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Pathogenesis of osteoarthritis may have a systemic metabolic component. This study was undertaken to assess the prevalence of primary knee osteoarthritis (OA) in a sample of Egyptian patients with metabolic syndrome (MetS) and to examine the relationship of metabolic syndrome and its components with clinical, functional, and radiographic findings of knee OA. A total of 60 patients (55 females, 5 males) diagnosed as having MetS according to the National Cholesterol Education Program Adult Treatment Panel III (ATP III) criteria and 30 obese subjects without MetS (24 females, 6 males), serving as a control group, were included in this study. All participants had completed preliminary questionnaires, clinical and laboratory examinations, and an evaluation for radiographic knee OA. Scores from the Western Ontario and Mc-Master University (WOMAC) were used for the pain, stiffness, and disability assessments of OA patients. X-rays were classified according to the Kellgren-Lawrence (KL) radiographic rating scale. We tested the relationship of metabolic syndrome and its components with the WOMAC score and radiographic findings of knee OA after adjusting for BMI. The prevalence of OA was 83.3% in MetS group compared with 63.3% in control group (P = 0.034). MetS patients with OA had higher WOMAC score and radiographic grading than controls with OA (P = 0.034, 0.019). MetS patients with OA had more waist circumference (WC) (P = 0.022), and higher frequency of hypertension (HTN) and diabetes mellitus (DM) (P = 0.009, 0.002 respectively) than MetS patients without OA. There were significant associations of MetS, WC, HTN, DM, high TG, and low HDL with OA (P = 0.041, 0.007, < 0.001, < 0.001, 0.016, 0.012 respectively) by linear regression analysis. There were also significant associations of MetS with WOMAC score and X-ray grading (P = 0.003, 0.019 respectively) by linear regression analysis. Knee OA is prevalent in patients with MetS and associated with worse pain and functional impairment score and advanced radiographic changes. Abdominal obesity, hypertension, and diabetes are the most common components of MetS in patients with knee OA.

Aim of the work: To assess brain abnormalities in neuropsychiatric systemic lupus erythematosus (NPSLE) patients using magnetic resonance imaging (MRI) and to compare the findings to those in SLE patients without neuropsychiatric manifestations as well as to compare disease activity between SLE patients with and without MRI brain abnormalities.Patients and methods: The study was conducted on 55 SLE patients (48 female/7 male) with a mean age of 27.3 ± 4.6 years and disease duration of 4 ± 1.6 years. Patients with NPSLE (n = 30) and without neuropsychiatric (no-NPSLE) (n = 25) underwent MRI brain. The SLE disease activity index (SLEDAI), headache disability index and mini mental state score were considered.Results: Brain abnormalities were detected in 21 SLE patients (38.2%); 16 NPSLE and 5 no-NPSLE. The brain abnormalities included a significantly higher frequency of white matter changes in NPSLE (14 patients; 46%) compared to no-NPSLE patients (5 patients; 20%) (p = 0.038). In NPSLE patients, ischemia was present in 5 patients (16.7%), hemorrhage in 3 (10%) and encephalopathy in another 3 (10%). The SLEDAI was significantly higher in NPSLE patients with cognitive impairment(33.6 ± 9.1) and NPSLE patients with headache (24.2 ± 5.6) compared to the score in no-NPSLE patients (7.2 ± 4.7) (p = 0.001). Patients with MRI brain abnormalities had significantly longer disease duration (p = 0.03), higher SLEDAI (p = 0.001), mini mental state score (p = 0.005) and headache score (p = 0.019) than those without. The study revealed an MRI sensitivity of 0.64.

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There has been a renewed interest in anti-chromatin and anti-histone antibodies in the last few years. To assess the prevalence of anti-chromatin and anti-histone antibodies in patients with systematic lupus erythematosus (SLE) and to correlate serum levels of these antibodies with clinical features of the disease, the presence of anti-chromatin and anti-histone antibodies in 38 patients with SLE was investigated by an enzyme-linked immunosorbent assay (ELISA). To determine the specificity of these antibodies, 15 patients with rheumatoid arthritis, 15 patients with systemic sclerosis, and 15 normal controls were also tested. Sensitivity of anti-chromatin antibodies in SLE patients was 89.5% and specificity was 80.0%, while sensitivity of anti-histone antibodies was 92.1% and specificity was 82.2%. Significant associations were found between the levels of anti-chromatin antibodies and arthritis, malar rash, oral ulcer, pulmonary affection (P < 0.05) also, lupus nephritis (P < 0.01), and disease activity score as measured by SLE disease activity index (SLEDAI; P < 0.001). Significant association was found between anti-histone antibodies and fatigue (P < 0.05). The incidence of positive anti-chromatin and anti-histone antibodies was significantly higher than that of anti-dsDNA antibodies in early stage of the disease. We conclude that anti-chromatin and anti-histone antibodies are both sensitive and specific for SLE and could be a useful addition to the laboratory tests that can help in the diagnosis of SLE. Anti-chromatin antibodies seem to be a promising marker useful in early diagnosis and assessment of disease activity in SLE patients especially in patients who are negative for anti-dsDNA antibodies.