Association among B lymphocyte subset and rheumatoid arthritis in a Chinese population

Abstract Background and aim Autoantibody production are the main risk factors for inflammation of rheumatoid arthritis (RA). This study aimed to investigate differences in B lymphocyte subsets (native B, memory B, and plasmablasts) and several cytokines in RA patients and their correlation with the clinical parameters. Methods In total, 81 RA patients (active RA and inactive RA) and 40 healthy subjects were recruited between September 2018 and October 2020. The distribution of B lymphocyte subsets in peripheral blood samples was measured via flow cytometry and the plasma cytokines were detected by enzyme linked immunosorbent assay. The receiver operating characteristic curve (ROC) was used to evaluate the value of each index for RA diagnosis and activity prediction. Results The percentages of native B and memory B cells in RA patients did not differ significantly from the percentages of those in healthy controls. However, the percentage of plasmablasts in active RA patients was significantly higher compared with healthy subjects and inactive RA patients. The percentage of plasmablasts was significantly related to C reaction protein. ROC curve analysis showed that when the best cutoff value of plasmablasts/B cell was 1.08%, the area under the curve (AUC) for diagnosing RA was 0.831 (95% CI 0.748 ~ 0.915), the specificity was 91.4%, and the sensitivity was 67.5%. The AUC predicted by the combination of plasmablast and anti-CCP for active RA patients was 0.760, which was higher than that of plasmablast and anti-CCP. Conclusion In conclusion, the percentage of plasmablast varies among RA patients in different stages. The percentage of plasmablasts can be used as an early diagnosis marker for RA.

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Association Among B Lymphocyte Subset and Rheumatoid Arthritis in A Chinese Population

10.21203/rs.3.rs-793561/v1 ◽

2021 ◽

Author(s):

Haiyan You ◽

Mengwei Cheng ◽

Cui Ma ◽

Wenjuan Zheng ◽

Yu Jiang ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Healthy Subjects ◽

B Lymphocyte ◽

Lymphocyte Subsets ◽

Characteristic Curve ◽

Area Under The Curve ◽

Enzyme Linked Immunosorbent Assay ◽

Roc Curve Analysis ◽

Autoantibody Production ◽

Plasma Cytokines

Abstract Background and aim: Autoantibody production are the main risk factors for inflammation of rheumatoid arthritis (RA). This study aimed to investigate differences in B lymphocyte subsets (native B, memory B, and plasmablasts) and several cytokines in RA patients and their correlation with the clinical parameters. Methods In total, 81 RA patients (active RA and inactive RA) and 40 healthy subjects were recruited between September 2018 and October 2020. The distribution of B lymphocyte subsets in peripheral blood samples was measured via flow cytometry and the plasma cytokines were detected by enzyme linked immunosorbent assay. The receiver operating characteristic curve (ROC) was used to evaluate the value of each index for RA diagnosis and activity prediction. Results The percentages of native B and memory B cells in RA patients did not differ significantly from the percentages of those in healthy controls. However, the percentage of plasmablasts in active RA patients was significantly higher compared with healthy subjects and inactive RA patients. The percentage of plasmablasts was significantly related to C reaction protein. ROC curve analysis showed that when the best cutoff value of plasmablasts/B cell was 1.08%, the area under the curve (AUC) for diagnosing APN was 0.831 (95% CI 0.748ཞ0.915), the specificity was 91.4%, and the sensitivity was 67.5%. Conclusion In conclusion, the percentage of plasmablast varies among RA patients in different stages. The percentage of plasmablasts can be used as an early diagnosis marker for RA.

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Urine β-2-glycoprotein 1 as a biomarker for diagnosis of systemic lupus erythematosus

Lupus ◽

10.1177/09612033211014268 ◽

2021 ◽

pp. 096120332110142

Author(s):

Jung Sun Lee ◽

Eun-Ju Lee ◽

Jeonghun Yeom ◽

Ji Seon Oh ◽

Seokchan Hong ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Medical Center ◽

Characteristic Curve ◽

Area Under The Curve ◽

Diagnostic Value ◽

Urine Samples ◽

Enzyme Linked Immunosorbent Assay ◽

Systemic Lupus ◽

Asan Medical

Objective The need for a biomarker with robust sensitivity and specificity in diagnosing systemic lupus erythematosus (SLE) remains unmet. Compared with blood samples, urine samples are more easily collected; thus, we aimed to identify such a biomarker based on urinary proteomics which could distinguish patients with SLE from healthy controls (HCs). Methods Urine samples were collected from 76 SLE patients who visited rheumatology clinic in 2019 at Asan medical center and from 25 HCs. Urine proteins were analyzed using sequential windowed acquisition of all theoretical fragment ion spectra-mass spectrometry, and the candidate marker was confirmed by enzyme-linked immunosorbent assay (ELISA). Receiver operating characteristic curve analysis was used to determine the diagnostic value of the candidate biomarker. Results Of 1157 proteins quantified, 153 were differentially expressed in urine samples from HCs. Among them were previously known markers including α-1-acid glycoprotein 1, α-2-HS-glycoprotein, ceruloplasmin, and prostaglandin-H2 D-isomerase. Moreover, the amount of β-2 glycoprotein (APOH) was increased in the urine of patients with SLE. The ELISA results also showed the level of urine APOH was higher in patients with SLE than in HCs and patients with rheumatoid arthritis. Moreover, the level was not different between SLE patients with and without nephritis. The urine APOH had an area under the curve value of 0.946 at a cut-off value of 228.53 ng/mg (sensitivity 91.5%, specificity 92.0%) for the diagnosis of SLE. Conclusion The results indicate that the urine APOH level can be an appropriate screening tool in a clinical setting when SLE is suspected.

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Using protein microarray reveals clinical correlation between self-perception of patient and the apoptosis-related proteins in rheumatoid arthritis

10.21203/rs.3.rs-39433/v1 ◽

2020 ◽

Author(s):

Jian-ting Wen ◽

Jian Liu ◽

Hui Jiang ◽

Lei Wan ◽

Ling Xin ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Mononuclear Cells ◽

Expression Profiles ◽

Enzyme Linked Immunosorbent Assay ◽

Healthy Controls ◽

Self Perception ◽

Roc Curve Analysis ◽

Peripheral Blood Mononuclear ◽

Related Proteins ◽

Potential Biomarkers

Abstract Background: The most severe effects of rheumatoid arthritis (RA) are loss of physical function, which may have a significant impact on self-perception of patient (SPP). However, the inherent relationship between SPP and the key proteins is not clear. The aim of this study was to get an insight into SPP of RA in connection with the the apoptosis-related proteins. Methods: We set out to investigate changes of the apoptosis-related proteins expression in the peripheral blood mononuclear cells (PBMCs) of RA. Additionally, we aimed to correlate the apoptosis-related proteins expression profiles with SPP and clinical indexes. To this end, we employed antibody microarrays of the the apoptosis-related proteins in PBMCs from four RA patients and seven healthy controls. We used bioinformatics to screen several the apoptosis-related proteins. To validate key protein candidates, we performed Enzyme linked immunosorbent assay (ELISA) on 30 RA patients and 30 healthy controls. Results: We found the expression of ten the apoptosis-related proteins (caspase3, CD40, SMAC, HSP27, HTRA, IGFBP-1, IGFBP-6, sTNF-R1, sTNF-R2, TRAILR-3) were significantly altered in PBMCs of RA patients. Receiver operating characteristic (ROC) curve analysis suggested that these ten the apoptosis-related proteins are potential biomarkers of RA. Spearman Correlation analysis and Logistic-regression analysis revealed that the 10 selected the apoptosis-related proteins correlated with SPP and clinical indexes. Conclusion: Therefore, we highlight some the apoptosis-related proteins may serve as potential biomarkers in prediction of SPP for RA patients, although the underlying mechanisms need to be further explored.

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Urine CA-2 as a biomarker for diagnosis urinary stone and prediction of its complications

10.21203/rs.3.rs-59394/v1 ◽

2020 ◽

Author(s):

Yuan-jing Leng ◽

Hai-bin Zhou ◽

Jiang-ling Fu ◽

Wen-juan Wang

Keyword(s):

Healthy Subjects ◽

Characteristic Curve ◽

Urinary Stone ◽

Urinary Stones ◽

Enzyme Linked Immunosorbent Assay ◽

Control Group ◽

Healthy Control ◽

The Mean ◽

The Difference ◽

The Relationship

Abstract PURPOSECarbonic anhydrase-2 (CA-2) plays a role in mineralization and calcification in organism. Strong evidence suggests that CA-2 is associated with urolithiasis. However, the relationship between CA-2 and urinary stone remains unclear. The study aimed to assess the association of urine CA-2 (uCA-2) level and the potential risk of urinary stone.METHODSFrom March 2017 to November 2019, a prospective cohort study was conducted on patients with urinary stones and healthy subjects to determine the pretreatment uCA-2 level detection by Enzyme linked immunosorbent assay (ELISA). The difference of uCA-2 level between patients with urinary stones and healthy subjects was compared. Then comparison between stone patients with complications and without complications was carried out as well as correlation analysis to detect factors associated with biomarker expression.RESULTS118 patients with urinary stones were into urinary stones group and 42 healthy subjects were into healthy control group. The mean pretreatment uCA-2 level was significantly higher in patients with urinary stones group than healthy controls group (P=0.028). Furthermore, The uCA-2 level was positive correlation with urinary stones complications (R=0.379, P=0.000), especially pain complications (R=0.524, P=0.000) and hematuria complications (R=0.374, P=0.000). Receiver operating characteristic curve (ROC) analysis that a uCA-2 level threshold of 10.94 ng/mL had 83.67% sensitivity and 68.12% specificity for predicting urinary stones complications. CONCLUSIONSExcessive uCA-2 excretion is a major risk factor for urinary stone. Our findings suggested that uCA-2 may be used as an unappreciated biomarker for the diagnosis urinary stone in patients and to predict its complications.

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Predictive Value of The Combined Detection of Platelets, D-Dimer, and Procalcitonin On Severe Heat Stroke

10.21203/rs.3.rs-618567/v1 ◽

2021 ◽

Author(s):

wang lei ◽

jiang dai shan ◽

zhang Yi ◽

jia han yu ◽

shen jun hua

Keyword(s):

Body Temperature ◽

Characteristic Curve ◽

Heat Stroke ◽

Area Under The Curve ◽

General Information ◽

The Body ◽

Control Group ◽

Clinical Test ◽

Roc Curve Analysis ◽

Combined Detection

Abstract BackgroundTo explore the clinical characteristics of patients with severe heat stroke, we explored the early sensitive indicators of heat stroke (HS) patients, with a view to early intervention for HS patients. MethodsFrom July 30, 2015 to October 5, 2020, 70 inpatients with severe heat stroke admitted to the Second Affiliated Hospital of Nantong University, Jiangsu Province were selected as the research objects. The general information and clinical test indicators of the patients were recorded, and all patients were assessed for acute physiology (APACH Ⅱ) upon admission. According to the severity of heatstroke, they were divided into three groups: control group (heat cramps and heat exhaustion), EHS, and CHS to compare the differences in indicators of each group. Further draw the receiver operating characteristic curve (ROC).Results1. According to the severity of heat stroke, 28 cases were divided into the control group, 24 cases in the EHS group, and 18 cases in the CHS group. The body temperature of the EHS group and the CHS group was significantly higher than that of the control group (both P<0.05), but there was no statistical difference in the body temperature of the EHS group and the CHS group; the DD, PCT, and APACH of the EHS group were significantly higher than those of the control group and the CHS group (both P＜0.05); PLT, CRP, Na, GLU of EHS group were lower than those of control group and CHS group (all P＜0.05), and the decrease of PLT was more significant; CHS group HbA1C was significantly higher than that of control group and EHS group (all P <0.05). 2. ROC curve analysis the areas under the curves of DD, PCT, and PLT are 0.670, 0.705, 0.791, respectively, the sensitivity is 40.48%, 100%, 73.81%, and the specificity is 96.43%, 32.14%, 78.57%, respectively. Using the combined analysis of the three series tests, the area under the curve was 0.838, the sensitivity was 71.43%, and the specificity was 85.71%. ConclusionsEHS patients have higher DD, PCT, APACH, but PLT, CRP, Na, and blood sugar are lower. At the same time, the significant decrease of PLT and the increase of PCT and DD may be early sensitive indicators of HS. The combined detection of the three can be used as a reference basis for early diagnosis of HS and critical illness.

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14-3-3η Protein in Rheumatoid Arthritis: Promising Diagnostic Marker and Independent Risk Factor for Osteoporosis

Laboratory Medicine ◽

10.1093/labmed/lmaa001 ◽

2020 ◽

Vol 51 (5) ◽

pp. 529-539

Author(s):

Tingting Zeng ◽

Liming Tan ◽

Yang Wu ◽

Jianlin Yu

Keyword(s):

Rheumatoid Arthritis ◽

Logistic Regression ◽

Regression Analysis ◽

Risk Factor ◽

Logistic Regression Analysis ◽

Independent Risk Factor ◽

Multiple Logistic Regression Analysis ◽

Area Under The Curve ◽

Enzyme Linked Immunosorbent Assay ◽

Disease Monitoring

Abstract Background Early identification and disease monitoring are challenges facing rheumatologists in the management of rheumatoid arthritis (RA). Methods We utilized enzyme-linked immunosorbent assay (ELISA) to determine 14-3-3η and anticyclic citrullinated peptide antibody (anti-CCP) levels, with rheumatoid factor (RF) level detected by rate nephelometry. The diagnostic value of each index was determined via receiver operating characteristic (ROC) curve, and the association between 14-3-3η and osteoporosis was assessed using multiple logistic regression analysis. Results Serum levels of 14-3-3η were 3.26 ng per mL in patients with RA. These levels were helpful in identifying patients with the disease, with the area under the curve (AUC) being 0.879 and 0.853, respectively, from all healthy control individuals and patients with RA. Combining 14-3-3η with RF or anti-CCP increased the diagnostic rate. Logistic regression analysis identified 14-3-3η as an independent risk factor for RA-related osteoporosis (odds ratio [OR], 1.503; 95% confidence interval [CI], 1.116–2.025; P <.01). Conclusions Serum 14-3-3η detection by itself or combined with other serum indices was helpful in differentiating patients with RA. Also, it was a promising biomarker for disease monitoring in RA.

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The Value of Serum Midkine Level in Diagnosis of Hepatocellular Carcinoma

International Journal of Hepatology ◽

10.1155/2015/146389 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 17

Author(s):

Karim Y. A. Shaheen ◽

Abeer I. Abdel-Mageed ◽

Eslam Safwat ◽

Ashraf M. AlBreedy

Keyword(s):

Healthy Subjects ◽

Operating Characteristic ◽

Diagnostic Marker ◽

Characteristic Curve ◽

Area Under The Curve ◽

Tumor Diameter ◽

Control Groups ◽

Tumor Number ◽

Healthy Control ◽

Operating Characteristic Curve

Background and Aim. Identification of sensitive biomarkers to improve early diagnosis of HCC is needed. We aimed to evaluate serum midkine (MDK) as a biomarker for HCC diagnosis.Patients and Methods. 40 HCCs, 30 liver cirrhosis patients, and 30 healthy subjects were enrolled. Serum MDK using ELISA was measured in all included subjects.Results. Serum MDK was significantly elevated in HCC group compared to cirrhotic and healthy control groups (0.625 versus 0.15 and 0.125 ng/mL), respectively. No significant association was found between MDK and either BCLC stage, tumor diameter, tumor number, or AFP level. Receiver operating characteristic curve showed that best cutoff for MDK and AFP was 0.387 and 88.5 ng/mL, respectively. Area under the curve of MDK was significantly larger than that of AFP (0.941 versus 0.671). The sensitivity of MDK at 0.387 ng/mL for HCC diagnosis was significantly higher than that of AFP at cutoffs 20, 88.5, and 200 ng/mL (92.5 versus 62.5, 40, and 25%), respectively. Sensitivity of MDK reached 93.3% in patients with AFP <20 ng/mL. Moreover, MDK at 0.387 ng/mL had significant better sensitivity than AFP at 20 ng/mL in distinguishing HCC from BCLC 0/A (90 versus 40%).Conclusion. Serum MDK might be a potential diagnostic marker for HCC particularity in its early stages.

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SAT-086 Pituitary Volume as a Diagnostic Measure for Determining the Etiology of Short Stature in Children: Receiver Operating Characteristic Curve Analysis and Cutoff Values

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.106 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Liam McGuirk ◽

Tara P Patale ◽

Nicholas Andrew Krasnow ◽

Alice Alexandrov ◽

James Haigney ◽

...

Keyword(s):

Short Stature ◽

Standard Error ◽

Characteristic Curve ◽

Area Under The Curve ◽

Curve Analysis ◽

Youden Index ◽

Pediatric Endocrinology ◽

Roc Curve Analysis ◽

Gh Secretion ◽

Cutoff Values

Abstract Background: It is speculated that pituitary volume (PV) is a marker of chronic growth hormone (GH) secretion. In previous studies, we determined that children with GH deficiency (GHD) and idiopathic short stature (ISS) had significantly smaller PVs than normal controls (NCs). Cutoff values for small PVs are needed to improve the clinical utility of PV in determining children who qualify for GH therapy. Objective: To define the cutoff between pathologic and nonpathologic PV in prepubertal and pubertal children with short stature (SS). Patients and Methods: The SS group was selected from the database of a pediatric endocrinology center, which was queried for siblings (SBs) aged 6–18 yrs who underwent a GH stimulation test and MRI between 2013–2019. All 77 SBs had SS, defined as 2 SDs below mean height for age, subnormal growth velocity for at least 6 months, or predicted height at least 2 inches discrepant from midparental height. The NC group was selected from the database of a neuroradiology center; these NCs consisted of 170 randomly selected subjects aged 6–18 yrs. Patients with MRI abnormalities were excluded. PVs were calculated using the ellipsoid formula (LxWxH/2). ROC curve analysis was utilized to generate cutoff values. The diagnosis of short stature was the dependent variable and PV was the independent variable. The PV with the highest Youden index was selected as the definitive cutoff for a small PV. Results: The mean (MN) and median (MD) age of SBs was 11.6 ±2.2 and 11.9 yrs, respectively, and the MN and MD age of the NCs was 12.6 ±3.4 and 13.2 yrs, respectively. The MN and MD age of prepubertal SBs (n=29) and NCs (n=58) were 9.3 ±1.2 and 9.7, and 8.6 ±1.4 and 8.6 yrs, respectively. The MN and MD age of pubertal SBs (n=48) and NCs (n=112) were 13.0 ±1.4 and 12.7, and 14.7 ±1.9 and 14.6 yrs, respectively. The difference in MN age between SBs and NCs was significant (p<0.05). For prepubertal subjects, sensitivity was 86.21% and specificity was 68.97%. The distance to corner was 0.3396, and the highest Youden index was 0.5517, corresponding to a PV of 215.02 mm3. The Area Under the Curve (AUC) was 0.8395 with a standard error of 0.0426 (p<0.001). For pubertal subjects, sensitivity was 81.25% and specificity was 79.46%. The distance to corner was 0.2781, and the highest Youden index was 0.6071, corresponding to a PV of 315.0 mm3. The AUC was 0.8460 with a standard error of 0.0337 (p<0.001). Conclusion: To our knowledge, we present the first study on the sensitivity and specificity of PV in determining the etiology of SS. Our data suggest that prepubertal patients with a PV<215.02 mm3 and pubertal patients with a PV<315.00 mm3 have small pituitary glands. Statistically calculated cutoffs are necessary to accurately diagnose pituitary hypoplasia and should be utilized to determine the etiology of SS. Future studies should include children with Tanner staging and height SDs to generate more accurate PV cutoffs.

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B-lymphocyte depletion therapy in rheumatoid arthritis and other autoimmune disorders

Biochemical Society Transactions ◽

10.1042/bst0300824 ◽

2002 ◽

Vol 30 (4) ◽

pp. 824-828 ◽

Cited By ~ 41

Author(s):

J. C. W. Edwards ◽

M.J. Leandro ◽

G. Cambridge

Keyword(s):

Rheumatoid Arthritis ◽

B Lymphocyte ◽

Lymphocyte Subsets ◽

Autoimmune Disorders ◽

Lymphocyte Depletion ◽

Rate Limiting Step ◽

Limiting Step ◽

Early Evidence ◽

Wide Range ◽

Rate Limiting

B-lymphocyte depletion therapy is being explored in a wide range of autoimmune disorders. In many, there is early evidence for efficacy, and immunosuppression has not been a major problem. The mechanism of action is unclear, but appears to be consistent with the lowering of autoantibody levels, where relevant antibodies are quantifiable. An interesting finding is the persistence of clinical improvement for periods of 1 year or more after B-lymphocyte return, which supports the concept that stochastic generation of rare pathogenic B-lymphocyte subsets may be a rate-limiting step in pathogenesis.

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AB1253 EVALUATION OF CYSTEINE-RICH 61 IN RHEUMATOID ARTHRITIS AS A DIAGNOSTIC MARKER AND PREDICTOR OF ATHEROSCLEROSIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.752 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1918.2-1918

Author(s):

H. A. Esaily ◽

D. M. Serag ◽

M. S. Rizk ◽

A. Sonbol ◽

D. Salem

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Vascular Complications ◽

Area Under The Curve ◽

Intima Media Thickness ◽

Enzyme Linked Immunosorbent Assay ◽

Matricellular Protein ◽

Laboratory Assessment ◽

Cross Sectional ◽

Rheumatoid Arthritis Disease

Background:Matricellular protein Cysteine-rich protein 61 (Cyr61) is involved in chronic inflammatory disorders like rheumatoid arthritis (RA) and atherosclerosis.Objectives:This study aimed to assess the value of serum Cyr61 in diagnosis of rheumatoid arthritis, evaluating its correlation with disease activity and its relation to atherosclerosis.Methods:Cross-sectional study included 105 RA patients classified into active and inactive groups according to disease activity score (DAS28) with 50 healthy age and gender-matched controls. Full clinical and laboratory assessment was done including enzyme-linked immunosorbent assay (ELISA) measurement of Cyr61. Bilateral assessment of carotid intima-media thickness (CIMT) was done using high resolution-ultrasonography. Comparison of Cyr61 between RA patients and controls, correlation between Cyr61 and disease activity and CIMT were analyzed with appropriate statistical analyses.Results:Significant elevation of Cyr61 in RA patients compared to controls (235.62±62.5 vs. 73.11±18.2) respectively. The cut off value of Cyr61 was 99.25 pg/ml, with area under the curve (AUC) =0.995, P <0.001, 98 % sensitivity and 95% specificity. Cyr61 was inversely correlated with DAS28 and its components in RA patients (r=- 0.92, r=- 0.94) (p<0.001). There was a significant positive correlation between Cyr61 levels and CIMT in inactive and active RA patients (r=0.88, r=0.47) respectively.Conclusion:Serum Cyr61 as a potential diagnostic biomarker in RA is inversely correlated with disease activity. High Cyr61 in RA is a risk factor for atherosclerosis. Disruption of serum Cyr61 is engaged in the pathogenesis of both rheumatoid arthritis and atherosclerosis which is a clue for a future treatment strategy of RA.References:[1]Smolen JS, Aletaha D, Barton A, Burmester GR, Emery P, Firestein GS, Kavanaugh A, McInnes IB, Solomon DH, Strand V, Yamamoto K (2018) Rheumatoid arthritis. Nature reviews Disease primers 4:18001. doi:10.1038/nrdp.2018.1[2]Pelechas E, Kaltsonoudis E, Voulgari PV, Drosos AA (2019) Rheumatoid Arthritis. In: Pelechas E, Kaltsonoudis E, Voulgari PV, Drosos AA (eds) Illustrated Handbook of Rheumatic and Musculo-Skeletal Diseases. Springer International Publishing, Cham, pp 45-76. doi:10.1007/978-3-030-03664-5_3[3]Sparks JA (2019) Rheumatoid Arthritis. Annals of Internal Medicine 170 (1):ITC1-ITC16. doi:10.7326/aitc201901010[4]Abd El-Monem S, Ali A, Hashaad N, Bendary A, Abd El-Aziz H (2019) Association of rheumatoid arthritis disease activity, severity with electrocardiographic findings, and carotid artery atherosclerosis. Egyptian Rheumatology and Rehabilitation 46 (1):11-20. doi:10.4103/err.err_36_18[5]Rawla P (2019) Cardiac and vascular complications in rheumatoid arthritis. Reumatologia 57 (1):27-36. doi:10.5114/reum.2019.83236[6]de Brito Rocha S, Baldo DC, Andrade LEC (2019) Clinical and pathophysiologic relevance of autoantibodies in rheumatoid arthritis. Advances in Rheumatology 59 (1):2. doi:10.1186/s42358-018-0042-8Disclosure of Interests:None declared

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