Behçet's disease (BD) is an uncommon autoimmune/autoinflammatory disease. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were investigated in many diseases as a marker of inflammation. In this study, we investigated NLR and PLR in patients with BD as a marker of disease activity and its association with different clinical manifestations. The study included 23 BD patients; their mean age was (32.5 ± 6.76) and M:F ratio was 16:7. Complete blood picture was done for all patients. NLR and PLR were compared in both active and inactive BD patients and its relation with different clinical manifestations was assessed. NLR was higher in active BD patients than in inactive BD patients (P < 0.01). Although both NLR and PLR were correlated with Behçet's Disease Current Activity Form (BDCAF), the correlation of NLR with BDCAF was much stronger than that of PLR. NLR was associated with some mucocutaneous lesions. Both NLR and PLR were associated with articular and GIT manifestations, but also NLR showed more significant results. In our studied patients, both NLR and PLR were not informative about any ongoing ocular activity (P > 0.05). Both ratios were not affected by the presence of neurologic deficits nor previous vascular events (P > 0.05). NLR was superior to PLR as an indicator of disease activity. NLR was closely related to skin manifestations while PLR was not. In our study, both were not considered reliable in representing ocular activity.

The aim was to explore possible correlations of antibodies to extractable nuclear antigens (ENA) with clinical manifestations and disease activity indices in systemic lupus erythematosus (SLE) patients. A total of 70 consecutive SLE patients (64 females) were included. Disease activity was assessed by SLE activity index (SLEDAI), and British Isles Lupus Assessment Group (BILAG). Anti-Ro/SSA correlated positively with, headache (r=0.24, p=0.04), blurring of vision (r=0.25, p=0.03) and SLEDAI (r=0.25, p=0.04) and negatively with C3 (r=-0.35, p=0.003). Anti-Ro/SSA correlated with anti La/SSB antibodies (r=0.69, p<0.001), but not with anti-DNA, anti-RNP and anti-Sm antibodies. Anti-La/SSB antibodies correlated with headache (r=0.26, p=0.03), SLEDAI (r=0.25, p=0.03) and negatively with C3 (r=-0.34, p=0.004). Anti-La/SSB did not correlate with anti-RNP or anti-Sm antibodies. Anti-Sm antibodies correlated with disease duration (r=0.34, p=0.003), 24 hours urinary proteins (r=0.31, p=0.008), SLEDAI (r=0.31, p=0.009), BILAG renal score (r=0.29, p=0.02) and negatively with age at onset (r=-0.27, p=0.02), WBCs (r=-0.29, p=0.014) and C4 (r=-0.25, p=0.049). In multivariate analyses, anti-Ro/SSA antibodies remained associated with headache, blurring of vision and C3 and anti-La/SSB antibodies remained associated with C3 and with headache. Anti-Sm antibodies were independently associated with disease duration and total SLEDAI scores, while anti-RNP antibodies remained significantly associated with BILAG mucocutaneous scores only. Antibodies to ENAs are associated with clinical aspects of SLE and may play a role in the assessment of disease activity. Insight into these ENAs may lead to new approaches to diagnostic testing, accurate evaluation of disease activity and lead to target approach for SLE.

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Background:Rheumatoid arthritis (RA) is a systemic auto immune inflammatory disorder, which primarily affects the synovial joints, but it may have an impact on oral health.Objectives:The present study aimed to describe oral manifestations in patients with Rheumatoid arthritis (RA).Methods:A cross sectional study including RApatients, which consulted or were hospitalized in Rheumatology department in Taher Sfar Hospital of Mahdia Tunisia, during a period of 10 months. The diagnosis of RA was based on ACR/EULAR 2010 criteria. Oral and periodontal examination was practiced by a trained dentist in the same hospital. Oral hygiene, teeth status (missing teeth) and paradental parameters (bleeding index of Loe and Silness (IG), plaque indexed O’Leary (IP) were determined for each patient, to assess oral and periodontal diseases in RA.Results:Our study included 51 patients with an average age of 51.11 years ±12.4 [21-74years].50patients (92.6%of cases) were women and 8patients (14.8%) were diabetic. Only one patient was a smoker. The mean duration of RA was 10.7 years 7.7± [10months-35years]. Rheumatoid factor (RF) was positive in 25 Patients (46.3%of cases). Anti-citrullinated peptide antibody (ACPA) was positive in 32 patients (59.3 %).41patients (75.4%) had radiological impairments and 28(51.9%) had specific deformations of RA. The average disease activity score (DAS28-VS) and (DAS28-CRP) were respectively 4.1±1.5[1.4-7.3] 3.4±1.5 [1.24-6.71]. Oral examination revealed a poor oral hygiene in 36patients (69.2% of cases) and 4.7% of our patients (2 cases) were toothless. Xerostomia was observed in 32 patients (80%). Gingivitis was diagnosed in 26 Patients (52%): localized in 6 patients (26.1%) and generalized in 17 patients (73.9%). 21 patients had periodontitis (41.2%). Basing on bleeding index of Loe and Silness (IG),27 patients (55.1%) had degree 2 and9 patients (18.8 %) had degree 3. Supragingival plaque and subgingival plaque were detected respectively in 45 patients (90 %) and 47 patients (95.9 %). In our study, tooth loss was significantly correlated with increased age (p=0.001) and post-menopausal status (p=0.03). Xerostomia, gingivitis and periodontitis were associated with increased age. But no association was found between oral manifestations and DAS28 nor biological inflammatory parameters.Conclusion:Rheumatoid arthritis is destructive and disabling rheumatism with a great risk to develop dental and periodontal diseases. So, it is important to systematically control oral hygiene of our patients to prevent complications.Disclosure of Interests:None declared

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Rheumatoid arthritis (RA) is an autoimmune disease with increasing activity of T lymphocytes and abnormal production of inflammatory cytokines. Interleukin-27 (IL-27), a multifunction cytokine with contradictory inflammatory effect. Polymorphism of IL-27 was reported to be predisposed to many inflammatory diseases and autoimmune diseases. We aimed to assess the role of IL-27 polymorphism in the predisposition of RA in Egyptian population. A case control study included 100 patients with RA and 100 healthy subjects represented the control group. The IL-27−924A/G gene polymorphism was investigated by RFLP-PCR. The serum level of IL-27was estimated by enzyme-linked immunosorbent assay. The AA genotype was significantly higher in patients with rheumatoid arthritis as compared with the control group (P=0.02, OR (95% CI)=0.4 (0.1-1.2). In addition, we observed significant elevation in the level of serum IL-27 in the patients group in comparison with the A. Badawy, et al. 2 Genetics and Molecular Research 17 (2): gmr16039915 healthy subjects. We found that patients with AA genotype or A allele had significant higher level of serum IL-27. There was positive relationship between the serum level of IL-27 and severity of the disease. It was concluded that AA genotype of IL-27 gene might be a risk factor for the incidence of RA in Egyptian population. Patient with significantly higher blood levels of IL-27 were at risk for increasing disease activity.

Background:The assessment of health-related quality-of-life (HRQoL) in rheumatoid arthritis (RA) is becoming a common tool in clinical practice. The medical outcomes survey short form 36 (SF- 36) is one of the most widely used tools for measuring HRQoL in RA as well as the HAQ scale.Objectives:The aim of our study is to evaluate the impact of the RA in the quality of life (QoL) of our patients using the SF-36 and the HAQ questionnaires.Methods:This is a cross-sectional study during a period of the year 2020, including 70 patients followed in the department of Rheumatology in Mahdia, Tunisia. All patients were diagnosed with RA based in ACR 1987/EULAR 2010. We evaluated for each patient, the mean global scale and the eight domains of SF-36 (physical functioning (PF), role physical (RP), bodily pain (BP), general health (GH), vitality (VT), a social functioning (SF), role emotional (RE) and mental health (MH)), scored from 0 (worst) to 100 (best).Results:Our study included 70 patients (59 females/11males) with an age ranged from 21 to 76 years. The mean age was 54 ± 12 years. The mean duration of the disease was 11 ± 10 years [1-40]. The mean number of tender joints was 9.7 ±9.4 and swollen joints were 4.2 ±6.1. The mean disease activity score (DAS28) was 4.6 ±1.9 [1.2-8.4]. The mean HAQ score was 1.5±1.3, 47.1% of patients had specific joint deformations, 82.9% had radiologic involvement and 31.4% had osteoporosis. The biologic analysis showed that the mean ESR was 46.7 ± 30.5 and the CRP was 15.8 ±23.3. Rheumatoid factors were positive in 42.9% of cases, the ACPA were positive in 50% of cases. 84.3% of RA patients were treated by methotrexate, 4.3% were treated by salazopyrin and 11.4% were treated by biologic treatments.The SF-36 global score was 50.4 ± 26.3 [15.3-92.8]. 46 patients (65.7% of cases) had impaired QoL (SF-36<66.7). The means of different domains (PF, RP, BP, GH, VT, SF, RE, MH) were respectively 51; 41.4; 51.4; 50; 51.2; 57.7; 41.9; 59.2. The most severely impacted domains were the RP and RE.Our study showed a significant correlation between the SF-36 global score and the number of tender joints (p=0.002), the DAS28 (p=0.017) and the HAQ(p=0.000).Conclusion:Our study showed that 65.7% of RA patients presented impaired QoL (SF-36<66.7), which is associated with high disease activity. So it’s important to jugulate the disease, in order to ameliorate the quality of life of our patients.References:[1]Matcham, F., Scott, IC, Rayner, L., Hotopf, M., Kingsley, GH, Norton, S.,… Steer, S. (2014). L’impact de la polyarthrite rhumatoïde sur la qualité de vie évalué à l’aide du SF-36: une revue systématique et une méta-analyse. Séminaires sur l’arthrite et les rhumatismes, 44 (2), 123-130. doi: 10.1016 / j.semarthrit.2014.05.001.Disclosure of Interests:None declared

Background:Patients withsystemic lupus erythematosus (SLE) have a better survival than decades ago. Nevertheless, they still experience a low health-related quality of life (HRQoL). The Systemic Lupus Erythematosus-Specific Quality of Life Questionnaire (SLEQoL) is one of the most widely used specific tools for measuring HRQoL in SLE.Objectives:The aim of our study is to assess the impact of the SLE in the HRQoL using the SLEQoL tool.Methods:This is a cross-sectional study during a period of the year 2020, including patients followed in the departments of Internal Medicine and Rheumatology in Mahdia, Tunisia. All patients were diagnosed with SLE based in ACR 1997/SLICC2012. The SLEQoL is composed of 40 items scored from 1 to 7, it includes six HRQoL domains: physical functioning (Items 1 to 6), activities (items 7 to 15), symptoms (items 16 to 23), treatment (items 24 to 27), mood (items 28 to 31) and self-image (items 32 to 40) with higher values corresponding to worse HRQoL.Results:Forty patients were enrolled. The age of the SLE patients (36 females/4 males) ranged from 11 to 87 years. The mean age was 47.75±17.59 years. The mean disease duration was 2.3 ±2.9 years. The mean SLEDAI score was 5.78±4.94. The main target organs involved were cutaneous, musculoskeletal, neurological, pulmonary, cardiovascular and renal in 85%, 82.5%, 32.5%, 17.5%, 15% and 7.5% of cases respectively. The biologic analysis showed the positivity of anti-nuclear antibodies in 97.5% of cases, low serum complement C3 and C4 in 20% and 32.5% of cases respectively. A biological inflammatory syndrome was found in 37.5% of cases and Anemia in 42.5%. 85% of SLE patients were treated by anti-malarial, 62.5% were treated by Glucocorticoids and 5% by Methotrexate. The mean SLEQoL global score was 77.92 ± 34.02 [40-153]. The means of different domains (physical functioning, activities, symptoms, treatment, mood and self-image) were respectively 12.1±6.49 [6-30]; 19.6±10.9 [9-49]; 16.4±8.1 [8-34]; 5.5±2.36 [4-14]; 9.6±5.4 [4-20]; 14.9±7.5 [9-36]. The most severely impacted domains were activities and symptoms. The less affected domains were treatment and mood. The SLEQoL global score was correlated with increased age (p=0.03), longer disease duration (p=0.05), SLEDAI score (p=0.02), visual analog scale of pain (p=0.04), musculoskeletal manifestations (p=0.04), cutaneous manifestations (p=0.05) and pulmonary manifestations (p=0.05). By analyzing biological tests of our patients, we found a correlation between the SLEQoL global score and Erythrocyte sedimentation rate [ESR] (p=0.05), Anemia (p=0.04), low serum complement C3 (p=0.02) and C4 (p=0.003). SLEQoL global score and its six domains were not correlated with gender, educational level nor marital status.Conclusion:Our study showed that HRQoL is impaired in patients with SLE. The most important predictors of low HRQoL were older age, longer disease duration, some clinical manifestations, biological activity disease indicators (ESR, anemia and low complement level) and the SLEDAI score.References:[1]Leong, K. P., Kong, K. O., Thong, B. Y. H., Koh, E. T., Lian, T. Y., Teh, C. L., et al (2005). Development and preliminary validation of a systemic lupus erythematosus-specific quality-of-life instrument (SLEQOL). Rheumatology, 44(10), 1267–1276.Disclosure of Interests:None declared