History

Proton pump inhibitors (PPIs) are drugs used o reduce the stomach acidity caused by the treatment with anti-inflammatory drugs in some rheumatoid arthritis (RA) patients. The effect of these drugs on the parathyroid hormones (PTH) and related electrolytes (calcium, magnesium, and phosphate is not studied yet. The present study aims to accomplish this goal by measurements of the mentioned serum parameters in 70 RA patients treated with PPIs (PPI group) and comparing their results with 70 not treated with PPIs (No PPI group). The results showed a significant increase in serum calcium and magnesium levels in the PPI group compared with the No-PPI group. While no significant difference in the PTH level between groups.  The severe RA group showed a significant increase in WBCs counts compared with the mild-moderate RA group indicating the role of inflammation as an indicator of severity. Serum calcium showed a significant correlation with the duration of the disease and a negative correlation with the disease activity. Serum intact-PTH has a significant correlation with serum inorganic phosphate, and inversely with serum calcium. Serum calcium has an inverse correlation with the ESR value. The results showed a significant correlation between calcium and hemoglobin. Receiver operating characteristic (ROC) for differentiation between severe and mild RF indicates that the increase in serum PTH level to a value higher than the cut-off value (55.50 pg/ml), indicates significantly that the patients may have a severe RA form in a sensitivity of 60.9% and specificity of 61.7%.