1Tayel MY and 2Morad Z.
1Departments of Internal Medicine, Unit of Rheumatology and 2Clinical Pathology, Faculty of Medicine, Alexandria University.
The aim of this study was to assess soluble E-Selectin in rheumatoid arthritis patients with and without vasculitic peripheral neuropathy and correlate its level with clinical features and disease activity. Thirty rheumatoid patients group I and fifteen healthy controls group II were studied. The musculoskeletal system was assessed using Ritchie's articular score and the neurological evaluation was based on a neurological disability score system. Accordingly, patients were divided into two subgroups: those suffering from peripheral neuropathy and without peripheral neuropathy. Patients underwent a battery of routine laboratory investigations, also rheumatoid activity was assessed through the estimation of rheumatoid factor, C-reactive protein and erythrosedimentation rate. Determination of soluble E-Selectin level was done by Elisa. The rheumatoid patients with peripheral neuropathy (group IA) showed significantly (P< 0.001) longer duration of the disease, longer duration of morning stiffness (P< 0.001), larger number of swollen and painful joints than group IB those without neuropathy (P< 0.001 and 0.002), also Ritchie’s articular score and neurological disability score were higher in group IA than in group IB (P< 0.001.). Group IA was characterized by renal impairment manifested by increased level of serum creatinine, increased disease activity and severity manifested by elevated erythrocyte sedimentation rate, serum level of rheumatoid factor and positive C-reactive protein titre. The highest levels of sE-selectin was detected in group IA patients (108.54±13.2 ng/ml). Nerve conduction studies revealed significantly delayed distal latency, and slower nerve conduction velocity of the nerves of the upper limbs (motor and sensory), and some of the lower limbs (motor and sensory) in group IA as compared to group II (P< 0.05 for all).