A study of serum levels of B cell-attracting chemokine-13 (CXCL 13) and rheumatologic manifestations of chronic hepatitis C virus infection in a cohort of Egyptian patients

Available online 17 April 2013

Peer review under responsibility of Alexandria University Faculty of Medicine.

Figures & data

Table 1 Comparison between patients and controls as regards laboratory data.

Variables	Patient group n = 40 Mean ± SD	Control group n = 20 Mean ± SD	P	Sig.
Total bilirubin (mg/dl)	2.3 ± 2.5	0.60 ± 0.3	P < 0.001	H.S
Alkaline phosphatise (IU/L)	140.30 ± 89.1	48 ± 12.9	P < 0.001	H.S
Aspartate aminotransferase (AST) (IU/L)	70.1 ± 50.1	29.1 ± 7.8	P < 0.001	H.S
Alanine aminotransferase (ALT) (IU/L)	65.1 ± 49.9	28.1 ± 9.1	P < 0.001	H.S
Albumine (gm/dl)	2.8 ± 0.6	4.2 ± 0.4	P < 0.001	H.S
Total protein (gm/dl)	8.1 ± 1.1	6.8 ± 0.28	P > 0.05	N.S
Serum Creatinine (mg/dl)	1.1 ± 0.4	0.8 ± 0.2	P > 0.05	N.S
Platelet count × 10^3/L	201 ± 20.1	209 ± 28.3	P > 0.05	N.S
White blood cells × 10^3/L	7.8 ± 3.1	7.9 ± 2.1	P > 0.05	N.S

Table 2 Comparison between patients and controls as regards immunological data.

Variables	Patient group n = 40		Control group n = 20		P	Sig.
Cryoglobulins	10	25%	0	0%	P < 0.05	S
Rheumatoid factor	18	45%	1	5%	P < 0.001	H.S
Anti-nuclear antibodies (ANA)	0	0%	0	0%
	Range		Range
	Mean ± SD		Mean ± SD
Complement 3 mg/dl	(40–147)		(90–150)		P < 0.001	H.S
	100.2 ± 25.7		123.1 ± 18.9
Complement 4 mg/dl	(8–45)		(24–45)		P < 0.05	S
	25.45 ± 8.3		36.3 ± 4.1
Serum CXCL 13 Pg/L	(72–371)		(37–59)		P < 0.001	H.S
	208.78 ± 60.84		48.11 ± 11.15

Figure 1 Distribution of different joint affection among HCV patients.

Table 3 Comparison between cryoglobulin positive and negative patients as regards prevalence of rheumatic manifestations.

Variables	Group A (n = 10)		Group B (n = 30)		P	Sig
Rheumatic manifestations	8	80%	26	86%	P > 0.05	N.S
Chronic fatigue	2	20%	6	20%	P > 0.05	N.S
Arthralgia	6	60%	20	66%	P > 0.05	N.S
Arthritis	1	0%	0	0%	P > 0.05	N.S
Myalgia	5	50%	10	33%	P > 0.05	N.S
Fibromyalgia	3	30%	6	20%	P > 0.05	N.S
Tendenitis	0	0%	4	13.3%	P > 0.05	N.S
Sicca syndrome	4	40%	0	0%	P > 0.05	N.S
Raynaud’s phenomenon	0	0%	4	13.3%	P > 0.05	N.S
Peripheral neuropathy	1	10%	0	0%	P > 0.05	N.S

Table 4 Comparison between US findings of cryoglobulin positive and negative patients.

Variables	Total patients n = 40		Group A 10 patients		Group B 30 patients		Chi-square
	No.	%	No.	%	No.	%	X^2	P
Hepatomegaly	14	35	2	20	12	40	0.58	0.44
Ascitis	8	20	8	80	0	0	25.2	<0.001^a
Liver cirrhosis	13	32	7	70	6	20	6.4	0.01^b

a Highly significant; P < 0.001.

b Significant; P < 0.05.

Figure 2 Longitudinal ultrasound at the level of the second metacarpophalangeal joint shows synovitis seen as low reflective intra-articular tissue(A), (B) following compression with the probe, fluid is squeezed into parts of the joint so the effusion is compressible, distinguishes it from synovitis (non-compressible).

Figure 3 (A) longitudinal ultrasound of the knee shows joint effusion, (B) following compression with the probe, fluid is squeezed into parts of the joint so the effusion is compressible, distinguishes it from synovitis.

Table 5 Comparison of the levels of CXCl3 between patients with and without synovial hypertrophy.

Level of CXCL13	Patients with synovial hypertrophy	Patients without synovial hypertrophy	T	P	Sig
Mean ± SD	250.45 ± 60.82	200.41 ± 70.15	2.25	0.03	S