Background: Earlier studies have shown that active systemic lupus erythematosus (SLE), though an inflammation, is not associated with high C-reactive protein (CRP) levels. But a few recent studies have shown that high sensitivity CRP (hsCRP) may be elevated in SLE and is associated with organ damage. Objective: To evaluate the association between hsCRP levels and SLE disease activity index (SLEDAI). Methods: This cross-sectional study was conducted in 40 SLE patients. The SLEDAI was calculated and the hsCRP level was measured in the serum. Correlation between hsCRP levels and SLEDAI was assessed. Relationship of hsCRP levels with individual components of SLEDAI was also analyzed. Results: Out of 40 patients, 38 (95%) were female. The mean age was 28.15 years. The mean SLEDAI was 27.4 ± 17.8, indicating that most of the patients had high disease activity. The mean hsCRP levels were 6.64 ± 5.09 mg/L. hsCRP levels and SLEDAI showed strong positive correlation (Pearson's correlation coefficient r ¼ 0.91; p < 0.0001). hsCRP levels were higher in patients with serositis, nephritis, nervous system manifestations and immunological abnormalities. Conclusion: hsCRP levels reflect SLE disease activity and are higher in patients with major organ involvement.

Background: High-sensitivity C-reactive protein (hsCRP) is a marker of systemic inflam- mation. hsCRP have been related to disease presence and clinical activity in systemic lupus erythematosus (SLE). Aim: To understand the association between hsCRP and SLE disease manifestations and other associated immune parameters. Material & methods: One hundred and ten SLE patients were studied and SLE disease activity was evaluated by SLE Disease Activity Index (SLEDAI). Among these 42.7% patients had lupus nephritis (LN). hsCRP and complement levels were detected by nephelometer. Results: A total of 40/110 (36.4%) had elevated hsCRP levels. High CRP was associated with presence of infection (p < 0.001) Patients having bacterial, parasitic and viral infections had elevated levels of hsCRP. LN patients showed slightly higher hsCRP levels (29.3 ± 29.9 mg/L than non-LN group (27.3 ± 21.3 mg/L) but this difference was not significant. Patients with raised hsCRP levels showed a higher prevalence of low complement levels as compared to patients with normal CRP levels (p ¼ 0.03). Conclusion: Elevated hsCRP levels were found to be associated with infections in SLE pa- tients and low complement levels. Elevated hsCRP levels can be used as a marker of active infection in SLE patients.

Objective: To determine the quality of life and parental stress in children with juvenile idiopathic arthritis (JIA). Methods: Patients with juvenile idiopathic arthritis (JIA) and their parents were interviewed by a trained nurse in the clinic. Demographic data of parent's education, income, children disease subtype, medications and disease severity were collected. Quality of life was assessed by the Juvenile Arthritis Quality of Life Questionnaire (JAQQ) and parental stress was assessed by Pediatric Inventory for Parents (PIP). Results: 69 Consecutive children with JIA were recruited. Those children with Polyarticular JIA subtype and with deformity as JIA disease severity grade had poor QOL and those parents of children with Polyarticular subtype and with deformity had high parental stress. The was negative correlation between the QOL and parental stress (r ¼ -0.55; p ¼ 0.003). Conclusion: Quality of life in children with JIA depends on disease subtype and outcome. As the child's QOL decreases parental stress increases. Clinicians should adopt effective techniques to help parents understand their children's medical condition and support them.

Kidney is involved in upto 75-80% of various ANCA associated vasculitis (AAV) and re- mains the major cause of mortality and morbidity. The classic clinical presentation is that of rapidly progressive renal failure with cresenteric glomerulonephritis being its pathologic correlate. ANCA positivity has been implicated in the pathogenesis and is useful for diagnosis. The treatment of renal AAV involves the use of steroids in combination with other immunosuppressive agents like cyclophosphamide to induce remission followed by maintenance therapy with a less potent agent like azathioprine. Plasmapharesis has a definite role especially in presence of renal failure while Rituximab is emerging as a promising alternative for remission induction.

A 22-year-male presented with painless swelling with deformities of the proximal inter- phalangeal joints of 10 years duration. Inflammatory markers were negative. Hand radio- graph showed typical changes of Thiemann disease with epiphyseal irregularities. Thiemann disease is a rare genetic disorder that is considered to be a form of avascular necrosis of the proximal interphalangeal joints of the fingers and toes. The clinical symptoms usually appear in adolescence or puberty and may be confused with juvenile idiopathic arthritis. Treatment of this condition is usually symptomatic.