Autoimmune thyroiditis CRP association

Background: C-reactive protein (CRP) is an acute phase reactant and its serum levels may be risen during many diseases. Hypothyroidism is a clinical disease state accompanied by mild inflammation that is known to be significantly associated with atherosclerosis. In this study, we aim to determine and compare serum CRP levels in overt and subclinical hypothyroidism subgroups and research their association with autoimmune markers.Methods: Around 79 patients who are diagnosed with overt and subclinical hypothyroidism in our polyclinic were included in this study. Patients’ morning blood samples were collected after 8hours of fast and thyroid functions, CRP, sedimentation rate, anti TG and anti TPO antibody levels were studied. Thyroid ultrasonography was planned for each patient.Results: We found significant differences regarding age, sT3, sT4, TSH, anti-TPO, anti-TG and CRP levels between overt and subclinical groups. There was no significant difference between the groups in thyroxin use, nodularity and sedimentation rate. No significant difference was found between CRP levels and autoimmunity markers anti-TPO and anti-TG among the groups as well. A significant cut-off value was determined for CRP in overt hypothyroidism by using Roc analysis and this value was also considered for being a possible cardiovascular risk marker.Conclusions: In this study, we found out that CRP levels were high in both overt and subclinical subgroups, CRP levels were increased during progression of the disease from subclinical to overt and this increase may be related with higher inflammation and tendency to cardiovascular diseases.

Ultrasound evaluation of metabolic syndrome patients with hepatosteatosis

Objective: The exact incidence of hepatosteatosis in patients with metabolic syndrome (MetS) is unknown; also there is no valid, simple and inexpensive method to evaluate and follow-up for patients with MetS. In our study, we aimed to demonstrate the frequency of hepatosteatosis, and whether demonstrate presence and degree of steatosis using liver ultrasonography may provide additional benefit for evaluating and following-up in MetS patients with non-alcoholic fatty liver disease. Methods: One hundred and twelve patients with MetS were included to the study. Patients divided into three groups; control group (n= 36) consisted of patients without hepatosteatosis, group 1 (n=43) consisted of patients with grade 1 hepatosteatosis. Finally, group 2 (n= 33) consisted of patients with grade 2 hepatosteatosis. The relationship between the presence and degree of the hepatosteatosis and MetS parameters were analyzed.Results: The incidence of hepatosteatosis was found 69.4% in patients with MetS. There were significantly differences in HOMA-IR, AST, ALT and GGT levels among control group and group 1 (p<0.05 for all). There were also significantly differences in waist circumference, fasting blood glucose, fasting insulin, HOMA-IR, AST, ALT, GGT, ferritin, CRP, sedimentation, uric acid and microalbuminuria levels among control group and group 2 (p<0.05 for all). Blood pressures and lipid profiles were similar among all groups (p>0.05 for all). Besides, there were significantly differences in waist circumferences, fasting insulin, HOMA-IR, GGT, uric acid, CRP levels among group 1 and 2 (p<0.05 for all).Conclusion: Our study indicates that MetS related parameters; especially insulin resistance, were significantly different in patients with hepatosteatosis compared to patients without hepatosteatosis. Because of the different measurment of waist circumferences among groups, we recommend to use liver ultrasonography and waist circumference together to evaluate and follow-up for MetS patients with hepatosteatosis. J Clin Exp Invest 2013; 4 (2): 153-158Key words: Fatty Liver, metabolic syndrome X, ultrasonograph

Relationship between disease impact scores and C-reactive protein/albumin ratio in patients with psoriatic arthritis

Aim To evaluate the relationships between the C-reactive protein (CRP)/albumin ratio (CAR), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and Disease Activity in Psoriatic Arthritis (DAPSA) and Psoriatic Arthritis Impact of Disease 12-item-questionnaire (PsAID-12) scores in patients with psoriatic arthritis (PsA). Methods This cross-sectional study involved 160 (121 female) patients with PsA who were >18 years old and treated in the rheumatology clinic of Dışkapı Yıldırım Beyazıt Education and Research Hospital between January 2020 and January 2021. Demographic and clinical data, PsAID12 and DAPSA scores, CRP, erythrocyte sedimentation rate (ESR), albumin level, neutrophil, lymphocyte, and platelet counts were recorded. Results The mean age was 46.49±11.12 years; median (min-max) disease duration was 2 years (0.5-34). The PsAID score was ≥4 (high disease impact) in 74.4% of patients. Patients with high disease impact had significantly higher CRP, ESR, CAR, NLR, PLR, neutrophil counts, and DAPSA scores (P<0.001). PsAID scores significantly highly correlated with CRP (rho 0.864, P<0.001), DAPSA significantly highly correlated with the CAR (rho 0.890, P<0.001). Receiver operating characteristic curve analysis showed that the CAR (area under the curve [AUC] 0.901, P<0.05, 95% confidence interval [CI] 0.855-0.947, NLR (AUC 0.759, P<0.05, 95% CI 0.680-0.838), and PLR (AUC 0.686, P<0.05, 95% CI 0.591-0.782) predicted high disease impact. The cut-off value for the CAR was 0.98. Conclusion The CAR can be useful in daily practice as a simple and quick assessment method to evaluate disease impact in Ps

Diagnostic value of acustic radiation force impulse imaging in the assessment of salivary gland involvement in primary Sjogren's sydrome

Aims: The aim of this study is to investigate the diagnostic value of Acoustic Radiation Force Impulse (ARFI) imaging in the assessment of salivary gland involvement in primary Sjogren's syndrome (pSS). Material and methods: Twenty five patients with pSS and 25 healthy volunteers were included. First, echostructures and the thickness of the submandibular and parotid glands were evaluated by B-mode ultrasonography. Then, ARFI imaging with Virtual Touch Quantification (R) was performed. Ten independent shear wave velocity measurements were taken from each gland. Finally, the mean shear wave velocity (SWV) values were calculated, and used for further analysis. Results: The mean SWV values of parotid and submandibular glands were significantly higher in the pSS patients than in the healthy control group (p 0.005). Conclusions: Our findings indicate that ARFI imaging may provide a non-invasive, simple and fast means of assessment of glandular impairment as an alternative test when other salivary gland tests are inconclusive or cannot be performed. ARFI may be a valuable adjunct for the clinical diagnosis of pSS

Spontaneous HBsAg seroconversion after severe flare of chronic hepatitis B infection

The results of the acute exacerbations of hepatitis B virus are varied from silent to severe acute hepatitis. HBsAg seroconversion induced by either antiviral drugs or occurred spontaneously, as a targeted end point of HBV infection management is infreaquent. The affect of the severe hepatitic flare on HBsAg seroconversion was reported before, however the predictive markers of HBsAg seroconversion are not clear yet. The reasons of the spontaneously HBV re-activations, or its usual results are not known well. We, herein reported a case, with the high serum HBV DNA titer during an acute spontaneously induced severe exacerbation of HBV infection which spontaneously resulted in total HBV recovery