher when based on the present sample curves, especially after one year of age. Infants of the first year of life in the present curve were taller than those in the WHO standard (> +2SD). Conclusion and Recommendations: A reference based on healthy breastfed infants is required if the growth patterns of infants following international feeding recommendations are to be correctly assessed. So, the WHO 2006 curves for age 0 to 24 months, based on longitudinal data, are the best choice.
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