Objectives: To study the role of vascular endothelial growth factor (VEGF) and monocyte chemoattractant protein-1 (MCP-1) in Behηet's disease and their relation to clinical manifestations particularly vascular manifestations and disease activity. Methods: Forty Behηet's disease patients (32 males, 8 females), diagnosed according to the criteria proposed by the International Study Group for Behηet's disease were assessed clinically and serum VEGF and MCP-1 were measured by enzyme-linked immunosorbent assay. Results: Serum VEGF and MCP-1 levels were detected in patients and control groups with highly significant increase in Behηet's group. A highly significant increase in the level of serum VEGF and MCP-1 was found in patients with vascular manifestations compared to those without vascular complications. A significant increase in the level of VEGF and MCP-1 was found in patients with active disease compared to inactive. Conclusion: Our findings suggest that serum VEGF and MCP-1 levels are elevated in active Behηet's patients and in patients with vascular complications. So, we conclude that VEGF and MCP-1 play a crucial role in the pathogen- esis of vascular complications of Behηet's disease. Therefore, the serum levels of these cytokines serve to predict a possible acute thrombosis in Behηet's disease.

Background: Classic serum sickness was initially reported after antitoxin therapy for diseases such as diphtheria and tetanus. The illness was shown to be due to an adverse reaction to the antigenic substance of the serum pro- teins of the animal in which the antitoxin was prepared. Today, it is usually encountered as an adverse effect to certain medications, especially penicillin group of antibiotics. In these cases it is called a serum sickness-like reaction. The aim of this study was to determine the aetiological fac- tors of serum sickness-like reaction, influence of age and sex and clinical manifestations of this disease in Iranian children. Materials and Methods: The study included all children under 16-year-old who were diagnosed as serum sickness- like reaction and were admitted in the department of Paediatric Rheumatology in Mofid Children's Hospital between April 2009 and September 2010. Diagnosis was based on history of recent exposure to the antigenic substance that triggered the reaction and the development of signs and symptoms of typical serum sickness. Children with infections that result in a similar clinical picture of fever and rash were excluded from the study. Results: Twenty-eight patients were included in this study. The most common medication causing serum sickness- like reaction in our study was furazolidone (5 cases, 18%). Cefixime (4 cases, 14%), amoxicillin, co-trimoxazole, cephalexin and co-amoxiclav, (with 2 cases each, 7%) were the other causes of serum sickness-like reaction in this study. The time interval between consumption of antigenic substance in 25 cases (89%) and the appearance of clin- ical manifestations was 1-3 weeks. Skin rash and angio-oedema was observed in all our patients. Arthralgia was observed in 85%, fever in 75% and arthritis in 36% of patients. Conclusion: As any medication, especially antibiotics may cause serum sickness-like reaction; it is advisable to avoid prescribing unnecessary drugs in children.

Background: Endothelial dysfunction is an important cause of cardiovascular morbidity and mortality in patients of systemic lupus erythematosus (SLE), causing atherosclerosis and its related complications, even in the absence of conventional cardiovascular risk factors. Objective: The present study was aimed at finding the prevalence of endothelial dysfunction in SLE and its relation with disease activity. Methods: Fifty SLE patients without traditional cardiovascular risk factors, and equal number of age and sex matched controls were chosen. Endothelial function was assessed by flow mediated vasodilatation (FMV) on brachial artery, using B-mode ultrasonography. Results: Mean age of SLE patients was 26.06 ± 6.231 years. Thirty-seven (74%) of the patients were having severe disease activity, defined as systemic lupus erythematosus disease activity index (SLEDAI) > 8. We found signifi- cantly lower levels of basal brachial artery diameter in SLE patients (0.3499 ± 0.075 cm) compared to controls (0.3826 ± 0.0002 cm), as also impaired FMV (2.57 ± 2.32% and 8.7082 ± 1.5776%, respectively). Flow mediated vasodilatation significantly correlated with SLEDAI (r = −0.52) and complement (C3) levels (r = 0.33). Conclusion: Endothelial dysfunction in SLE correlates with disease activity.

Nailfold capillaroscopy (NFC) is a simple and non-invasive technique for the analysis of microvascular abnormalities seen in various systemic connective tissue diseases (SCTD), especially in systemic sclerosis (SSc) group of disorders. The techniques for NFC have evolved over several decades and nailfold video capillaroscope (NVC) is considered the gold standard tool for NFC. Nailfold video capillaroscope is an expensive equipment and usually not available in most developing countries. Other instruments that have been utilised for NFC are a magnifying lens, an ophthalmo- scope, a dermatoscope, a stereomicroscope and a wide field microscope. Faced by shortcomings of multiple instru- ments, we have innovated a cost effective and simple technique for NFC using a handheld and universal serial bus (USB) digital microscope. This article elaborates on the advantages and disadvantages of various instruments and tech- niques for NFC, with emphasis on our innovative techniques. We recommend USB digital microscope for NFC in clin- ical practice especially for evaluation of scleroderma-related disorders.