Egyptian Rheumatologist最新文献

{"title":"Comorbid fibromyalgia is independently associated with multidimensional PROMIS outcomes in rheumatoid arthritis and systemic lupus erythematosus: a cross-sectional comparative study","authors":"Nermeen Mohammed Elmenayar,&nbsp;Wedad Mahmoud Ghazy,&nbsp;Rasha Ali Abdelmagied,&nbsp;Omima Ahmed El-Farra","doi":"10.1016/j.ejr.2026.10.004","DOIUrl":"10.1016/j.ejr.2026.10.004","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the association between fibromyalgia and multidimensional patient-reported symptom burden measured by PROMIS in patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), and to compare these associations with those observed for disease activity.</div></div><div><h3>Methods</h3><div>In this cross-sectional study, 201 patients (RA <em>n</em> = 100; SLE <em>n</em> = 101) completed PROMIS short-form instruments assessing physical function, pain intensity, pain interference, fatigue, sleep disturbance, anxiety, and depression. Fibromyalgia was ascertained using the 2016 ACR Fibromyalgia Diagnostic Criteria. Disease activity was evaluated using the 28-joint Disease Activity Score (DAS28-ESR) in RA and the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2 K) in SLE. Multivariable linear regression models were used to assess independent associations.</div></div><div><h3>Results</h3><div>PROMIS profiles were largely comparable between RA and SLE, with SLE demonstrating better physical function (35.8 ± 7.9 vs 32.1 ± 6.7, <em>p</em> &lt; 0.001). In both diseases, the presence of fibromyalgia was associated with significantly worse PROMIS scores across most domains. In adjusted models, fibromyalgia remained independently associated with higher pain intensity (RA β = 5.19, <em>p</em> &lt; 0.001; SLE β = 6.31, <em>p</em> &lt; 0.001), greater fatigue (RA β = 6.94, <em>p</em> &lt; 0.001; SLE β = 7.50, <em>p</em> &lt; 0.001), higher anxiety (RA β = 5.25, <em>p</em> = 0.007; SLE β = 6.24, <em>p</em> = 0.01), and higher depression scores (RA β = 6.79, <em>p</em> &lt; 0.001; SLE β = 6.61, <em>p</em> = 0.009). Fibromyalgia was also independently associated with poorer physical function in both diseases (RA β = −3.06, <em>p</em> = 0.012; SLE β = −5.99, <em>p</em> &lt; 0.001). Associations were consistent across domains and of greater magnitude than those observed for disease activity.</div></div><div><h3>Conclusion</h3><div>Fibromyalgia was independently associated with substantially worse multidimensional PROMIS outcomes in both RA and SLE, stronger associations than disease activity across several PROMIS domains.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"48 4","pages":"Pages 255-262"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149153729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Anifrolumab in the treatment of mucocutaneous manifestations of lupus erythematosus: a scoping review","authors":"Filipa Maio Teixeira,&nbsp;Bernardo Sousa-Pinto,&nbsp;Iva Brito,&nbsp;Alberto Mota,&nbsp;Gilberto Pires da Rosa","doi":"10.1016/j.ejr.2026.09.002","DOIUrl":"10.1016/j.ejr.2026.09.002","url":null,"abstract":"<div><h3>Aim of the work</h3><div>Cutaneous lupus erythematosus (CLE) is a heterogeneous, often treatment-refractory entity. Anifrolumab has shown efficacy in systemic lupus erythematosus (SLE), but efficacy in CLE is less clearly defined. We aim to map evidence on its efficacy and safety across CLE subtypes and lupus-related mucocutaneous manifestations.</div></div><div><h3>Patients and Methods</h3><div>Systematic search of PubMed, Scopus, Web of Science, and Cochrane Library (inception to October 10, 2025). We included anifrolumab studies on CLE, along with SLE studies that reported extractable mucocutaneous outcomes. Adverse events and treatment discontinuations were extracted where available.</div></div><div><h3>Results</h3><div>Fifty studies (29 case series, 21 case reports) included 205 patients (88% female; 12–78 years). Discoid LE (DLE) was most frequently reported (32 studies), with complete and partial responses in a significant proportion of patients (47/84 and 36/84, respectively). Lupus panniculitis showed favorable responses among evaluated patients (5/7 complete; 2/7 partial). Tumid lupus achieved complete response in all cases (<em>n</em> = 6), and chilblain lupus improved in most (8/11 complete; 3/11 partial). In subacute CLE (SCLE) and acute CLE (ACLE), complete responses (SCLE 33/52; ACLE 16/31) outnumbered partial ones (SCLE 17/52; ACLE 12/31), with relapses mainly linked to treatment interruption or systemic flares. Alopecia and mucosal lesions also improved (complete response in 16/34 and 18/26 of cases, respectively). Adverse events were mostly mild; serious events were uncommon.</div></div><div><h3>Conclusions</h3><div>Available evidence, largely from small observational studies, suggests potential efficacy of anifrolumab across CLE subtypes and lupus-related mucocutaneous manifestations, with a safety profile consistent with that reported in major SLE trials.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"48 4","pages":"Pages 237-245"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149153780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of methotrexate treatment for joint manifestations of PAPA syndrome","authors":"Nacif Eddine Ghodbane,&nbsp;Assia Haddouche,&nbsp;Samy Slimani","doi":"10.1016/j.ejr.2026.10.002","DOIUrl":"10.1016/j.ejr.2026.10.002","url":null,"abstract":"<div><div>Pyogenic arthritis, pyoderma gangrenosum, and acne (PAPA) syndrome is a rare disease (OMIM #<span><span>604416</span><svg><path></path></svg></span>) that mainly affects the joints and skin and is caused by an autosomal dominant mutation of the Proline-Serine-Threonine Phosphatase-interacting Protein 1 (PSTPIP1). Studies have shown that the response to anti-IL-1 agents, such as anakinra, is variable, with anakinra exhibiting better effectiveness for joint manifestations than for cutaneous involvement. Instead, anti- tumor necrosis factor alpha (TNF) treatment is more effective in the treatment and prevention of pyoderma gangrenosum lesions. Here, we describe four cases of clinically suspected PAPA syndrome in patients from the same family, who were treated empirically with initial corticosteroid therapy combined with methotrexate to improve joint symptoms. The results were promising in terms of both efficacy and tolerance. We concluded that while biologics remain the ideal therapeutic option, methotrexate is an accessible and well-tolerated alternative that can offer significant clinical improvement in joint involvement, especially in early or mild cases. Further studies are needed to better define its place in the therapeutic arsenal for PAPA syndrome.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"48 4","pages":"Pages 263-266"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149199641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psoriatic arthritis, fibromyalgia and osteoporosis: A tricky therapeutic approach in familial hypercholesterolemia","authors":"Francesco Sbrana,&nbsp;Beatrice Dal Pino","doi":"10.1016/j.ejr.2026.10.005","DOIUrl":"10.1016/j.ejr.2026.10.005","url":null,"abstract":"","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"48 4","pages":"Pages 267-269"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149199642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of the HALP score with disease activity in ankylosing spondylitis: a comparative analysis with inflammatory markers","authors":"Çiğdem Güner,&nbsp;Gülşah Çelik,&nbsp;Sevcan Uğur,&nbsp;Evin Aslan","doi":"10.1016/j.ejr.2026.10.001","DOIUrl":"10.1016/j.ejr.2026.10.001","url":null,"abstract":"<div><h3>Background</h3><div>The hemoglobin, albumin, lymphocyte, and platelet (HALP) score is a biomarker reflecting systemic inflammation and immunonutritional status. This study aimed to investigate the relationship between HALP score and disease activity in patients with ankylosing spondylitis (AS) and compare its performance with inflammatory markers.</div></div><div><h3>Methods</h3><div>This retrospective cross-sectional study included 105 patients with AS and 93 age- and sex-matched healthy controls. Disease activity was assessed using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Ankylosing Spondylitis Disease Activity Score based on C-reactive protein (ASDAS-CRP). HALP score was calculated from hemoglobin, albumin, lymphocyte, and platelet values. Correlation, logistic regression, and receiver operating characteristic (ROC) analyses evaluated the association between HALP and disease activity.</div></div><div><h3>Results</h3><div>The HALP score was significantly lower in patients with AS than in healthy controls (p=0.002) and decreased across increasing ASDAS-CRP activity groups (p&lt;0.001). HALP demonstrated an AUC of 0.768 (95% CI: 0.667–0.869) for ASDAS-CRP-defined activity and 0.723 (95% CI: 0.623–0.823) for BASDAI-defined activity. In multivariable analyses, HALP remained significantly associated with active disease using both ASDAS-CRP (OR=0.958, 95% CI: 0.932–0.983, p=0.001) and BASDAI (OR=0.962, 95% CI: 0.941–0.984, p=0.001).</div></div><div><h3>Conclusion</h3><div>HALP may serve as an objective and inexpensive biomarker associated with disease activity in AS. The consistent associations observed using both ASDAS-CRP and BASDAI support its potential clinical utility, although further studies are needed to validate these findings.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"48 4","pages":"Pages 246-254"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149153781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relation between chemerin and visfatin serum levels and the bone mineral density in patients with inflammatory bowel diseases","authors":"Mohammed A. Nouh,&nbsp;Naglaa S. Elabd,&nbsp;Noran T. Aboelkhair,&nbsp;Amera M. Maher,&nbsp;Zeinab M. Metwalli,&nbsp;Mohamed E. Eltantawy,&nbsp;Ahmed A. Teima","doi":"10.1016/j.ejr.2026.09.001","DOIUrl":"10.1016/j.ejr.2026.09.001","url":null,"abstract":"<div><h3>Background</h3><div>Inflammatory bowel disease (IBD) is associated with a high prevalence of abnormal bone mineral density (BMD), via pro-inflammatory pathways, adipokines like visfatin and chemerin may be involved in bone loss. This study aimed to evaluate relationship between chemerin and visfatin levels and BMD in IBD patients and to determine their diagnostic value as non-invasive predictors of abnormal BMD.</div></div><div><h3>Methods</h3><div>A total 90 IBD patients (70 with ulcerative colitis and 20 with Crohn's disease) and ninety healthy controls matched for age and gender participated in this cross-sectional study. BMD was measured by dual-energy X-ray absorptiometry (DXA). ELISA was used to quantify chemerin and visfatin serum levels. To check diagnostic accuracy, ROC curve analysis was used.</div></div><div><h3>Results</h3><div>IBD patients had significantly higher levels of chemerin and visfatin than in controls (<em>p</em> &lt; 0.001 for both) with higher levels in active disease. In IBD patients, 66.66% had abnormal BMD (42.22% had osteopenia and 24.44% had osteoporosis). IBD patients with abnormal BMD had significantly higher chemerin and visfatin levels (<em>p</em> &lt; 0.001 for both) compared to normal. The sensitivity, specificity, and AUC of chemerin (cut-off 962.14 ng/ml) were 96.67%, 73.33%, and 0.884 (<em>p</em> &lt; 0.001) and of visfatin (cut-off 6.6177 ng/ml) were 93.33%, 78.33%, and 0.871 (<em>p</em> &lt; 0.001). Combination of both markers improved performance (AUC 0.944). Univariate analysis showed that older age, active disease, chemerin. and visfatin levels (<em>p</em> = 0.002, 0.013, 0.006 and 0.003, respectively) were significantly associated with abnormal BMD. In multivariate analysis, none of these variables remained statistically significant after controlling for confounders.</div></div><div><h3>Conclusion</h3><div>A high chemerin and visfatin level was closely linked to decreased BMD in IBD patients. Their combination suggests potential as non-invasive biomarkers for early detection of bone disease risk in IBD. To validate their prognostic value and therapeutic implications, longitudinal studies are required.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"48 4","pages":"Pages 230-236"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149153731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Altered gut microbiota in patients with early rheumatoid arthritis","authors":"Amany A. Sholkamy ,&nbsp;Mariana V. Gerges ,&nbsp;Ahmed Z. Darwish ,&nbsp;Shawky A. Fouad ,&nbsp;Reham A. Dwedar ,&nbsp;Mohamed T. Hegazy","doi":"10.1016/j.ejr.2026.05.004","DOIUrl":"10.1016/j.ejr.2026.05.004","url":null,"abstract":"<div><h3>Background</h3><div>The pathophysiology of rheumatoid arthritis (RA) is complex and not fully elucidated, involving interactions among genetic, environmental, and immunological factors. Emerging evidence suggests a potential role of gut microbiota in RA pathogenesis.</div></div><div><h3>Aim of the work</h3><div>To assess alterations in the fecal abundance of selected gut microbiota: <em>Collinsella, Eggerthella, Faecalibacterium, Lactobacillus, Bifidobacterium, Bacteroides, Prevotella,</em> and <em>Atopobium</em> in patients with RA, and to evaluate their association with RA-related autoantibodies and disease activity.</div></div><div><h3>Patients and methods</h3><div>The study included 30 patients with early RA and 20 healthy first-degree relatives as controls. Stool samples were collected for quantitative analysis of gut microbiota using real-time polymerase chain reaction (PCR). Laboratory assessments in RA patients included erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), and anti-cyclic citrullinated peptide (anti-CCP) antibodies. Disease activity was evaluated using the disease activity score (DAS28).</div></div><div><h3>Results</h3><div>The mean age of RA patients was 49.27 ± 13.48 years. The female-to-male ratio was 4:1. RA patients showed a significant increase in the fecal abundance of Collinsella and Lactobacillus (<em>p</em> &lt; 0.001) and Atopobium (<em>p</em> = 0.031) compared to controls. No significant associations were found between alterations in the gut microbiota and RA autoantibody levels (RF, anti-CCP) or disease activity (DAS28).</div></div><div><h3>Conclusion</h3><div>Alterations in gut microbiota composition may contribute to the pathogenesis of RA; however, their relationship with disease activity and serological markers appears limited.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"48 3","pages":"Pages 174-177"},"PeriodicalIF":1.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148185690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential vagal nerve ultrasound signatures in patients with autoimmune and demyelinating neuropathies","authors":"Amira Elsonbaty,&nbsp;Mohamed A. Abdalraziq,&nbsp;Doaa M. Mahmoud","doi":"10.1016/j.ejr.2026.06.004","DOIUrl":"10.1016/j.ejr.2026.06.004","url":null,"abstract":"<div><h3>Background</h3><div>Ultrasound has emerged as a valuable tool for assessment of peripheral nerves affection in several immune mediated diseases. Vagus nerve involvement has been described in <strong>chronic inflammatory demyelinating polyneuropathy</strong> (CIDP) and Guillain–Barré syndrome (GBS) but has not been carefully investigated in systemic lupus erythematosus (SLE). <strong>Aim of the work:</strong> To evaluate vagus nerve ultrasonographic difference among adult patients with SLE, CIDP and GBS, focusing on size variability, fascicular distribution, and echogenicity compared to healthy controls. <strong>Patients and methods:</strong> This study was conducted on 59 SLE, 51 GBS and 13 CIDP patients as well as 119 controls. Mid cervical level of vagus nerve was assessed bilaterally by neuromuscular ultra sound for all participants.</div></div><div><h3>Results</h3><div>The mean vagal nerve cross-sectional area (CSA) was 2.6 ± 0.7 mm² in SLE, 3.5 ± 1 mm² in GBS, CIDP 4.5 ± 1.5 mm² and 2.6 ± 0.6 mm² in control. The CSA was similar between SLE and controls (p 0.223) with a significant vagus nerve enlargement in CIDP and GBS patients (<em>p</em> &lt; 0.0001). Vagus nerve possessed a heterogeneous echotexture and irregularly distributed fascicles mainly in CIDP patients followed by GBS, but not in SLE, when compared to the uniform fascicular pattern in controls. <em>The right vagus nerve was minimally enlarged; however, side-to-side difference evaluation revealed no significant asymmetry among the four groups (p &gt; 0.05).</em></div></div><div><h3>Conclusion</h3><div>This study highlights the importance of neuromuscular ultrasound evaluation of vagus nerve among other usually studied nerves in assessing different autoimmune and demyelinating neuropathies and possibly including it in future validated diagnostic and follow up protocols.</div></div><div><h3>Key Summary Points</h3><div><ul><li><span>•</span><span><div>Vagus nerve morphology is significantly altered in CIDP and GBS compared with healthy controls.</div></span></li><li><span>•</span><span><div>In lupus patients, vagus nerve size and structure appear preserved, suggesting a more benign course.</div></span></li><li><span>•</span><span><div>Neuromuscular ultrasound provides a rapid, non-invasive tool for detecting autoimmune neuropathic involvement.</div></span></li><li><span>•</span><span><div>Findings highlight the potential of ultrasound as an adjunct in early diagnosis and treatment monitoring.</div></span></li></ul></div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"48 3","pages":"Pages 201-205"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148452645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anxiety and depression in rheumatoid arthritis: Associations with disease activity and treatment status","authors":"Merve Sungur Özgünen,&nbsp;Esra Kayacan Erdoğan,&nbsp;Süleyman Özbek","doi":"10.1016/j.ejr.2026.06.002","DOIUrl":"10.1016/j.ejr.2026.06.002","url":null,"abstract":"<div><div><strong>Background:</strong> Rheumatoid arthritis (RA) is associated with significant psychological comorbidities; however, the impact of treatment remains unclear. <strong>Aim of the work:</strong> To evaluate anxiety and depression in patients with RA and to examine their relationship with disease activity and disease-modifying antirheumatic drugs (DMARDs); conventional synthetic (csDMARDs) versus biological/targeted synthetic (b/tsDMARDs),over time. <strong>Patients and methods:</strong> This prospective study included 112 patients with RA and 30 control. Patients were categorized into those newly initiating csDMARD (<em>n</em> = 35) or b/tsDMARD (<em>n</em> = 41) with a low-to-moderate disease activity (LMDA) as a stable reference group (<em>n</em> = 36). Assessments were performed at baseline, month 3, and month 6 using the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Hospital Anxiety and Depression Scale (HADS), and the Disease Activity Score (DAS28) were assessed. <strong>Results:</strong> Patients with RA had higher anxiety and depression scores than controls (HADS-A: 8 (6–11) and HADS-D: 7 (3–9) vs 5 (2–9) and 3(2–6.3), respectively;<em>p</em> = 0.033 and <em>p</em> = 0.007). Baseline DAS28-ESR correlated significantly with HADS-D (<em>r</em> = 0.42,<em>p</em> &lt; 0.001) and HADS-A (<em>r</em> = 0.35,<em>p</em> &lt; 0.001). b/tsDMARD group had higher baseline disease activity than csDMARD (p &lt; 0.001). Both treatment groups showed significant clinical improvement over 6 months, with greater reductions in depressive symptoms in the b/tsDMARD group. By month 6, disease activity and psychological scores were comparable to LMDA group. Lower educational level was associated with higher psychological distress (HADS-D: <em>r</em> = −0.31,<em>p</em> &lt; 0.001; BDI: <em>r</em> = −0.33,p &lt; 0.001; BAI: <em>r</em> = −0.34,p &lt; 0.001). <strong>Conclusion:</strong> Anxiety and depression are common in RA and closely linked to disease activity. Improvements in disease activity parallel psychological recovery, supporting routine psychological assessment within treat-to-target strategies.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"48 3","pages":"Pages 191-195"},"PeriodicalIF":0.8,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148452659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Musculoskeletal ultrasound and Mac-2 binding protein level as indicators of psoriatic arthritis risk in psoriasis patients","authors":"Nada M. Gamal ,&nbsp;Tayseer M. Khedr ,&nbsp;Safaa Mahran ,&nbsp;Eman R. Badawy ,&nbsp;Marwa M. Mekkawy ,&nbsp;Sylvia V. Ross","doi":"10.1016/j.ejr.2026.05.005","DOIUrl":"10.1016/j.ejr.2026.05.005","url":null,"abstract":"<div><h3>Background</h3><div>Identifying psoriasis patients at risk of developing psoriatic arthritis (PsA) is challenging but crucial as it enables early diagnosis and reduces disability.</div></div><div><h3>Aim of the work</h3><div>To evaluate the value of musculoskeletal ultrasound (MSUS) and Mac-2 binding protein (Mac-2BP) in early detection psoriasis patients who are likely to develop PsA.</div></div><div><h3>Patients and methods</h3><div>The study included 137 psoriasis patients, 44 patients diagnosed clinically as PsA, in addition to 45 healthy controls. All patients underwent MSUS assessment. Serum Mac-2BP level was measured by Enzyme linked immunosorbent assay (ELISA).</div></div><div><h3>Results</h3><div>The patients were 74 males and 63 females (M:F 1.2:1) and mean age of 38.8 ± 12.4 years. Family history of psoriasis was represented in 15.3%. Subclinical PsA with minimal or no musculoskeletal symptoms was successfully detected in 46 patients showing ultrasound abnormalities, clearly distinguishing them from 47 patients with only skin psoriasis (PsO). Serum Mac-2BP level was significantly elevated in subclinical PsA patients 165.9 ± 14.8 ng/ml compared to PsO 102.4 ± 34.4 ng/ml and controls 82.8 ± 39.5 ng/ml (<em>p</em> &lt; 0.001) while non-significant difference was found between PsO and controls (<em>p</em>=0.19). The optimum cut-off for Mac-2BP was &gt;143 ng/ml to discriminate PsA and subclinical PsA from PsO with sensitivity 100%, specificity 100%, <em>p</em> &lt; 0.001. MSUS dactylitis (β=603.2, <em>p</em>=0.001) and MSUS arthritis (β=163.4, <em>p</em>=0.043) were found as predictors of increase serum Mac-2BP level.</div></div><div><h3>Conclusion</h3><div>Early and silent musculoskeletal changes in psoriasis patients are detected by MSUS, while serum Mac-2BP helps identify subclinical PsA; together, they enable earlier diagnosis and better patient outcomes.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"48 3","pages":"Pages 178-185"},"PeriodicalIF":1.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148185691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}