BackgroundPentraxin-3 (PTX3) is a secretory acute phase protein which is produced and expressed in many immune cells especially macrophages, fibroblasts and endothelial cells at different inflammatory sites [1]. PTX3 is known to have an interesting role in regulation of innate immunity and it is a key player in regulation of many inflammatory reactions [2].ObjectivesThis study aimed to measure serum and synovial fluid (SF) levels of PTX3 in juvenile idiopathic arthritis (JIA) patients and to correlate them with different clinical, laboratory and musculoskeletal ultrasound parameters of disease activity.MethodsWe measured PTX3 in the serum (n=57) and SF samples (n=18) from 57 JIA patients and in the serum from twenty healthy control. Disease activity was calculated using the Juvenile Arthritis Disease Activity Score in 27 joints (JDAS27) and musculoskeletal ultrasound examination (MSUS) was performed using grey scale (GS) and power Doppler (PD) 10-joint score (bilateral knee, ankle, wrist, elbow and the 2nd metacarpophalangeal (MCP) joints)[3]; Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) levels, serum ferritin, rheumatoid factor (RF) titre were measured and the Juvenile arthritis multidimensional assessment report (JAMAR) was documented.ResultsSerum PTX3 level was significantly higher in JIA patients (3.59± 2.38 ng/mL) compared to serum level in the healthy controls (1.5 ± 0.9 ng/mL) (p<0.001). There was no significant difference between SF PTX3 level (4.73 ± 2.62 ng/mL) and its level in paired serum samples(4.23± 2.93 ng/mL) (p=0.59). JIA patients with systemic onset subtype (n=13) had higher PTX3 serum levels (5.57± 2.52 ng/mL) compared to serum level in the oligoartiular (n=25) and polyarticular (n=19) subtypes (2.88± 2.13 ng/mL and 3.18 ±11.92 ng/mL respectively) (p=0.001 and 0.005 respectively). In JIA patients, serum PTX3 level significantly correlated with JDAS27 (r=0.52, p<0.05), CRP titres (r=0.46, p<0.05) and serum ferritin (r=0.48, p<0.05). Both serum and SF PTX3 levels significantly correlated with PD score (r=0.51 and 0.48 respectively, p<0.05). SF PTX3 (p =0.001) was shown to be superior to serum PTX3(p =0.02), ESR (p =0.07) and comparable to CRP (p =0.001) at predicting PD synovitis score.ConclusionJIA patients have significantly increased serum and synovial fluid levels of Pentraxin 3 that remarkably correlated with the JDAS27 and MSUS parameters of inflammations suggesting that it could be a useful marker to reflect JIA disease activity.References[1] Liu S, Qu X, Liu F, Wang C. Pentraxin 3 as a Prognostic Biomarker in Patients with Systemic Inflammation or Infection. Mediators Inflamm; 2014:421-429.[2] Mantovani A, Garlanda C, Doni A, Bottazzi B. Pentraxins in innate immunity: from C-reactive protein to the long pentraxin PTX3. J Clin Immunol. 2008Jan;28(1):1-13.[3] Collado P, Naredo E, Calvo C, Gamir ML, Calvo I, García ML, et al. Reduced joint assessment vs comprehensive assessment for ultrasound detection of synovitis in juvenile idiopathic arthritis. Rheumatology (Oxford). 20...

Background: Juvenile idiopathic arthritis (JIA) is a heterogeneous group of inflammatory arthritis of unknown etiology in children with impending risk of impaired joint function. It is defied by the presence of at least one inflamed joint persisting 6 weeks with the onset before 16 years of age. The aim of this study was to determine the extent and pattern of cervical spine involvement in children with JIA using plain radiography. Methods: This study was carried on 50 JIA patients together with 20 age and sex matched apparently healthy volunteers representing a control group. Patients were subjected to history taking , full clinical examination, disease activity was measured using Juvenile Arthritis Disease Activity Score-27(JADAS-27) and X-ray was done to assess cervical spine involvement and Atlanto-Dens interval (the distance between anterior arch of atlas and the dens of axis) (ADI) was measured. Results: Cervical curve was straightened in 60% of patients' group. Intervertebral discs, retropharyngeal spaces, Spinolaminar line alignment and ADI measurements were normal in all cases. JIA patients of polyarticular type, had a higher incidence of neck pain and neck stiffness (P value = 0.798). There were no statistical significant difference regarding ADI measurements in JIA patients suffering from neck pain and neck stiffness (P value = 0.984). Conclusion: Neck pain & stiffness were more frequent in Polyarticular JIA patients than oligo articular or systemic onset type. No radiological abnormalities were detected between different types of JIA.

The global spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) generated a pandemic which severely impacted on care delivery worldwide. Aim of the work: To assess the correlation between CORADS score and different CBC indices and the sensitivity of CORADs score compared to lymphopenia and neutrophil/ lymphocyte ratio in diagnosing patients with COVID-19. Patients and methods :This study is a retrospective data review study done 106 patients who were visiting the emergency room at Benha University hospital for assessment of symptoms for the possibility of COVID 19.Results: Symptoms were variable ; the most common was fever (92.5%), mean total leucocytic count (TLC) 7.5±3.4 (10*3/UL); neutrophil count 5.5±3.3 (10*3/UL), lymphocytic count was 1.42 ± 0.77.CT scan done to all patients where GGO was the most common pattern. CORAD score was ranging from 0 to 5 with mean 3.96±1.59, There was no correlation between CORAD score and different CBC parameters; CORAD scores ≥ 4 had a sensitivity of 71% while CORAD 5 has a sensitivity of 60% in diagnosis. Lymphopenia <2 has a sensitivity of 82%, lymphocytes < 1.5 has sensitivity of 65% and lymphopenia <1.1 has a sensitivity of 40%. Neutrophil lymphocyte ratio > 3 has a sensitivity of 61% but increased to 68% with ratio>2.4. Conclusion: CORAD score and lymphopenia are rapid and valuable tools in diagnosis of COVID 19. CORAD has a sensitivity 60 to 71% according to the cut off used while lymphopenia has a sensitivity 40 to 82%, neutrophil/ lymphocyte ratio 61 to 68%.

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