Anti-Ribosomal-P Antibody Association with Neuropsychiatric Lupus in Sudanese Patients Attending Rheumatology Clinic in Omdurman Military Hospital.

Purpose: To assess and establish the relationship between neuropsychiatric systemic lupus erythematosus (NPSLE) involvement and serological biomarkers like antiribosomal-P antibodies. Patients and Methods: This is an analytical cross-sectional hospital-based study conducted on patients attending Omdurman Military Hospital from July 2019 to December 2019. A total of 90 patients were enrolled, 30 of whom had NPSLE compared with 60 SLE patients without NPSLE. SLE diagnosis was established based on the revised SLICC criteria (presence of at least 4 criteria) for SLE classification, with neuropsychiatric manifestations defined based on the ACR nomenclature. The immunological examination results have been performed by (ELISA immune-enzymatic method, immunofluorescence, and Western immunoblotting test). SPSS v 21.0 software was utilised for data analysis. Results: NPSLE patients exhibited +ve ANA in 96.7% vs 75% in non-NPSLE (P-value = 0.008), antiribosomal-P antibodies (46.7% vs 20%; P-value = 0.0001), anti-nucleosome antibodies (26.7% vs 5%; P-value = 0.005), and anti-histones antibodies (40% vs 20%; P-value = 0.04). ANA antibodies were significantly associated with neurological manifestations as ANA antibodies were common in epilepsy (n = 9; 91%) and stroke (n = 8; 27.6%) (P-value < 0.001). Conclusion: Neuropsychiatric manifestation of systemic lupus erythematosus exhibits variable clinical manifestations. Neuropsychiatric manifestations of SLE are strongly associated with the anti-ribosomal P antibody presence and can be employed as a powerful diagnostic tool.

A rare cause of acute compartment syndrome after gluteal cyst rupture.

Acute Compartment Syndrome (ACS) is a serious medical condition that often results in high morbidity. ACS more commonly presents after substantial trauma in the extremities where compartment pressures can be measured. Here, we present an unusual case of a healthy man who presented with ACS of the thigh secondary to rupture of the gluteal cyst which was formed after multiple unsupervised testosterone injections. Our goal is to encourage a broad differential diagnosis while keeping limb threatening conditions and emergencies on top in patients complaining of leg pain and also to educate the patient population on safety concerns of unsupervised intramuscular injections.

CD10 and CA19.9 immunohistochemical expression in transitional cell carcinoma of the urinary bladder.

BACKGROUND: Transitional cell carcinoma of the bladder is the most common malignancy affecting the urinary tract ranking the 5(th) among males and the 9(th) among females' cancers in Iraq. The prognosis depends largely on the histological grade and stage of the tumor at diagnosis; however, there is no reliable parameter predicting the risk of recurrence or progression; molecular and immunological markers may be required to estimate the individual prognosis of patients as well as for effective diagnosis and treatment. OBJECTIVES: To evaluate CD10 and CA19.9 immunohistochemical expression in transitional cell carcinoma of the urinary bladder and to correlate this expression with the grade and stage of the tumor. MATERIALS AND METHODS: This study was retrospectively designed. Forty-nine cystoscopy specimens of urothelial carcinoma of the bladder were retrieved from the archival materials of the Specialized Surgical Hospital and Al-Khadhmiya Teaching Hospital in Baghdad for the period from January 2010 to June 2011. Three sections of 5-µm thickness were taken from each case. One section was stained with Hematoxylin and Eosin; the other two were stained immunohistochemically with CA19.9 and CD10. RESULTS: Immunohistochemical expression of CA19.9 and CD10 had a significant correlation with WHO 2004 grade of urothelial carcinoma. There was no significant correlation between CA19.9 and CD10 immunohistochemical expression with stage. CONCLUSIONS: CA19.9 and CD10 immunohistochemical expression could be of value in assisting the differentiation between high and low-grade urothelial carcinoma cases and consequently in determining the prognosis in such cases.

NMDA receptor encephalitis--expanding the clinical spectrum.

A young woman presented with memory problems of subacute onset. Imaging was normal. She was admitted with severe complex partial status epilepticus requiring intensive care support and ventilation. Fits proved difficult to control requiring high dose anticonvulsants. She developed a profound amnesic syndrome. A clinical diagnosis of autoimmune encephalitis was considered and she was treated with intravenous steroids with an excellent cognitive outcome. She continues to have occasional seizures.