Rheumatoid arthritis (RA) is a chronic systemic autoimmune inflammatory disease of unknown etiology that principally attacks the synovial joints. The pathology of the disease process often leads to destruction of bone and cartilage with reduction of the functional capacity (Majithia and Geraci, 2007).
Systemic or extra-articular manifestations are common in patients with rheumatoid arthritis (RA). Hematologic abnormalities, especially anemia are present in the majority of patients (Wilson et al., 2004).
Hepcidin, a small cysteine-rich peptide (Theurl et al., 2006), can affect both inflammation and red blood cell kinetics in health and disease (Roy et al., 2005). Further, hepcidin mRNA expression is increased in response to inflammatory stimulus such as lipopolysaccharides and infection (Pigeon et al., 2001).
This study was carried out on 30 patients suffering from RA and 20 healthy volunteers matched for age and sex with the patients. Both patients and control groups were selected from the Rheumatology, Rehabilitation and Physical medicine outpatient clinic and inpatient department of Benha university hospitals.
The aim of this study was to determine whether the prohepcidin could reflect RA disease activity, to analyze the relationship between serum Prohepcidin concentration and the anemia profiles of RA and to discover the possible utilization of serum Prohepcidin levels in differential diagnosis of ACD
All patients were subjected to the following:
1-Full history taking, complete clinical examination
2-Locomotor system examination
3-Assessment of disease activity using Disease Activity Score-28 (DAS-28)
4- Laboratory investigations included:
• Complete blood count.
• Erythrocyte sedimentation rate.
• Rheumatoid factor.
• C - reactive protein.
• Measurement of serum Prohepcidin levels by enzyme linked immunosorbant assay (ELISA).
5- Plain x-ray on both hands.
The result of our study were calculated, tabulated and statistically analyzed.
The findings of this study were as follows:
1. Hb level, RBCs count, HCT, MCH and MCHC were lower in patients group than control group with statistically significant difference between both of them.
2. MCV was lower in the patients group than the control group with no statistically significant difference between both of them.
3. Mean prohepcidin concentrations were higher in patients group than control group with highly statistically significant difference between both of them.
4. Mean Prohepcidin concentrations in females were higher than males within the patients group with statistically significant difference between both of them.
5. There were positive significant correlations between serum Prohepcidin concentrations and (TJC, SJC, DAS-28, Larsen score and ESR).
6. There were negative significant correlations between serum Prohepcidin concentrations and RBCs count.
7. There were insignificant correlations between serums Prohepcidin and (Hb, HCT, MCV, MCH, MCHC).
8. Serum Prohepcidin concentrations were higher in RA patients with DAS-28 >5.1 than RA patients with DAS-28 ≤5.1 with highly statistical significant difference between both of them.
9. Serum Prohepcidin concentrations were the highest in RA patients with normocytic anemia and the lowest in control group with highly statistically significant difference among them.
10. Serum Prohepcidin concentrations were the highest value in RA patients with Larsen score grade 5 and the lowest value in patients with Larsen score grade 1 without statistically significant difference among them.
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