The prevalence of metabolic syndrome in psoriatic arthritis patients, a hospital-based cross-sectional study on Iranian population

Background: Psoriasis is a T-cell mediated chronic inflammatory disorder with multiple skin, nails and joints involvement. The reported prevalence of psoriatic arthritis varies from 5 to 42 cases per 100 psoriasis patients. Insulin resistance is believed to be central to the pathogenesis of metabolic syndrome, a constellation of major risk factors for cardiovascular diseases, including atherogenic dyslipidemia, truncal adiposity, hypertension and hyperglycemia. The association of psoriasis and psoriatic arthritis with metabolic syndrome is increasingly being reported. Although the literature relating psoriatic arthritis to metabolic syndrome is accumulating, there is still a paucity of evidence, especially from Asia. Here, we examined the prevalence of metabolic syndrome and its components in patients with psoriatic arthritis. Methods: The study was performed among outpatients attending the specialty clinic and rheumatology ward of Rasoul-e-Akram general hospital between January 2014 and April 2015. A consecutive sample of 80 patients diagnosed as having psoriatic arthritis was studied. Age, gender, body mass index, blood pressure and waist circumference, and history of smoking of patients were measured and asked at the enrolment visit. Venous samples were taken after 8 h of overnight fasting for the estimation of serum lipid profile, glucose and uric acid levels. Also an ultrasonographic examination was done for detection of non-alcoholic fatty liver disease. Results: 46 patients (57.5) were male and 34 patients (42.5) were female. Mean age of the participants was 43 years (SD: 11.3). The prevalence of abnormal components of metabolic syndrome was 53.8 for BMI, 48.8 for TG level, 50 for HDL, 46.3 for LDL, 45 for Cholesterol, 23.8 for FBS, 46 for waist circumflex in men and 47.7 in women and 42.5 for uric acid. 40 of the patients had abnormal SBP and 41.2 had abnormal DBP. Thirty percent of the participants were current smokers and 43.8 had NAFLD on ultrasonographic examination. Conclusion: 51.3 of patients had metabolic syndrome according to the adult treatment panel III criteria for adult Asian patients. � 2016, Tehran University of Medical Sciences. All rights reserved

Fatal idiopathic hypereosinophilic syndrome presenting with refractory ascites: Case report study

Hypereosinophilic syndromes were a group of divergent disorders united by overproduction of eosinophils and the several organ damages ascribed to this persistent eosinophilia. Among all the presenting symptoms, gastrointestinal symptoms were the least common. We were reporting a 21 year old man with a 2 year history of refractory ascites, hepatomegaly, portal and hepatic veins thrombosis and cutaneous lesions. Bone marrow aspiration and biopsy revealed granulocytic hyperplasia with marked eosinophilia. After ruling out common causes of eosinophilia, a diagnosis of idiopathic hypereosinophilic syndrome was made. The patient was treated with corticosteroids and imatinib but due to the advanced progression of the disease, resulted in a fatal outcome. Since early diagnosis and treatment is the key for improving the prognosis of HES patients, a high clinical suspicion is necessary in the diagnosis of this condition