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Aim of the work: To evaluate the value of three hematological indices to determine subclinical inflammation in Familial Mediterranean Fever (FMF) patients during attack-free period. Patients and methods: This study included 60 FMF patients without FMF-related symptoms or signs in the preceding month and 50 age and sex matched healthy control. Subclinical inflammation was defined as the presence of elevated C-reactive protein (CRP) > 5 mg/dL and/or serum amyloid A (SAA) levels > 6.4 mg/L in the absence of any FMF related clinical signs and symptoms. The neutrophil/lymphocyte ratio (NLR), the platelet/lymphocyte ratio (PLR) and mean platelet volume (MPV) were evaluated. Results: The median age of the patients was 32 and 80% were females. They were 12 (80%) with subclinical inflammation and 48 (80%) without. Mutations of MEFV gene were analyzed in 43 (56.6%) patients and were homozygous in 21, heterozygous in 12 and compound heterozygous in 10. The most common mutation was of M694V. The NLR and PLR were significantly higher and MPV lower in patients with inflammation (p = 0.002, p = 0.02, p = 0.03, respectively) but was comparable to the values in the control. Only NLR was significantly higher in those with inflammation compared to those without (p = 0.009) whereas MPV and PLR were similar (p = 0.45 and p = 0.22, respectively). The best cut-off value for NLR in predicting subclinical inflammation in patients was 2.94 (sensitivity 66.7%, specificity 94.9%;p = 0.009). Conclusions: Only NLR increased in FMF patients with subclinical inflammation which may be used as a marker in determining early activity or flare in addition to other markers.

Background: Systemic sclerosis (SSc) is a systemic autoimmune disease characterized by microangiopathy, inflammation, fibrosis. Interstitial lung disease (ILD) is common among SSc patients. Objective: This study aims to define the clinical, laboratory, and serologic characteristics of SSc patients with ILD and to present the frequency of chest computed tomography features. Methods: Two hundred twenty-six SSc patients who applied to the Rheumatology Department between January 2007 and August 2019 were retrospectively examined. A total of 100 SSc patients with ILD (44.2%) were determined. Clinical, laboratory, and serological features of SSc patients with and without ILD were compared. Results : Both groups had similar characteristics in terms of age and sex. The duration of disease (p=0.001) and follow-up time (p=0.001) were longer in SSc patients with ILD. Multivariable logistic regression analysis indicated that the duration of disease (OR: 1.06 (1.01-1.13), p=0.029), presence of gastrointestinal system involvement (OR: 3.29 (1.28-8.46), p=0.013) and anti-SCL70-positivity (OR: 6.04 (2.35-15.49), p Conclusion: We have shown a relationship between anti-SCL70, disease duration, gastrointestinal system involvement, and ILD in SSc patients.

Objective In this study, it was aimed to reveal the hospitalization reasons for patients diagnosed with primary Sjögren syndrome (pSS) and potentially associated factors in a tertiary health center. Method One hundred and sixty-three pSS patients who regularly attended their follow-ups between January 2010 and May 2021 were included in the study. These patients’ reasons for hospitalization, duration of hospitalization, and numbers of presenting to the hospital were recorded. The demographic, clinical and serological characteristics of the hospitalized and non-hospitalized patients were compared. Results Hospitalization occurred in 22.7% of the patients, and the total number of hospitalizations was 79. The hospitalization incidence density rate was 6.21 per 100 patient-years. The most frequently encountered reason for hospitalizations was pSS-related organ involvement (44.3%). Infections (17.7%), malignancy (16.5%), endocrine, and various other reasons were the other indications for hospitalization. While male sex (p = 0.005), the presence of extra-glandular involvement (p

AIM High Mobility Group Box-1 (HMGB-1) is a nuclear protein acting as a proinflammatory molecule. The serum HMGB-1 levels were found elevated in chronic inflammatory diseases. In this cross-sectional study, serum HMGB-1 levels in Behcet's disease (BD) patients and healthy controls (HC) were studied. Also, its association with disease activity scores and clinical findings were evaluated. METHOD Ninety BD patients and 50 age-sex matched HC were included in the study. Disease activity scores were assessed by Behcet Disease Current Activity Form (BDCAF) and Behcet Syndrome Activity Score (BSAS). Serum HMGB-1 levels were measured using a commercial ELISA kit. A p-value of < 0.05 was considered to be statistically significant. RESULTS Serum HMGB-1 levels were significantly higher in BD than in HC (43.26 pg/mL and 16.73 pg/mL; p< 0.001 respectively). Serum HMGB-1 levels were statistically significantly associated with presence of erythema nodosum (EN) and genital ulcers in the last one month prior to recruitment (p= 0.041 and p< 0.001, respectively). BDCAF and BSAS scores were positively correlated with serum HMGB-1 level (p= 0.03 and p= 0.02, respectively). CONCLUSION HMGB-1 may play a role in the development of BD. Also, due to its positive correlation with disease activity indices, it can be used as a novel disease activity parameter in BD.

Objectives:The study aimed to reveal the clinical, laboratory and serological features of patients with antiphospholipid syndrome (APS) followed in a referral center and to demonstrate the possible differences of the patients with recurrent thrombosis.Materials and Methods:The data of 43 patients with APS, who applied to our center between January 2010 and January 2019, were scrutinized retrospectively. Clinical, laboratory and serological features of the patients were recorded. The patients with and without recurrent thrombosis were compared. P-value

Objective: Calprotectin is an inflammatory biomarker which assesses disease activity in rheumatoid arthritis (RA). The objective of this study was to test whether serum calprotectin is associated with clinical and ultrasonographic disease activity in patients with RA, and to analyse its predicting value for disease activity evaluation despite normal C-Reactive protein (CRP) levels. Methods: We included 80 patients with RA and 30 healthy subjects. Patients were examined clinically and by ultrasound, (US7 score) along with laboratory parameters (calprotectin, CRP, erythrocyte sedimentation rate [ESR]). Disease activity scores (DAS28) were calculated to assess disease activity. Firstly, patients were divided into four subgroups according to the DAS28-ESR (high, moderate, low disease activity, and remission), then into two subgroups; group-1 (DAS-28≤3.2) and group-2 (DAS28>3.2). The predicting value of calprotectin for disease activity in patients with normal CRP was analysed with univariate and multivariate analysis and receiver operating characteristic curves. Results: Calprotectin levels were higher in RA patients than controls (96.3±45.9 ng/ml, 54.7±50.0 ng/ml, respectively; p

Background Beta-2 microglobulin (β2M) is mainly released from activated lymphocytes. Increased serum β2M levels have been shown in autoimmune diseases. The aim of this study was to analyse the serum levels of β2M in rheumatoid arthritis (RA) patients and to evaluate its relationship with disease activity measures. Material and Methods This cross-sectional study included 137 RA patients, 102 ankylosing spondylitis patients (AS) and 50 healthy controls (HC). To assess the disease activity of RA patients, the 28-joint Disease Activity Score-Erythrocyte Sedimentation Rate (DAS28-ESR), the 28-joint Disease Activity Score-C-Reactive Protein (DAS28-CRP), the Simplified Disease Activity Index (SDAI) and the Clinical Disease Activity Index (CDAI) were used. A p value of Results Serum β2M levels were significantly higher in RA patients (2.95±1.19 mg/L) compared with HC (2.21±0.54 mg/L) and AS patients (2.200.58 mg/L) (p Conclusion Our study revealed that serum β2M levels were higher in RA patients than in healthy controls, and, in contrast to other studies, we found positive correlations between β2M levels and RA disease activity measures.

Objectives:In this study, we aimed to determine the clinical, laboratory and demographic characteristics of patients with rheumatoid arthritis (RA) using tofacitinib, and the drug survival rates.Materials and Methods:A total of 78 RA patients who were prescribed tofacitinib between May 2016 and July 2019 were retrospectively evaluated and included in the study. The clinical, laboratory and demographic features of the patients were recorded. Drug survival rates were analyzed using Kaplan-Meier survival analysis. P

Background/aim High mobility group box- 1 (HMGB- 1) is a nuclear protein acting as a proinflammatory molecule. The serum HMGB- 1 levels were found elevated in chronic inflammatory diseases. In this cross-sectional study, serum HMGB- 1 levels in Behcet’s disease (BD) patients and healthy controls (HC) were studied. Also, its association with disease activity scores and clinical findings were evaluated. Materials and methods Ninety BD patients and 50 age-sex matched HC were included in the study. Disease activity scores were assessed by Behcet Disease Current Activity Form (BDCAF) and Behcet Syndrome Activity Score (BSAS). Serum HMGB- 1 levels were measured using a commercial ELISA kit. A p value of < 0.05 was considered to be statistically significant. Results Serum HMGB- 1 levels were significantly higher in BD than in HC (43.26 pg/mL and 16.73 pg/mL; p < 0.001, respectively). Serum HMGB- 1 levels were statistically significantly associated with presence of erythema nodosum (EN) and genital ulcers in the last one month prior to recruitment (p = 0.041 and p < 0.001, respectively). BDCAF and BSAS scores were positively correlated with serum HMGB- 1 level ( p = 0.03 and p = 0.02, respectively). Conclusion HMGB - 1 may play a role in the development of BD. Also, due to its positive correlation with disease activity indices, it can be used as a novel disease activity parameter in BD.

Primary Sjögren syndrome (pSS) is usually encountered between the fourth and sixth decades. It is known that the age of onset in autoimmune diseases may affect the clinical features. In this study, we aimed to investigate the clinical and laboratory characteristics of early onset pSS patients.The data of 352 pSS patients were analyzed retrospectively. The patients were divided into two groups as those with the onset age of 35 or younger (early-onset) and those with the onset age of older than 35. The clinical, laboratory, and serological characteristics of the two groups were compared. p 0.05 was considered statistically significant.Forty patients in the group with an onset age of 35 or younger (11.4%) and 312 patients with an onset age of older than 35 (88.6%) were analyzed. The frequency of skin (22.5% vs 1.9%, p 0.001) and renal involvement (10% vs 2.2%, p = 0.026) was significantly higher in the early-onset group than the late-onset group. There was no significant difference between the two groups in terms of xerostomia, eye dryness, arthritis, and other systemic involvement. Anti-Ro52 positivity (p = 0.04), elevated serum IgG levels (p = 0.004), and low C4 (p = 0.002) presence were more frequent in the early-onset group.Consequently, it is seen that the clinical phenotype of early-onset pSS patients may be different to those with later onset. Especially the more frequent observation of poor prognostic factors at early-onset ages shows the necessity to monitor these patients more regularly.• The clinical and laboratory features of patients with early-onset primary Sjogren syndrome may differ from late-onset patients.

Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with a wide spectrum of clinical manifestations such as organ damage, pain, fatigue, sleep disorders, depression and cognitive deficits. It is known that pain catastrophising may have serious impact in individuals with SLE. Furthermore, catastrophising and maladaptive coping strategies are linked to higher levels of functional impairment and depression in SLE. Objectives: The aim of this study was to identify factors associated with pain catastrophising to detect possible susceptible targets in individuals with systemic lupus erythematosus. Methods: A total of 104 individuals (mean age: 55.54±12.09 years; BMI: 27.17±4.01 kg/m2) with SLE participated to the study. The Pain Catastrophizing Scale (PCS) was used to measure the extent to which people catastrophize in response to pain. The Tampa Scale for Kinesiophobia (TSK) was used to assess pain-related fear of movement. The Beck’s Depression Inventory (BDI) was used to measure characteristic attitudes and symptoms of depression. The Body Awareness Rating Questionnaire (BARQ) was used to reflect on their self-reported body awareness. The multiple stepwise linear regression models with R-square (R2) were used to compare across the models and explain the total variance. Results: Mean PCS was 22.12±12.09; mean TSK was 42.94±7.76; mean BDI was 15.63±11.18 and mean BARS was 88.94±19.85. Linear regression analysis revealed that TSK, BDI, BARS and BMI were independently associated with PCS in predicting pain catastrophising in individuals with SLE (p≤0.001; R2=0.52). There were no correlations between PCS and disease activity (mean SLAM-R:5.39±3.68; r=0.105) and organ damage (mean SLICC-DI:0.58±0.87; r=0.153) (p>0.05). Conclusion: This study increases the understanding of the modifiable predictors to enhance pain coping behavior in accordance with the pharmacological treatment in SLE population. Results demonstrate major importance to explore the main stressors of pain catastrophising such as kinesiophobia, depression level, body awareness and BMI that affect coping behavior. Thus, pain catastrophising may limit the patients’ ability to perform from simple to complex activities. In addition, body image concerns SLE patients as they experience weight gain which negatively impact their self-esteem. The patient reported outcomes could guide health professionals to identify unmet needs of patients at risk to facilitate incorporation of the biopsychosocial model into SLE management. References: [1] Somers, T. J., Kurakula, P. C., Criscione‐Schreiber, L., Keefe, F. J., & Clowse, M. E. (2012). Self‐efficacy and pain catastrophizing in systemic lupus erythematosus: Relationship to pain, stiffness, fatigue, and psychological distress. Arthritis care & research, 64(9), 1334-1340. [2] Fischin, J., Chehab, G., Richter, J. G., Fischer-Betz, R., Winkler-Rohlfing, B., Willers, R., & Schneider, M. (2015). Factors associated with pain coping and catastrophising in patients with systemic lupus erythematosus: a cross-sectional study of the LuLa-cohort. Lupus science & medicine, 2(1), e000113. Disclosure of Interests: None declared

Neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), mean platelet volume (MPV), and red cell distribution width (RDW) may potentially reflect inflammatory status in systemic autoimmune diseases. The aim of this study is to investigate the association between these proposed markers and disease manifestations, activity, and severity in systemic sclerosis (SSc). We conducted a cross-sectional study of 69 systemic sclerosis (SSc) patients and 50 healthy volunteers in a single center. Adult patients with SSc and healthy controls were compared in terms of NLR, MLR, MPV, RDW, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). Venous blood samples were drawn after at least 8 h of fasting in the morning. Extension of skin fibrosis was evaluated by using modified Rodnan skin score (mRSS). Disease severity and activity were assessed by Medsger disease severity and European Scleroderma Trials and Research Group (EUSTAR) disease activity scores, respectively. Associations of disease manifestations, clinical, laboratory, and capillaroscopic findings, mRSS, and the disease activity and severity scores with the proposed hematological markers were evaluated. Multiple regression models were generated for significant associations. The neutrophil number was higher (p = 0.004) and lymphocyte number was lower (p

BACKGROUND/OBJECTIVE Interleukin (IL) 35 is a member of the IL-12 family. Studies show that IL-35 is an important anti-inflammatory cytokine and suppresses effector T-cell activity. In this study, we aimed to evaluate serum IL-35 levels in systemic sclerosis (SSc) patients and its potential relation with clinical findings. METHODS We conducted a cross-sectional analysis of 70 SSc patients and 29 healthy volunteers in a single center in 5 months' period. Extension of skin fibrosis was evaluated by using modified Rodnan skin score. Disease severity was assessed by Medsger disease severity scores. Serum IL-35 was measured using a commercial enzyme-linked immunosorbent assay (ELISA) kit (Cloud-Clone Corp, Wuhan, China). The relationship between IL-35 levels and clinical and laboratory parameters was investigated. Mann-Whitney U test was used to compare parameters among the groups. Correlation was tested by Spearsman correlation coefficient. RESULTS Serum IL-35 levels was significantly higher in SSc patients (8.69 [interquartile range, 29.33] pg/mL) than in healthy controls (7.11 [interquartile range 7.53] pg/mL; p < 0.001). There was no significant relationship between serum IL-35 levels and organ involvement. There was a negative correlation between serum IL-35 levels and Medsger disease severity score (Rho, -0.333; p = 0.006), modified Rodnan skin score (Rho, -0.307; p = 0.010), and C-reactive protein (Rho, -0.294; p = 0.015). There was no relationship between IL-35 and disease duration and erythrocyte sedimentation rate. CONCLUSIONS Our study revealed that IL-35 levels were higher in SSc patients, and in contrast to previous studies, it was the first study that showed that IL-35 levels did not increase in SSc patients with pulmonary fibrosis.