Podocyte loss indicated by podocalyxin immunohistochemical expression reflects the degree of activity and severity of LN and the degree of podocyte effacement by E/M.

Cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) is an inhibitory molecule that has an essential role in T-cell homeostasis and self-tolerance because of its inhibitory signals. Genetic polymorphisms in the CTLA-4 gene have been associated with several autoimmune diseases. We aimed to assess the association between the CTLA-4 +49 A/G polymorphism (rs231775) and rheumatoid arthritis (RA) in Egyptian RA patients. The study included 104 RA patients and 81 apparently healthy control individuals. The polymorphism was assessed using restriction fragment-length polymorphism analysis. Genotype distribution was compared between patients and controls under different models of inheritance. Under the codominant model, RA patients showed a higher frequency of AG and GG genotypes compared to the control subjects (p=0.0092). Under the dominant model, RA patients showed a higher frequency of AG and GG genotypes grouped together compared to control subjects (p=0.0026). Under the over-dominant model, the AG genotype was more frequent in RA patients compared to control subjects (p= 0.0395). No association was observed between CTLA-4 polymorphism rs231775 and RA using the recessive model (p=0.1356). A significant association was observed between carrying the G allele and the presence of RA (p=0.0032). In conclusion, our findings showed a positive association between the CTLA-4 gene +49 A>G polymorphism and RA. However, discrepancies in literature reflect both ethnic variability in CTLA-4 gene polymorphisms as well as the complex pathogenesis of RA.

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Objective To compare between Sonographic Madrid score index (MASEI) versus Spondyloarthritis research consortium of canada (SPARCC) for early assessment of enthesopathy among psoriatic skin patients. Patients and Methods This study included fifty psoriatic skin patients. All underwent history, laboratory investigation, clinical examination using SPARCC score, Psoriasis Area and Severity Index (PASI) and musculoskeletal ultrasound using MASEI score with power Doppler (PD) bilaterally for assessment of enthesitis. Results The mean age of fifty patients was 42.00 ± 10.923 years, disease duration of 11.110 ±7.402 and BMI of 29.356 ± 3.753. The mean PASI was 12.950±8.044. SPARCC score was positive in 10 out of 50 patients (20%).MASEI score was positive in 20 out of 50 patients (40%) with 10 out of 50 patients had power Doppler signals. Highly statistically significant difference between MASEI and SPARCC score( pvalue <0.001). Highly statistically significant positive correlation was observed between PASI score and MASEI(r = 0.498, p-value <0.001). Conclusion musculoskeletal ultrasound is useful for early detection of enthesitis and to be a sensitive tool in detecting of enthesitis and subclinical enthesitis that can be missed during routine clinical examination.