الفهرس 
Distribution of the studied patients according to their H.pylori FAT at baseline and after 2 months of treatmentOnly 14 pages are availabe for public view
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Abstract
Helicobacter pylori is a widely prevalent microbe, with between 50 and 80% of the population infected worldwide. Clinically, infection with H. pylori is commonly associated with peptic ulcer disease, but many of those infected remain asymptomatic. H. pylori has evolved a number of means to affect the host immune response and has been implicated in many diseases mi-tigated by immune dysregulation such as immune thrombocytopenic purpura , atrophic gastritis, and MALT lymphoma. Rheumatoid arthritis is an autoimmune inflammatory disorder primarily characterized by a symmetric destructive polyarthritis affecting small, medium, and large joints. A number of genetic and environmental factors, including smoking, contribute to disease onset and severity . In addition, a number of viral and bacterial pathogens may have arole in disease pathogenesis as well. Because of its ability to elicit a chronic immune response in the host, studies have suggested a possible role for H. pylori in the development of autoimmune diseases. The association of H. Pylori infection in the pathogenesis of RA is controversial. The present study was conducted on 40 patients with rheumatoid arthritis suffering from dyspeptic symptoms. They were devided into two groups, H.pylori positive and H.pylori negative according to H.pylori fecal antigen titre measurement. Rheumatoid arthritis was diagnosed according to ACR revised criteria for classification of RA in 1988. All patients were subjected to the following: 1) Full medical history taking 2) Clinical examination a. General examination b. Locomotor examination 3) Laboratory investigation A- Investigations for RA: 1-Routine investigations:- *Complete blood count (CBC). *Liver function tests (SGOT &SGPT). *Kidney function tests (Serum creatinine &blood Urea). 2-Investigations for disease activity evaluation:- *Erythrocyte sedimentation rate (ESR). *C-reactive protein (CRP). *Rheumatoid factor (RF) titre (by Rose Waaler method). B-Investigations for Helicobacter Pylori infection: *Fecal Antigen Test (FAT):Which identifies H.pylori antigen titre in stool by ELISA. 4) Disease activity evaluation using modified DAS 28. 5) Functional performance evaluation:- According to Stanford Health Assessment Questionnaire (HAQ). 6)Statistical analysis of the data. The results showed the following: The studied group of patient’s age ranged from 20 to 50 years with RA disease duration of 6 to8 years. There were 17 patients with positive H. pylori FAT titre at the start of study (42.5%) who respond to the triple therapy for H.pylori for 14 days and became with negative FATafter 2 months duration. There was no statistically significant difference between FAT positive and negative groups according to age , sex or rheumatoid arthritis disease duration (p value > 0.05). The FAT positive group had significantly prolonged period of morning stiffness , higher numbers of tender and swollen joints and elevated disease activity scores than the negative group at the start of study (p value < 0.05). Regarding the laboratory measures, the positive group had significantly higher CRP levels but insignificantly higher serum RF titres than the negative one (p value < 0.05). After treatment of H. pylori, the positive group experienced significant improvement in the number of tender and swollen joints and disease activity scores (p value < 0.05). Regarding the laboratory investigations , there were significant reduction in CRP and serum RF(p value <0.05). ESR value decreased also but was non significant (p value > 0.05).