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Background: Rheumatoid arthritis (RA) patients experience reduced health-related quality of life (HRQOL). Previous studies suggest that yoga, a mind-body practice, can improve physical and mental health but it has not been extensively studied in RA. Objectives: To investigate the effect of yoga on HRQOL and secondary on fatigue, anxiety, depression and disease activity in RA patients Methods: 43 RA patients (mean (SD) age 55 (10) years, median (IQR) disease duration 5 (3, 8) years, 93% female), stable on standard pharmacological treatment and DAS28CRP < 5.1 were randomly assigned to 12 weeks yoga intervention (2x/week 90 min ; n=22) or arthritis-related educational lectures control (1x/week 60 min ; n=21). Yoga based on „Yoga in daily life system“ included asanas, relaxation, pranayama and meditation. Study evaluations at baseline, post- intervention and 3-month follow-up included The Short Form-36 (SF- 36) scores for Physical Component Summary (PCS) and Mental Component Summary (MCS), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), Hospital Anxiety and Depression scale (HADS) and Disease Activity Score-28CRP (DAS28CRP) questionnaires. Data were presented as change from baseline to each time point. Between group differences were analyzed using the t-test for normally and Mann- Whitney U test for non-normally distributed variables. P values 0.05). No serious adverse events were observed during trial period. Conclusion: Although no change in SF-36 scores and disease activity was observed, yoga practice produced significant and sustained improvement in fatigue and mood which strongly account for decreased life quality in RA. Despite limitations our findings suggest that yoga may be of benefit in management of RA patients.

Patients with rheumatoid arthritis have increased risk for the development of osteoporosis and osteoporotic bone fractures. There are several risk factors, including chronic ongoing infl ammation, glucocorticoid therapy, and immobility due to joint deformations. Here we present a patient with longstanding rheumatoid arthritis that developed spontaneous rib fractures. The patient was previously treated with methotrexate, sulfasalazine, glucocorticoids, and lastly with a biologic disease-modifying antirheumatic drug infl iximab. After the exclusion of malignant etiology of multiple fractures we concluded that the patient had osteoporotic fractured ribs and we continued treatment of osteoporosis and treatment of rheumatoid arthritis. This shows the importance of employing the treat-to-target strategy while treating patients with rheumatoid arthritis to prevent the infl uence of active disease on osteoporosis formation and prevent joint damage and immobility to overall prevent or postpone the development of osteoporosis.

Sažetak. Bolesnici s reumatoidnim artritisom imaju povišen rizik od razvoja osteoporoze i osteoporotskih prijeloma. Više čimbenika utječe na gubitak koštanog tkiva u bolesnika s reumatoidnim artritisom, primjerice, kronična upala, primjena glukokortikoida i tjelesna neaktivnost. U radu je prikazana bolesnica s višegodišnjim reumatoidnim artritisom u koje su se razvili prijelomi više rebara. Bolesnica je prethodno liječena metotreksatom, sulfasalazinom, glukokortikoidima i biološkim lijekom infliksimabom. Nakon isključenja malignoma kao uzroka višestrukih prijeloma zaključeno je da se radi o osteoporotskim prijelomima rebara pa je nastavljeno liječenje osteoporoze i osnovne bolesti. Prikaz bolesnice upozorava na važnost liječenja i kontrole reumatoidnog artritisa u skladu s principom liječenja prema zadanom cilju (engl. treat to target – T2T) da bi se smanjio utjecaj aktivne bolesti na nastanak / progresiju osteoporoze., Summary. Patients with rheumatoid arthritis have increased risk for the development of osteoporosis and osteoporotic bone fractures. There are several risk factors, including chronic ongoing inflammation, glucocorticoid therapy, and immobility due to joint deformations. Here we present a patient with longstanding rheumatoid arthritis that developed spontaneous rib fractures. The patient was previously treated with methotrexate, sulfasalazine, glucocorticoids, and lastly with a biologic disease-modifying antirheumatic drug infliximab. After the exclusion of malignant etiology of multiple fractures we concluded that the patient had osteoporotic fractured ribs and we continued treatment of osteoporosis and treatment of rheumatoid arthritis. This shows the importance of employing the treat-to-target strategy while treating patients with rheumatoid arthritis to prevent the influence of active disease on osteoporosis formation and prevent joint damage and immobility to overall prevent or postpone the development of osteoporosis.

Tranzitorna migrirajuća osteoporoza rijetka je, nedovoljno prepoznata bolest kostiju, nejasne etiologije. Češće obolijevaju žene u trećem trimestru trudnoće. Obično su zahvaćeni zglobovi koji podnose najveća opterećenja u tijelu. Tijek bolesti je samoograničavajući. Prikazujemo 38.-godišnju bolesnicu u 8. mjesecu trudnoće koja se javlja na prvi pregled u reumatološku ambulantu zbog bolova u gležnjevima koji su započeli 4 mjeseca ranije. Unatoč terapiji NSAR- om su u značajnoj progresiji i bolesnica je vrlo teško pokretna. Inicijalnom obradom utvr-den je blago povišen CRP (6, 1 g/L) dok su ostali rutinski nalazi uredni. Klinički su utvrđene blaže otekline oba TC zgloba, a ultrazvučno mala količina izljeva. Započeto je liječenje glukokortikoidima u niskoj dozi. Bolesnica ih samoinicijativno isključuje zbog neučinkovitosti. Daljnja obrada odgođena je do završetka trudnoće. Po porodu, koji je protekao uredno, bolovi u gležnjevima su i dalje prisutni, a javljaju se i bolovi u koljenima. Radiološki su utvrđene suspektne ostelitičke, mrljaste lezije distalnog femura i proksimalne tibije te stopala. MR-om prikazane su mrljaste, difuzne, konfluirajuće zone koštanog edema distalnog dijela tibije, talusa i tarzalnih kostiju, koje prvenstveno upućuju na regionalnu migrirajuću osteoporozu. Maligna bolest je isključena. Postupno u bolesnice dolazi do spontanog oporavka. Dijagnosticirana tranzitorna migrirajuća osteoporoza ubraja se u skupinu bolesti čija je karakteristika koštani edem. Diferencijalno dijagnostički potrebno je isključiti malignitet, osteomijelitis, stres frakture i avaskularnu nekrozu te ostalu rjeđu patologiju.

Granulomatosis with polyangiitis (Wegener's granulomatosis) is one of the anti-neutrophil cytoplasmic anti-body-associated small vessel vasculitides. Upper and lower respiratory system and kidneys are most commonly affected. The disease is characterized by granulomatous inflammation of the respiratory tract and necrotizing vasculitis of small to medium-sized blood vessels. Most patients show involvement of more than one organ systems at the time of diagnosis, and constitutional symptoms may be present. In around a quarter of patients the disease is initially localised, with involvement of upper respiratory tract or lungs. We report a 21-year-old female patient with chronic rhinitis, saddle nose deformity and subglottic stenosis who presented with inspiratory stridor and impending respiratory failure. Initially, urgent tracheotomy was performed. The patient was diagnosed with granulomatosis with polyangiitis limited to upper respiratory tract. Treatment with glucocorticoids and methotrexate was followed by clinical improvement.

Granulomatoza s poliangiitisom (Wegenerova granulomatoza) ubraja se u vaskulitise malih krvnih žila povezane s antineutrofilnim citoplazmatskim protutijelima. Najčešće su zahvaćeni gornji i donji dišni sustav te bubrezi. Obilježja bolesti uključuju granulomatoznu upalu dišnog sustava i nekrotizirajući vaskulitis malih do srednje velikih krvnih žila. U većine je bolesnika pri postavljanju dijagnoze zahvaćeno više organskih sustava te mogu biti prisutni i opći simptomi, dok je u oko četvrtine bolesnika inicijalno prisutan lokalizirani oblik bolesti sa zahvaćanjem najčešće gornjega dišnog sustava ili pluća. U radu smo prikazali dvadesetjednogodišnju bolesnicu s kroničnim rinitisom, razvojem sedlaste deformacije nosa i subglotičnom stenozom traheje koja je hospitalizirana zbog inspiratornog stridora. Zbog respiratorne insuficijencije učinjena je hitna traheotomija. U bolesnice je dijagnosticirana granulomatoza s poliangiitisom ograničena na gornji dišni sustav. Liječenje glukokortikoidima i metotreksatom dovelo je do kliničkog poboljšanja.

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides are rare diseases, with the average of 30 new cases per million inhabitants per year. Their main characteristic is systemic involvement with necrosis of the vessel walls (histological changes showing necrosis of the media and inflammation of adventitia and intima). In some forms granulomas may be found surrounding the vessels. ANCA-associated vasculitides include granulomatosis with polyangiitis (GPA, previously called Wegener's), microscopic polyangiitis (MPA) and eosinophilic granulomatosis with polyangiitis (EGPA, previously called Churg-Straus). Honorific eponyms are now changing to a disease-descriptive or etiology-based nomenclature. ANCA-associated vasculitides are a distinctive group of vasculitides because they dominantly involve small sized vessels, sometimes even medium sized vessels, are associated with antineutrophil cytoplasmic antibodies with high risk of developing glomerulonephritis and respond well to immunosuppresion with cyclophosphamide.

Kliničke manifestacije antineutrofilnih citoplasmatskih protutijela povezanih s vaskulitisom.

Osobe oboljele od sistemskog eritemskog lupusa imaju povećani rizik razvoja smanjene koštane mase zbogosnovne bolesti ili liječenja iste.

Od vrućice nejasne etiologije do visceralne lišmanijaze:prikaz bolesnika

Ponavljajući polihondritis rijetka je progresivna sustavna upalna bolest u kojoj recidivirajuće epizode upale hrskavičnih struktura prouzročuju razaranje hrskavice uha, nosa, dišnog i kardiovaskularnog sustava.

Uvod ASAS kriteriji za aksijalne i periferne spondiloartititise su prvi koji uključuju nalaze magnetske rezonancije (MR) sakroilijakalnih (SI) zglobova. Za dijagnozu sakroiliitisa potrebna je prisutnost subhondralnog koštanog edema. Sinovitis, kapsulitis ili entezitis bez koštanog edema nije dovoljan za dijagnozu. Cilj rada Usporediti short tau inversion recovery (STIR) sekvenciju s T1 fat sat (T1 FS) sekvencijom nakon primjene kontrastnog sredstva. Metode i materijali U istraživanje je uključeno 45 pacijenata koji su prezentirani na reumatološko*-radiološkim sastancima te potom upućeni na MR SI zglobova u KB "Dubrava".Snimanje je obavljeno na aparatu od 1, 5 Tesla (Magnetom Avanto, Siemens, Erlangen , Njemačka). Retrospektivno su uspoređene dvije gore navedene sekvencije te su analizirane akutne upalne promjene prema ASAS kriterijima. Rezultati Osam od 45 pacijenata je ispunilo kriterije za dijagnozu sakroiliitisa prema ASAS kriterijima. Od 8 pozivitivnih pacijenata kod 7 nije se dobilo dodatne informacije s upotrebom kontrastnog sredstva. Kod jednog se vidi sinovitis koji se nije prikazao na STIR-u, no osteitis se vidi na obje sekvencije. Zaključak U 44 od 45 pacijenata T1 FS s kontrastim sredstvom nije dao dodatne informacije, a kod jednog pacijenta vidljiv je sinovitis no uz obostani osteitis vidljiv na obje sekvencije. Zaključujemo stoga da je sama STIR sekvencija dovoljna za postavljanje vjerodostojne dijagnoze i kvantifikaciju akutnih upalnih promjena kod sakroileitisa. Stoga bi primjena samo STIR sekvencije pojednostavila pretragu, a ujedno i smanjila (nepotreban) rizik od posljedica primjenjenog kontrastnog sredstva.

Prikazana je 54.godišnja bolesnica sa SLE u koje je utvrđen sekundarni vaskuzlitis velikih krvnih žila kako bismo naglasili važnost preporznavanja i adekvatnog liječenja.

Ultrazvuk u dijagnostici i praćenju dermatomiozitisa -prikaz bolesnice

Raynaudov fenomen kao prvi znak maligne bolesti.

Seronegativni spondiloartritisi (SpA) skupina su upalnih reumatskih bolesti koje označava upala aksijalnog skeleta, asimetrični oligoartritis i entezitis s ili bez promjena na koži, sluznicama, aorti, srcu, očima i bubrezima. U SpA ubrajamo ankilozantni spondilitis, reaktivni artritis, psorijatični artritis, enteropatski artritis tj. artritis udružen s upalnom bolesti crijeva (Crohnovom bolesti i ulceroznim kolitisom) i nediferencirani spondiloartritis. Prevalencija SpA kao skupine iznosi 0, 5-2%.

Sistemska skleroza (SSc) sustavna je bolest nepoznatog uzroka čija su glavna obilježja krvožilne i fibrozne promjene kože i unutarnjih organa. Skerodermijska bubrežna kriza (SBK) javlja se u oko 5% bolesnika s najčešće difuznim oblikom SSc, a očituje se malignom hipertenzijom i oligo/anuričnim akutnim bubrežnim zatajenjem. Prognoza SBK je znatno bolja nakon otkrića i primjene inhibitora enzima konvertaze angiotenzina I (ACE-inhibitora). Liječenje sklerodermijske bubrežne krize zasniva se na redovitim kontrolama krvnog tlaka i agresivnom liječenju

Thrombotic microangiopathy (TMA) is a rare but life-threating disorder. Coexistence of thrombotic microangiopathy and adult onset Still's disease (AOSD) is extremely rare. A 34-year-old man was admitted to the hospital for a 4-week history of fever, arthralgias, diffuse muscle pain and skin rash. Physical examination revealed a temperature of 39º C, bilateral inflammation of the metacarpophalangeal joints, peripheral lymphadenopathy and a nonpruritic, macular rash. Initial laboratory findings revealed elevated erythrocyte sedimentation rate (ESR) 89mm/h (normal values [n.v.] 3-23 mm/h), C-reactive protein (CRP) 148 mg/l (n.v.

Antiishemijska terapija bolesnika sa STEMI ili NSTEMI u županijskoj i kliničkoj bolnici

Prostaglandins synthesis (PGE2 and PGI2) was determined in the liquors and serum of 19 hypoxic neonates by using ELISA method. Control group consisted of 8 children of the same age whose samples were taken because initial suspicion of neonatal meningitis. The prostaglandin concentrations in liquor were correlated with initial hypoxic-ischemic encephalopathy (HIE) stage and neurological findings of patients at age of 12 months. The values of PGE2 and PGI2 in the liquor of children with PNH were significantly higher than in the children from the control group. The values of PGI2 in serum were significantly higher than in liquor of patients with PNH. Although average values of PGE2 and PGI2 in the liquor were higher in children with advanced stage of HIE, the differences between different stages were not statistically significant. We did not find any significant correlation between average concentrations of prostaglandins and neurological findings of the 12-month-old children.

It is known that inflammatory cytokines influence the effect of hepatotoxic chemicals on liver. Previously we have shown that IL-1alpha and IL-6 have hepatoprotective effect if given to mice before administration of acetaminophen (APAP) and that this effect is partially mediated by PGE2. In these experiments we investigated the influence of IL-1beta in the same model, since we have been able to modulate its effect with specific antagonists (IL-1Ra and polyclonal anti- IL-1beta antibodies). APAP (300 mg/kg for survival and 200 mg/kg for determination of aminotransferases) or saline in controls were administered intragastrically to mice which were given phenobarbitone in drinking water for 7 days and fasted overnight IL-1beta 500 IU /mouse) or IL-1beta antibody (0.5 ml of rabbit to mouse IL-1, obtained by three consecutive injection of IL-1beta , first in complete FCA) were given i.p. 3 hours before APAP and IL-Ra (2.5 mg/mouse) half hour before APAP. The survival of mice was followed for 72 hours and concentration aminotransferases (AST and ALT) serum were determined 18-24 hours after administration of APAP. IL-1beta significantly increased the survival mice and decreased serum level of AST and ALT (p < 0.05). Just opposite effect had IL-1beta antibodies, but the effects were not significant. Similarly IL-1Ra, significantly increased serum concentration of AST and ALT (p < 0.05 or better) (the survival was not tested in this model). The finding that that IL-1Ra alone raised serum level of aminotranferases as well that potency IL-1beta antibodies alone showed the tendency to worse the manifestations of intoxication, promoted us to analyze the synthesis if IL-1 cytokines in non-treated animals intoxicated with AAP. RT-PCR analysis of the IL-1beta and IL-1alpha expression level in liver samples from APAP intoxicated mice has revealed that acetaminophen induces the expression of both cytokines already 1 hour after its intragastric administration. This expression was even higher at 6 hours following APAP administration and could be blocked by intravenous administration of aspirin at the dose which inhibits the activity of NF-kappa B transcription factor. Based on these results we hypothesized that organism intoxicated with APAP synthesizes its own IL-1 early on following APAP administration, which would represent a host defense reaction that could be helped by applying appropriate dose of exogenous cytokines.

Prikaz slučaja bolesnice koja dugi niz godina boluje od reumatoidnog artritisa koja je razvila vaskulitis odnosno gangrenu prstiju gornjih i donjih ekstremiteta.

We have previoulsy shown that both IL-1 alpha and IL-6 exhibit heaptopreotective effect if given before administration of acetaminophen (APAP) that is partially mediated by PGE2. When the effect of IL-1 beta was investigated using the same model, IL (1500IU/mouse)or anti-IL-1beta antibody (0.5ml of rabbit to mouse IL-1, obtained by three constitutive injection of Il-1 beta, first incomplete FCA) were given i.p. 3 hours before APAP. The survival of mice has been followed for 72 hours and the serum concetration of aminotransfereses (AST and ALT) were determined 18-24 hours after APAP administration. IL-1beta significantl< increased the survival of mice and decreased serum level of AST and ALT (p

Interleukin 18 (IL-18), originally described as IFN gamma inducing factor, is a member of IL-1 superfamily and it has previously been shown to be present in the synovium of rheumatoid arthritis (RA) patients. Its role in RA is due to its abilities to increase gene expression for IL-6, iNOS, COX-2 and the matrix metalloproteases in chondrocytes. In these study we investigated if there were any correlations between the concentrations of IL-18 in synovial fluid of 17 patients with RA and present disease activity assessed by Disease Activity Score (DAS28). The parameters of disease activity were as fallows: the number of tender and swollen joints assessed by physician (total of 28 joints), concentration of C reactive protein in mg/L and patient's global assessment of disease activity on Visual analogue Scale on 100 mm. The DAS28 score for each patient was then calculated by formula given by ESCIT. The concentrations of IL-18 were determined by specific ELISA kit in synovial fluid of RA patients. The average concentration of IL-18 in synovial fluid was 2642.1 ± ; 1248.2 pg/ml. The DAS28 ranged from 5.46 to 7.11. We found that there was positive correlation between levels of IL-18 and DAS28 score (R = 0.36) showing IL-18 relationship with disease activity. There was also positive correlation between IL-18 and erythrocyte sedimentation rate (ESR) (R = 0.23) and rheumatoid factor (RF) (R = 0.4). Also it is well known that TNF-alpha has a pathogenic role in RA, and that cyclic adenosinemonophosphate (cAMP) inhibits its production. We measured the concentration of cAMP in synovial fluid of 17 RA patients and the average concentration of cAMP was 0.53 ± ; 0.41 pmol/mL. We found that concentrations of IL-18 and DAS28 were significantly inversely correlated with concentrations of cAMP (R = -0.57 ; R = -0.56). These data show that IL-18 plays important role in pathogenesis of RA (but it is not the only factor). The data on role of IL-18 in RA appears important because IL-18 binding protein maybe soon used for therapy of RA.

U bolesnica s SLE ekspresija Tollu-sličnih receptora (TLR2 i TLR9) bila je podjednaka onim u zdravih kontrola. Po uvođenju teraqpije došlo je do smanjenja ekspresije TLR2 na monocitima u bolesnica u odnosu na zdravu kontrolu. Suprotno tome opažen je porast ekspresije TLE) u B limfocitima u boolesnica nakon trepije u usporedbi sa zdravim kontrolama.

Prikazana je povezanost izmedju rkoncentracije IL-18 u sinovijskoj tekućini i aktivnosti bolesti (DAS28) u bolesnika od reumatoidnog artritisa.

Background: It is well known that tumor necrosis factor-a (TNF-α ) has a pathogenic role in rhemathoid artthritis (RA) as well as that cyclic adenosine-monophosphate (cAMP) inhibits its production. Therefore, it appeared interesting to investigate posible correlation in concentration of these factors in synovial fluid of patients with RA and in control patients with osteoarthritis (OA). Moreover, there is now a quite lot of drugs, which can influence the synthesis, or degradation of cAMP. Materials and methods: Synovial fluid was aseptically taken from joint 9 patients with seropositive RA and 9 patients with OA. The fluid was stored at – 20o C until determination of TNF-α and cAMP concentration. Since most samples were viscous they all were incubated at 37o C for 30 minutes in the presence of hyaluronidase (Sigma) and centrifuged at 12 000 g for 5 minutes before these factors were determined in the supernatants. The concentration TNF-α and cAMP was determined by ELISA assay using Roche and Assay Designs kits, repectively. Results: Generally, the concentration of TNF-α . and cAMP were inversely correlated, both in patients with RA or OA ; r = -0.35, -0.36 and -038, in patients with RA, patients with OA and in all patients combined, respectively. Surprisingly, the concentration of TNF-α somewhat higher in patients with OA than in patients with RA (44, 34 pg/ml ± 16.3 SD and 23.31 pg/ml ± 31.0, respectively). However, the concentration of cAMP was somewhat higher in synovial fluid of patients with RA than in patients with OA (1, 23 pmol/ml ± 0.59 vs 0, 95 pmol/ml ± 0.28). Presently, we are determinig the same parameters in higher number of patients, and try to correlate their concentation with concentation PGE2 in synioval fluid as well as with the type of synovial cell effusion. Conclusion: It appears that the concentartion of TNF-α in synovial fluid in patients with RA or OA is inversely correlated with the concentration of cAMP. This may be due to the negative feedback control of TNF-α synthesis by cAMP. However, the presented investigations should be repated in much higher number patients/samples.

It is well known that tumor necrosis factor-a (TNF-α ) has a pathogenic role in rhemathoid artthritis (RA) as well as that cyclic adenosine-monophosphate (cAMP) inhibits its production. Therefore, it appeared interesting to investigate posible correlation in concentration of these factors in synovial fluid of patients with RA and in control patients with osteoarthritis (OA). Moreover, there is now a quite lot of drugs, which can influence the synthesis, or degradation of cAMP. Synovial fluid was aseptically taken from joint 9 patients with seropositive RA and 9 patients with OA. The fluid was stored at – 20o C until determination of TNF-α and cAMP concentration. Since most samples were viscous they all were incubated at 37o C for 30 minutes in the presence of hyaluronidase (Sigma) and centrifuged at 12 000 g for 5 minutes before these factors were determined in the supernatants. The concentration TNF-α and cAMP was determined by ELISA assay using Roche and Assay Designs kits, repectively. Generally, the concentration of TNF-α . and cAMP were inversely correlated, both in patients with RA or OA ; r = -0.35, -0.36 and -038, in patients with RA, patients with OA and in all patients combined, respectively. Surprisingly, the concentration of TNF-α somewhat higher in patients with OA than in patients with RA (44, 34 pg/ml ± ; 16.3 SD and 23.31 pg/ml ± ; 31.0, respectively). However, the concentration of cAMP was somewhat higher in synovial fluid of patients with RA than in patients with OA (1, 23 pmol/ml ± ; 0.59 vs 0, 95 pmol/ml ± ; 0.28). Presently, we are determinig the same parameters in higher number of patients, and try to correlate their concentation with concentation PGE2 in synioval fluid as well as with the type of synovial cell effusion. It appears that the concentartion of TNF-α in synovial fluid in patients with RA or OA is inversely correlated with the concentration of cAMP. This may be due to the negative feedback control of TNF-α synthesis by cAMP. However, the presented investigations should be repated in much higher number patients/samples.

Background: Interleukin-18 (IL-18) was first described in 1989 as IFN-gama inducing factor and the molecule was subsequently cloned. Many of biological properties of IL-18 are similar to those of IL-1. IL-18 is clearly a proinflammatory cytokine. Its role in rheumatoid arthritis (RA) is due to its abilities to increase gene expresion for IL-6, iNOS, COX-2 and the matrix metalloprotease stromelysin in chondrocytes. The aim of these study was to determine IL-18 in synovial fluid from patients with seropositive RA and osteoarthritis (OA). Also, we had analysed the morphologic composition of the cell population in joint fluid of RA and OA patients.Materials and methods: Synovial fluid was aseptically taken from joint 17 patients with seropositive RA and 15 patients with OA. The fluid was stored at – 20 0 C until determination of IL-18 concentration. Since most samples were viscous all samples were incubated at 37 0 C for 30 minutes in the presence of hyaluronidase (Sigma) and centrifuged at 12 000 g for 5 minutes and the cytokine was than determined in the supernatants. The concentration IL-18 was determined by ELISA assay using R&D kits and prescribed procedure of manufacture was followed.Results: Generally, the concentration of IL-18 was significantly higher in patients with RA than in patients with OA (2631.9 &plusmn ; 1199.0 pg/ml vs 620.9 &plusmn ; 276.9 pg/ml, respectively ; p< 0, 01). It appears that concentration of IL-18 is dependent on the type of synovial effusion i.e. on the type of cells present in the joint effusion with the tendency to be the highest in the synovial effusion type II i.e. with preponderance of lymphocites. However, more samples should be analysed to support this conclusion. We also plan to determine in the same samples (patients) the concentration of NO and PGE 2, in correlation with type of cells present in the joint effusions.Conclusion: The level of IL-18 is significantly higher in synovial fluid of patients with RA than in patients with OA, most probably because of higher absolut and relative number of lymphocites in effusions of former patients.

The concentration of interleukin-6 was determined in urine and plasma of patients with glomerular disease.