الفهرس 
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Abstract
Scleroma is a progressive, granulomatous infectious disease, usually limited to the respiratory tract and caused by klebsiella rhinoscleromatis. It is transmitted by close long contact with the patient. The term scleroma is preferred over the term rhinoscleroma because this disease affects not only the nose but it begins at the nose and may progress to involve the larynx, pharynx. The characteristic features of scleroma include slow development, long duration and its resistance to treatment may suggest the presence of certain immunological disturbances. Cell-mediated immunity in this disease has been scantily studied and was found deficient. The stress of recurrent infections is known to affect nutritional well-being, and compromised nutrition contributes to alterations in immunological functions.
There is currently a widely expanding area of research concerning the role of trace elements in immune function. Among the essential trace elements in human, Zinc and Iron are essential for integrity and optimum function of the immune system. Such role for trace elements in the integrity of immune system and the close association between cell mediated immune response and the pathogenesis of rhinoscleroma reveals the need for further studies assessing the association between trace elements, especially, Iron and Zinc and the development of rhinoscelroma.
The aim of this study is to demonstrate the possible variations of serum levels of Iron and Zinc trace elements in the course of rhinoscleroma and its relation to the stage of disease. 78 participants were enrolled for this study at the department of otorhinolaryngology
Menoufia University Hospital which divided in to 39 cases (diagnosed as Rhinoscleroma ) And 39 controls. Among the cases there were 25 female, 14 male, 29 rural, 10 urban, 25<40 years old and 14 ≥40 years old. Among the control group there were 18 female, 21 male, 27 rural, 12 urban , 30<40 years old and 9≥40 years old .
In the case group there was 19 cases in the atrophic stage, 11 cases in the fibrotic stage and 9 in the granulomatous stage.
In our study there was a significant decrease in serum Zinc in scleroma patients compared to control group, and there was a significant progressive decrease of serum Zinc level with progression of the disease stage. Also there was a significant decrease in serum Iron in scleroma patients, and there was a significant progressive decrease of serum Iron level with progression of the disease stage. There were anon significant difference between males and females regarding serum levels of Iron and Zinc which decreased in both , anon significant difference between rural and urban regarding serum levels of Iron and Zinc which decreased in both ,and anon significant difference between two age subgroup (< 40 years and ≥40 years) regarding serum levels of Iron and Zinc.