Assessment of Serum Prolactin Level in Patients Women with Rheumatoid Arthritis

The prolactin hormone played role in the many autoimmune disorders. To determine the importance of high levels of prolactin in triggering rheumatoid arthritis, thirty patient's women with hyperprolactinemia aged (20-45) years old have been investigated and compared with twenty five healthy individuals. All the studied groups were carried out to measure the concentration of citrulinated peptide(CCP) by enzyme linked immunosorbent assay( ELISA), antikeratin antibodies (AKA)and antinuclear antibodies(ANA) by indirect fluorescent assay IFAT. There was a significant elevation of CCP concentration compared with control groups (P< 0.05). The percentage of antikeratin antibodies and antinuclear antibodies was (20%, 10%) respectively, and there were significant differences (P< 0.05) between incidences percentage of antikeratin and antinuclear antibodies compared with control groups . This study indicated that women with rheumatoid arthritis may play a role as triggering factor of hyperprolactinemia

Is It Necessary to Combine Detection of Anticitrullinated Protein Antibodies in the Diagnosis of Rheumatoid Arthritis?

Objective.Antibodies against citrulline-containing epitopes, such as antiperinuclear factor (APF), antikeratin antibodies (AKA), antifilaggrin antibodies, and anticyclic citrullinated peptide (anti-CCP) antibodies, are specific in rheumatoid arthritis (RA). Detection of APF, AKA, and anti-CCP has been widely used in clinical practice. However, studies on combined detection of these anti citrullinated protein antibodies (ACPA) in the significance of diagnosing RA have been limited. We aimed to detect APF, AKA, and anti-CCP antibodies and to evaluate the significance of combined detection of these ACPA in RA.Methods.A total of 551 patients with arthritic disorders, 304 with RA and 247 with other rheumatic diseases, were selected at the Department of Rheumatology and Immunology during the past 2 years. AKA and APF were tested by indirect immunofluorescence assay. Anti-CCP was detected using the second-generation ELISA kit.Results.The sensitivities of anti-CCP, AKA, and APF tests for RA were 76.2%, 43.4%, and 34.5%, respectively, while the specificities were 96.0%, 98.4%, and 99.6%. The combination of anti-CCP, AKA, and APF positivity had the highest specificity (100%), but it yielded a low sensitivity (28.3%). When 2 of the 3 ACPA were positive, the sensitivity and specificity were 48.4% and 99.2%, respectively. When either anti-CCP or AKA or APF was positive, sensitivity increased to 77.3%, but specificity decreased to 94.7%.Conclusion.Anti-CCP was the most valuable marker in the diagnosis of RA, among the 3 ACPA. Combined detection of anti-CCP, AKA, and APF did not increase the diagnostic capability for RA.

Metastatic Zosteriform Squamous Cell Carcinoma in an Immunocompetent Patient

Background: Although described in several reports of internal malignancies metastasizing to the skin, zosteriform metastases have been reported in only two cases of cutaneous squamous cell carcinoma (SCC). In both of these reports, the patients were immunosuppressed related to renal transplantation. Objective: We present a case of an immunocompetent patient with zosteriform metastases originating from a recurrent cutaneous SCC. The lesions were present along the maxillary division of the trigeminal nerve. Methods: Biopsies from eight lesions were studied using hematoxylin and eosin (H&E) and with immunohistochemistry. Results: Neural involvement was detected in H&E preparations before and during excision of the metastatic nodules by Mohs micrographic surgery. The tumor cells reacted with antikeratin antibodies. The patient has had no evidence of recurrence or metastases 30 months following surgery. Conclusion: To our knowledge, this is the first case of cutaneous SCC with zosteriform metastases in a patient with an intact immune system. SCC should be included in the differential diagnosis of lesions presenting in a dermatomal distribution.