Role of Plasma Lipocalin-2 Levels as a Diagnostic and Prognostic Marker in Patients with Non-Alcoholic Fatty Liver Disease

Abstract Background Rheumatoid arthritis, the most common connective tissue disease associated with Sjogren syndrome, may result in some extra-articular manifestations called sicca symptoms that are including keratoconjunctivitis sicca or dry eyes and xerostomia or dry mouth. RA usually has high morbidity and mortality and in patients with RA occurrence of SS makes its course worse. Aim of the Work to evaluate diagnostic accuracy of salivary gland US in differentiating RA patients with or without SS by use of probability method and evaluate the relation of SS with RA disease characteristics. Patients and Methods This cross-sectional study (Diagnostic test accuracy study) included (100) RA adult patients for 5 years or more who were recruited randomly from Rheumatology outpatient clinic and inpatient internal medicine department, Ain Shams University Hospitals. Results In our study, there was a statistically highly significant increase in number and percent of RA patients in area of certainty (≤20%&≥80% probability) after salivary glands US. Also, there was a statistically highly significant decrease in number and percent of RA patients in vague or borderline area (40-60%) after salivary glands US, making SGUS a good tool for diagnosing SS that may replace the need for invasive biopsy. In the current study, there was a statistically significant longer RA disease duration and higher Anti CCP antibody titer in RA patients with secondary SS compared to those without secondary SS. There was statistically highly significant higher percentage of RA patients with secondary SS who had CTS compared to RA patients without secondary SS. Conclusion SS is a frequent complication in RA patients especially in association with longer disease duration, higher Anti CCP antibody titer and CTS. US of SG is a useful tool that help diagnosis and grading of severity of SS in RA