BACKGROUNDThe emerging role of vitamin D in immunology and autoimmune disorders has been a worldwide interest in the last decade. Systemic lupus erythematosus (SLE) patients are particularly at a delicate position predisposing them to suffer from vitamin D deficiency due to the multiple risk factors accompanying the disease. Whether vitamin D deficiency is also involved as a risk factor for developing SLE and affecting its course is a considerable concern.OBJECTIVESThe objective of this study was to estimate the prevalence of vitamin D deficiency in SLE patients and its relation to disease.MATERIALS AND METHODSIn our observational cross-sectional study, serum levels of vitamin D [25(OH)D] in 60 SLE patients and 30 age- and sex-matched healthy controls were assessed and estimated for deficiency and insufficiency at 10 and 30 ng/mL, respectively. Disease activity was evaluated by SLE disease activity index (SLEDAI), irreversible organ damage by Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR DI), and severity by Severity of Disease Index. Fatigue was measured by visual analog scale.RESULTSSignificantly lower levels of 25(OH)D were found in SLE patients (17.6 ± 6.9 ng/mL) in comparison to controls (79.0 ± 28.7 ng/mL), with a statistically high significant difference (t = −11.2, P < 0.001). High prevalence of vitamin D insufficiency and deficiency was detected as 73.3% and 23.3%, respectively. Vitamin D had a highly significant negative correlation with SLEDAI (r = −0.495, P < 0.001), SLICC (r = −0.431, P < 0.05), and fatigue (r = −0.436, P < 0.05).CONCLUSIONVitamin D deficiency and insufficiency were found to be prevalent in SLE patients in our study and related to disease activity and fatigue. If needed, routine screening and consequent repletion of vitamin D are recommended in SLE patients. Restoring adequate vitamin D levels in SLE patients should be more explored as a potential yet simple measure to their usual management to improve their condition.

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Background:In the past 2 decades, there has been increasing interest in calprotectin. It is released and detected in serum and body fluids as a potentially useful clinical inflammatory marker. The protein has been described in synovial tissue in rheumatoid arthritis (RA) patients, specifically in the lining layer adjacent to the cartilage–pannus junction, which is the primary site of cartilage destruction and bone erosion. Assessment of inflammatory activity in RA is of pivotal importance for the optimal treatment. Our aim in this study is to measure the serum calprotectin levels in RA patients and to assess its association—if there is any—with disease activity score and radiological findings using the musculoskeletal ultrasound.Patients and methods:In our case control study, we included 44 RA patients (Group I) and 20 age- and sex-matched healthy volunteers who served as the control group (Group II). Both groups were subjected to full history taking and thorough clinical examination. Assessment of RA disease activity state was done for all RA patients using the Disease Activity Score 28. Laboratory investigations included the measurement of complete blood cell count, erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor, anticitrullinated peptide antibodies, kidney, liver functions; serum calprotectin levels were determined using enzyme-linked immunosorbent assay and radiological joint assessment was done using musculoskeletal ultrasound score.Results:There was a statistically significant elevation of serum calprotectin levels among RA patients when compared with healthy controls. Statistically significant correlations were also found between serum calprotectin and the ultrasound grading score, Disease Activity Score 28, and erythrocyte sedimentation rate, which reflect the degree of inflammatory activity in the affected joints in RA patients. Moreover, the study yielded a significant correlation between serum calprotectin levels and rheumatoid autoantibodies (rheumatoid factor and anticitrulli-nated peptide antibodies), which are strong predictors of the aggressiveness of the disease. Serum calprotectin at a cutoff level of 93.9 μg/dL had 88.6% sensitivity and 100% specificity for diagnosis of RA.Conclusion:Calprotectin was found to have high association with laboratory and ultrasonography markers of inflammation in RA patients, so it is recommended for use as a marker of inflammatory activity in RA patients especially for the follow-up of patients on biological therapy to assess its efficacy.

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Background The relationship between thyroid disease and rheumatic disorders has been the subject of considerable debate. Thyroid abnormal function and/or autoimmune thyroid disease (AITD) were observed in patients with rheumatoid arthritis (RA), what could be explained by the natural feature of autoimmune diseases and their tendency to overlap (1,2). Objectives To investigate the association of hypothyroidism and thyroid autoantibodies with RA and study their correlation with RA disease activity. Methods One hundred and fifty RA patients & fifty control subjects were included in this study. RA patients were subjected to full medical & rheumatological history and examination as well as routine lab tests. Patients and controls underwent thyroid function testing including thyroid antibodies. Patients' disease activity was determined using the Modified Disease Activity Score (MDAS28), while their functional status was assessed with the Modified Health Assessment Questionnaire (MHAQ). Results The commonest thyroid dysfunction was hypothyroidism which was found in 36 RA patients (24%), followed by subclinical hypothyroidism in 6 patients (4%) while, subclinical hyperthyroidism was present in 2 patients (1.3%). AITD was present in 10 patients (6.6%) and absent in the controls. There was a significant positive correlation between TSH levels and RA disease activity parameters. Conclusions Hypothyroidism was the commonest thyroid disorder associated with RA, present in (24%) with a significant association with RA disease activity parameters. References Tunbridge WM, Vanderpump MP. (2000): Population screening for autoimmune thyroid disease. Endocrinol Metab Clin North Am.; 29(2): 239-253. Porkodi R, Ramesh S, Mahesh A, Kanakarani P, Rukmangathrajan S, Panchapakesa C. (2004).: Thyroid dysfunction in Sysytemic Lupus Erythematosus and Rheumatoid Arthritis. J Indian Rheumatol Assoc.; 12: 88 – 90. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.4521