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Background Macrophages play a crucial role in the pathogenesis of rheumatoid arthritis (RA). Growth differentiation factor‐15 (GDF‐15) acts as an autocrine regulator of macrophage activation. Objective: The aim of this study was to assess serum level of GDF‐15 as a potential biomarker for detecting RA activity. Method A total of 100 female RA patients and 55 age and weight matched healthy control females were enroled. The serum level of GDF‐15 was measured using enzyme‐linked immunosorbent assay. Results Serum levels of GDF‐15 in RA patients with high, moderate, low and no disease activity were 989.0 ± 161.9, 505.6 ± 220.5, 349.2 ± 155.9 and 349.0 ± 144.0 pg/mL, respectively. GDF‐15 with a cut‐off value higher than 705 pg/mL was indicative of high RA activity with sensitivity of 96% and specificity of 92%. Conclusion GDF‐15 serum levels may be used as a biomarker to predict high RA disease activity.

Aim of the work To assess the clinical manifestations, imaging findings and outcomes of corona virus disease 2019 (COVID-19) in patients with rheumatic diseases. Patients and methods : In a three-center study, patients with rheumatic diseases who developed COVID-19 were included. Patients were classified into two groups, i) inflammatory arthritis including rheumatoid arthritis (RA), spondyloarthritis (SpA) and undifferentiated arthritis, ii) connective tissue diseases (CTDs) including systemic lupus erythematosus (SLE), vasculitis and others. COVID-19 outcomes were assessed based on chest computed tomography severity score (CT-ss), the level of care, the number of patients who died and flare of underlying rheumatic disease. Results : One hundred ninety-six patients with a mean age of 47.9±15.1 years, 73.5% female, were included. Underlying rheumatic diseases were RA (57.7%), SLE and other CTDs (17.9%), SpA (11.2%), vasculitis (11.2%) and undifferentiated arthritis (2%). Myalgia, malaise and fever were the most common clinical manifestations of COVID-19. Pneumonia on computerized tomography (CT), hospitalization, admission in intensive care unit and need to mechanical ventilation were observed in 75.5, 37.2%, 10.7% and 6.6% of patients, respectively. Treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) and glucocorticoids, diabetes and underlying pulmonary disease were predictors of moderate to severe pneumonia and hospitalization. Fifteen (7.6%) patients died. Flare of underlying rheumatic disease occurred in 16.3% of patients. Flare of disease in patients with CTDs was significantly more than other rheumatic diseases. Conclusions : In rheumatic patients, treatment with NSAIDs or prednisolone, diabetes and pulmonary disease are risk factors of moderate to high CT-ss and hospitalization during COVID-19.

Introduction:Brucellosis is a zoonotic disease in humans and animals and is a worldwide public health problem. Changes in inflammatory cytokines levels might be deployed as markers for diagnosing infectious diseases from noninfectious medical conditions. This study aimed to evaluate the relationship between serum levels of interleukin-17 (IL-17) and transforming growth factorbeta (TGF-β) in pediatric brucellosis. Methods: The present case-control study included 40 brucellosis patients and 40 matched healthy controls. Serum levels of inflammatory cytokines were measured by ELISA, and the independent student t-test was used to compare the levels in the brucellosis and healthy group. Serum cytokine levels before and after treatment were compared by the paired samples t-test. Results: The serum TGF-β level was significantly lower in the patients compared to the control group (90.21 ± 24.44 vs. 125.63 ± 23.28 pg/mL, P<0.nv001), and the serum interleukin-17 level was significantly higher in the case group (83.74 ± 23.57 vs. 25.95 ± 17.80 pg/ml, P<0.001). After treatment, serum IL-17 levels significantly decreased in the case group. Conclusion:In brucellosis patients, the serum IL-17 levels decreased significantly, whereas TGF-β increased significantly in these patients. Hence, the serum levels of these inflammatory cytokines can be indicators for diagnosing pediatric brucellosis.