Egyptian Rheumatologist最新文献

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Idiopathic granulomatous mastitis in seventy seven-female patients: Management, follow up of an overlooked immune-mediated disease, and review of literature 77例女性患者的特发性肉芽肿性乳腺炎:一种被忽视的免疫介导疾病的治疗、随访和文献综述
IF 0.9
Egyptian Rheumatologist Pub Date : 2023-06-01 DOI: 10.1016/j.ejr.2023.03.003
Amira A. Shahin , Emad Khallaf , Lamiaa A. Salaheldin , Somia A.M. Soliman , Yosra S. Rezk , Marwa H. Niazy
{"title":"Idiopathic granulomatous mastitis in seventy seven-female patients: Management, follow up of an overlooked immune-mediated disease, and review of literature","authors":"Amira A. Shahin ,&nbsp;Emad Khallaf ,&nbsp;Lamiaa A. Salaheldin ,&nbsp;Somia A.M. Soliman ,&nbsp;Yosra S. Rezk ,&nbsp;Marwa H. Niazy","doi":"10.1016/j.ejr.2023.03.003","DOIUrl":"https://doi.org/10.1016/j.ejr.2023.03.003","url":null,"abstract":"<div><h3>Background</h3><p>Idiopathic granulomatous mastitis (IGM) cases have been increasingly recognized in the context of autoimmune diseases. Hence rheumatologists need to be acquainted with IGM detection and management. Although studies evaluating the response to the emerging immunosuppressive drugs were promising, prospective studies still remain scarce.</p></div><div><h3>Aim of the work</h3><p>This prospective study aimed to evaluate previous immunosuppressive regimens in the management of IGM cases.</p></div><div><h3>Patients and methods</h3><p>Seventy seven female IGM patients were followed up, and stratified into 2 groups based on the treatment modalities received: double therapy (Group D, n = 17) who received steroids and methotrexate (MTX), and triple therapy (Group T, n = 60) who received steroids, MTX and mycophenolate mofetil (MMF). Each group was followed up monthly till the end of treatment then every 3 months after stopping treatment for at least 2 years, and the patients' data were recorded on 3 visits (V1, V2, and V3).</p></div><div><h3>Results</h3><p>Female patients mean age was 33.9±6.2 years. IGM lesions improved in the form of pain relief, resolution of lumps; replacement of inflammatory lesions by granulation tissue, with superiority of triple therapy group T over double therapy in group D regarding significantly shorter duration of treatment (26.5±3.1 vs 18.1±4.4 months)(p &lt; 0.001), and decreased time needed to steroid tapering (14.1±3.6 vs 5.5±5.2 months)(p &lt; 0.001). No recurrence was noticed.</p></div><div><h3>Conclusions</h3><p>Treatment of IGM has been successful using MTX, or MTX and MMF besides to steroid therapy. Triple therapy was significantly superior with shorter duration of treatment and faster feasibility of steroid tapering.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"45 3","pages":"Pages 183-189"},"PeriodicalIF":0.9,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49792928","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}
引用次数: 0
Serum interleukin-26 is a promising biomarker in systemic lupus erythematosus patients: Particular relation to disease activity and nephritis 血清白细胞介素26是系统性红斑狼疮患者的一种有前景的生物标志物:与疾病活动性和肾炎的特殊关系
IF 0.9
Egyptian Rheumatologist Pub Date : 2023-06-01 DOI: 10.1016/j.ejr.2023.04.002
Noha M. Khalil , Esraa M. Abdelbaset , Aya Erfan , Sarah A. Hassan
{"title":"Serum interleukin-26 is a promising biomarker in systemic lupus erythematosus patients: Particular relation to disease activity and nephritis","authors":"Noha M. Khalil ,&nbsp;Esraa M. Abdelbaset ,&nbsp;Aya Erfan ,&nbsp;Sarah A. Hassan","doi":"10.1016/j.ejr.2023.04.002","DOIUrl":"https://doi.org/10.1016/j.ejr.2023.04.002","url":null,"abstract":"<div><h3>Aim of the work</h3><p>To investigate the clinical utility of serum interleukin-26 (IL-26) in patients with systemic lupus erythematosus (SLE).</p></div><div><h3>Patients and methods</h3><p>The study was carried out on 42 SLE patients and 42 matched controls. SLE disease activity index 2000 (SLEDAI-2K) and Systemic Lupus International Collaborating Clinics Damage Index (SLICC-DI) were assessed. Serum IL-26 was measured.</p></div><div><h3>Results</h3><p>The mean age of patients was 28.8±11.4 years with 78.6% females. 76.2% of patients were active; 7.1% very-high grade, 45.2% high, 16.7% moderate and 31% mild. 42.9% of patients had nephritis. The mean SLEDAI-2K was 10.4±6.4 and SLICC-DI 1.19±1.15. IL26 level was significantly higher in patients (64±76.4 pg/ml) compared to control (8.7±2.6 pg/ml), in active cases (79.2±81.9 pg/ml) compared to those inactive (15.3±4.8 pg/ml) and in those with nephritis (n = 18) (113.4±92.2 pg/ml) compared to those without (n = 24) (23.1±7.6 pg/ml).IL-26 level was significantly higher among cases receiving both steroids and mycophenolate mofetil than those receiving steroids with azathioprine (p = 0.005). There was a significant negative correlation between IL26 and serum albumin, hemoglobin and complement 3 (C3) levels (p &lt; 0.001, p &lt; 0.001 and p = 0.006 respectively). There was also a significant correlation between IL26 and both SLEDAI-2K (r = 0.95, p &lt; 0.001) and SLICC-DI (r = 0.68, p &lt; 0.001). At cut off value 16.3 pg/ml, IL26 differentiated patients and control; sensitivity 90.5%, specificity 100% (F. 2) and at 20 pg/ml detects active from non-active; sensitivity and specificity 100%.</p></div><div><h3>Conclusion</h3><p>IL-26 is a promising biomarker of SLE with high sensitivity and specificity. There is a relation of IL-26 with disease activity, damage and nephritis.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"45 3","pages":"Pages 219-224"},"PeriodicalIF":0.9,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49819190","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}
引用次数: 1
Disease damage in systemic lupus erythematosus patients: Disease activity, male gender and hypertension as potential predictors 系统性红斑狼疮患者的疾病损害:疾病活动、男性和高血压是潜在的预测因素
IF 0.9
Egyptian Rheumatologist Pub Date : 2023-04-01 DOI: 10.1016/j.ejr.2022.12.001
Lobna A. Maged, Esraa Soliman, Hanaa M. Rady
{"title":"Disease damage in systemic lupus erythematosus patients: Disease activity, male gender and hypertension as potential predictors","authors":"Lobna A. Maged,&nbsp;Esraa Soliman,&nbsp;Hanaa M. Rady","doi":"10.1016/j.ejr.2022.12.001","DOIUrl":"https://doi.org/10.1016/j.ejr.2022.12.001","url":null,"abstract":"<div><p><em>Aim of the work:</em> To identify factors associated with damage in systemic lupus erythematosus (SLE) patients. <em>Patients and methods:</em> Based on Systemic Lupus International Collaborating Clinics/American College of<!--> <!-->Rheumatology damage index (SDI) patients were divided into 2 groups; patients with damage (SDI ≥ 1) and without (SDI = 0). Groups were compared regarding demographic features, co-morbidities, cumulative clinical features, treatment and assessment of the modified SLE disease activity index (M−SLEDAI) at baseline and every 6 months till the end of follow up.<em>Results:</em> The study included172 patients; 152 (88.4%) females and 20 (11.6%) males with a mean age of 35.5 ± 8.6 years and disease duration of9.8 ± 1.2 years.Eighty-five (49.4%) patients had damage with a mean SDI of 1.04 ± 1.36. The musculoskeletal, renal and neuropsychiatric systems were damaged in 17.4%, 12.8% and 10.4% of patients, respectively. A comparison between patients with and without damage identified male gender (p = 0.001); older age (p = 0.002), age at onset (p &lt; 0.001); hypertension (p = 0.001); renal (p = 0.007) and neuropsychiatric involvement (p = 0.019); vasculitis (p = 0.044); M−SLEDAI last-visit (p = 0.004), average M−SLEDAI (p = 0.007), number and frequency of visits with active disease (p &lt; 0.001 for both); number of flares (p = 0.001); use and cumulative dose of pulse steroids (p &lt; 0.001 and p = 0.042, respectively), overall cumulative steroid dose (p = 0.007), cyclophosphamide use (p &lt; 0.001), hydroxychloroquine dose (p = 0.029) and less use of leflunomide(p = 0.01) as factors associated with damage. On multivariate regression, the association between damage and male gender (p = 0.02), hypertension (p = 0.016) and number of visits with active disease (p = 0.002) was retained. <em>Conclusion:</em> Male gender, hypertension and prolonged disease activity in SLE contribute to damage occurrence.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"45 2","pages":"Pages 121-126"},"PeriodicalIF":0.9,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49834818","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}
引用次数: 0
Rheumatoid factor and anti-citrullinated protein antibodies (ACPA) in psoriatic arthritis (PsA), and skin psoriasis: Relevance and clinical implications 银屑病关节炎(PsA)和皮肤银屑病中的类风湿因子和抗瓜氨酸蛋白抗体(ACPA):相关性和临床意义
IF 0.9
Egyptian Rheumatologist Pub Date : 2023-04-01 DOI: 10.1016/j.ejr.2023.01.003
Yasser Emad , Nashwa El-Shaarawy , Walaa Abdelrahman , Yasser Ragab , Ossama Ibrahim , Ahmed Elyaski , Ahmed Ismail , Yosra Hassan , Ahmed Elnaggar , Johannes J. Rasker
{"title":"Rheumatoid factor and anti-citrullinated protein antibodies (ACPA) in psoriatic arthritis (PsA), and skin psoriasis: Relevance and clinical implications","authors":"Yasser Emad ,&nbsp;Nashwa El-Shaarawy ,&nbsp;Walaa Abdelrahman ,&nbsp;Yasser Ragab ,&nbsp;Ossama Ibrahim ,&nbsp;Ahmed Elyaski ,&nbsp;Ahmed Ismail ,&nbsp;Yosra Hassan ,&nbsp;Ahmed Elnaggar ,&nbsp;Johannes J. Rasker","doi":"10.1016/j.ejr.2023.01.003","DOIUrl":"https://doi.org/10.1016/j.ejr.2023.01.003","url":null,"abstract":"<div><h3>Aim of the work</h3><p>Anti-citrullinated protein antibodies (ACPAs), is a highly specific markers for rheumatoid arthritis, can also be found in psoriatic arthritis (PsA). This work aimed to look into the frequency of rheumatoid factor (RF) and ACPA in PsA and psoriasis patients without clinical evidence of arthritis (PSO), and to correlate findings with demographics, disease characteristics, laboratory findings, and radiological damage in PsA. Patients and methods: The study included 78 PsA patients, 47 PSO patients, and 69 normal controls. Full clinical assessments, RF and ACPA assays, and modified radiological Steinbroker score (Mss) for PsA were performed. Results: The age of the patients was 45.6 ± 8.7 years and the M:F 59:66 (M:F 0.9:1). Positive RF was not significantly different between PsA and PSO groups (p = 0.35), but positive ACPA was significantly more common in PsA patients (p &lt; 0.001) than in PSO and controls. No significant difference was observed between the PSO and controls (p = 0.08). In PsA, RF titers correlated significantly with ESR (p = 0.002), swollen joint count (SJC)(p = 0.02), tender joint count (TJC)(p = 0.02), and mSS (p = 0.001), while in the PSO RF correlated significantly with ESR (p = 0.011) and CRP levels (p = 0.02). In the PsA, ACPA titer significantly correlated with CRP levels (p &lt; 0.001), SJC (p = 0.002), TJC (p = 0.003), mSS (p &lt; 0.001) and PASI (p &lt; 0.001), but with none of these in the PSO. Conclusion: PsA patients have more frequent positive RF and ACPA than PSO patients. ACPA values are significantly correlated with markers of inflammation, swollen and tender joint count and radiological damage in PsA and not in PSO patients.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"45 2","pages":"Pages 145-151"},"PeriodicalIF":0.9,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49792259","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}
引用次数: 1
Serum amyloid a level and musculoskeletal ultrasound in assessment of disease activity in rheumatoid arthritis patients 血清淀粉样蛋白a水平和肌肉骨骼超声对类风湿性关节炎患者疾病活动性的评估
IF 0.9
Egyptian Rheumatologist Pub Date : 2023-04-01 DOI: 10.1016/j.ejr.2023.01.001
Mai A. El Kosaier , Reham M. Shaat , Mohammed M. El.Arman , Abd El-Moaaty A. Afifi
{"title":"Serum amyloid a level and musculoskeletal ultrasound in assessment of disease activity in rheumatoid arthritis patients","authors":"Mai A. El Kosaier ,&nbsp;Reham M. Shaat ,&nbsp;Mohammed M. El.Arman ,&nbsp;Abd El-Moaaty A. Afifi","doi":"10.1016/j.ejr.2023.01.001","DOIUrl":"https://doi.org/10.1016/j.ejr.2023.01.001","url":null,"abstract":"<div><h3>Aim of the work</h3><p>To assess serum amyloid A (SAA) level and study its relation to musculoskeletal ultrasound (MSUS) findings and to clinical disease activity indices in rheumatoid arthritis (RA) patients.</p></div><div><h3>Patients and methods</h3><p>60 RA patients and 60 matched controls were enrolled. Disease activity score-C-reactive protein (DAS-28-CRP) and simplified disease activity index (SDAI) and clinical disease activity Index (CDAI) were determined. MSUS evaluation was done using 12 -joint power Doppler ultrasound (PDUS) score. SAA was analyzed using an enzyme-linked immunosorbent assay.</p></div><div><h3>Results</h3><p>SAA levels were highly significant in patients (35.1 ± 3.6 mg/l) than in controls (1.6 ± 0.12 mg/l)(p &lt; 0.001). There was significantly higher SAA level among steroid users (56.7 %)(p = 0.001) and a lower level among leflunomide users (30 %)(p = 0.04). SAA and PDUS significantly increased in patients with low disease activity (n = 13) compared to those in remission (n = 10)(p &lt; 0.001). SAA significantly correlated with disease duration (p = 0.004), morning stiffness duration, swollen joint count, tender joint count, rheumatoid factor, anti-cyclic citrullinated peptide, DAS-28-CRP, SDAI, CDAI, erythrocyte sedimentation rate, CRP and total 12-joint PDUS score (p &lt; 0.001). The highest discriminatory ability of active RA and remission was attributed to the combination of SAA, PDUS and CRP (accuracy = 96.7 %, AUC = 0.99; sensitivity 96 % and specificity 100 %).</p></div><div><h3>Conclusion</h3><p>RA patients have a significantly increased level of SAA which indicates a key pathogenic role in the disease. SAA level is a potentially effective biomarker in the assessment of disease activity in RAand allied to PDUS. Combining SAA, PDUS and CRP provide the highest sensitivity and specificity in discrimination of active RA from remission.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"45 2","pages":"Pages 153-158"},"PeriodicalIF":0.9,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49792258","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}
引用次数: 0
Frequency of fibromyalgia syndrome and anxiety post-corona virus disease-2019 (COVID-19) in patients attending the rheumatology clinic 在风湿病诊所就诊的患者中,2019年冠状病毒病(新冠肺炎)后纤维肌痛综合征和焦虑的频率
IF 0.9
Egyptian Rheumatologist Pub Date : 2023-04-01 DOI: 10.1016/j.ejr.2022.11.007
Soha Senara , Hisham Salah , Wafaa Abdel Wahed , Ahmed Yehia
{"title":"Frequency of fibromyalgia syndrome and anxiety post-corona virus disease-2019 (COVID-19) in patients attending the rheumatology clinic","authors":"Soha Senara ,&nbsp;Hisham Salah ,&nbsp;Wafaa Abdel Wahed ,&nbsp;Ahmed Yehia","doi":"10.1016/j.ejr.2022.11.007","DOIUrl":"https://doi.org/10.1016/j.ejr.2022.11.007","url":null,"abstract":"<div><h3>Aim of the work</h3><p>To screen for the new development of fibromyalgia syndrome (FMS) and anxiety in rheumatic diseases (RDs) patients and control who recovered from coronavirus disease 2019 (COVID-19).</p></div><div><h3>Patients and methods</h3><p>The study included 200 RDs patients and 100 matched controls with no previous history of FMS and who recovered from COVID-19. The patients’ RDs included rheumatoid arthritis (RA) (n = 50), systemic lupus erythematosus (SLE) (n = 50), juvenile idiopathic arthritis (JIA) (n = 40) and spondyloarthritis (SpA) (n = 60). The fibromyalgia symptom scale (FS), fibromyalgia impact questionnaire (FIQ) and Hamilton Anxiety rating scale were assessed.</p></div><div><h3>Results</h3><p>The mean age of patients was 35.9 ± 8.5 years with female: male 2.6:1. Fibromyalgia and anxiety were significantly higher in cases than control (22.5 % <em>vs</em> 12 % and 27 % <em>vs</em>16 %, p = 0.002, p = 0.03 respectively). Hypertension, obesity, anxiety, severe COVID-19, frequency of SLE and SpA were significantly higher in patients with FMS compared to those without (31.1 % <em>vs</em> 11.6 %, 68.9 % <em>vs</em> 21.9 %, 84.4 % <em>vs</em> 10.3 %, 48.9 % <em>vs</em> 16.8 %, 31.1 % <em>vs</em> 23.2 % and 40 % <em>vs</em> 27.1; p = 0.002, p &lt; 0.001, p &lt; 0.001, p &lt; 0.001, p = 0.014, p = 0.004 respectively).Severity of COVID-19, diabetes and anxiety were significant predictors of FMS(β = 1.1, p = 0.007; β = 3.03, p = 0.001 and β = 4.44, p &lt; 0.001 respectively). Fibromyalgia increases with increase anxiety grade; the percentage of fibromyalgia was 4.7 %, 50 %, 90 % and 100 % among patients with no anxiety, mild, moderate, and severe anxiety respectively (p &lt; 0.001).</p></div><div><h3>Conclusion</h3><p>Fibromyalgia is common in RDs patients post-COVID-19. Diabetes, COVID-19 infection severity and anxiety predict the risk of developing post-COVID-19 fibromyalgia. Post-COVID-19 fibromyalgia occurred more in hypertensive, obese, anxious and patients with severe COVID infection.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"45 2","pages":"Pages 127-131"},"PeriodicalIF":0.9,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49792639","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}
引用次数: 3
Clinical significance of peripheral nervous system involvement in systemic lupus erythematosus patients: Relation to disease activity and damage index 系统性红斑狼疮患者周围神经系统受累的临床意义:与疾病活动性和损伤指数的关系
IF 0.9
Egyptian Rheumatologist Pub Date : 2023-04-01 DOI: 10.1016/j.ejr.2023.01.005
Marwa H. Niazy , George N. Fakhry , Samar M. Fawzy
{"title":"Clinical significance of peripheral nervous system involvement in systemic lupus erythematosus patients: Relation to disease activity and damage index","authors":"Marwa H. Niazy ,&nbsp;George N. Fakhry ,&nbsp;Samar M. Fawzy","doi":"10.1016/j.ejr.2023.01.005","DOIUrl":"https://doi.org/10.1016/j.ejr.2023.01.005","url":null,"abstract":"<div><h3>Background</h3><p>Despite its potential impact on disease outcome, peripheral nervous (PN) system involvement in systemic lupus erythematosus (SLE) has received little attention.</p></div><div><h3>Aim of the work</h3><p>To assess the frequency and clinical features of PN system involvement in SLE patients.</p></div><div><h3>Patients and methods</h3><p>The medical records of 100 patients were revised. Cases with diabetes, hepatitis, vitamin B12 deficiency or carpal tunnel syndrome were excluded. Detailed history, clinical examination and laboratory investigations were recorded. PN events were documented. The SLE disease activity index (SLEDAI) and systemic lupus international collaborating clinics damage index (SLICC-DI) were evaluated<em>.</em></p></div><div><h3>Results</h3><p>Patients were 88 females and 12 males (F:M 7.3:1), mean age was 34.2 ± 8.3 years and disease duration 12.7 ± 5.4 years. The frequency of PN system involvement was 8 %; polyneuropathy (n = 5), mononeuritis multiplex (n = 2) and Guillain-Barré syndrome (n = 1). PN was associated with a significantly higher frequency of musculoskeletal (100 %), neuropsychiatric (100 %), pulmonary (62.5 %) and cardiovascular (37.5 %) manifestations as well as Raynaud's phenomenon (37.5 %) and secondary vasculitis (50 %) compared to those without (56.5 %,7.6 %,26.1 %,7.6 %,7.6 % and 12 %;p = 0.02,p &lt; 0.001,p = 0.04,p = 0.03,p = 0.03,p = 0.017 respectively).anti-nuclear antibodies (87.5 % vs 92.4 %) and anti-double stranded DNA (71.4 % vs 69.6 %) positivity were comparable (p &gt; 0.05). SLEDAI and SLICC-DI were significantly increased in patients with PN (26.5 ± 6.36 and 3.75 ± 0.98) compared to those without (11.5 ± 4.76 and 0.61 ± 0.56;p &lt; 0.001 each).</p></div><div><h3>Conclusion</h3><p>SLE patients with PN involvement had a higher frequency of musculoskeletal, neuropsychiatric, pulmonary and cardiovascular manifestations in addition to Raynaud's and vasculitis. There is a potential association with disease activity and damage. Careful neurological assessment should be included in the workup of SLE patients.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"45 2","pages":"Pages 177-181"},"PeriodicalIF":0.9,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49871779","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}
引用次数: 2
Influence of perception of glucocorticoids on compliance of treatment in patients with rheumatoid arthritis and systemic lupus erythematosus 糖皮质激素对类风湿性关节炎和系统性红斑狼疮患者治疗依从性的影响
IF 0.9
Egyptian Rheumatologist Pub Date : 2023-04-01 DOI: 10.1016/j.ejr.2023.01.002
Walaa Abdelrahman, Arwa Al-Shaarawy, Bassel El-Zorkany
{"title":"Influence of perception of glucocorticoids on compliance of treatment in patients with rheumatoid arthritis and systemic lupus erythematosus","authors":"Walaa Abdelrahman,&nbsp;Arwa Al-Shaarawy,&nbsp;Bassel El-Zorkany","doi":"10.1016/j.ejr.2023.01.002","DOIUrl":"https://doi.org/10.1016/j.ejr.2023.01.002","url":null,"abstract":"<div><h3>Background</h3><p>Glucocorticoids (GCs) are alleged as hazardous medications among Egyptian patients and their relatives.</p></div><div><h3>Aim of the work</h3><p>To highlight the beliefs held about GCs and the effect of these beliefs on adherence to GCs treatment.</p></div><div><h3>Patients and methods</h3><p>The study included 70 systemic lupus erythematosus (SLE) patients, 70 rheumatoid arthritis (RA) patients and 140 GC-naïve subjects as the control. The demographic and socioeconomic standards of the patients and control as well as the GCs use experience in patients were recorded. GCs perception was assessed by Beliefs about medication Questionnaire (BMQ). Adherence was assessed by Compliance Questionnaire of Rheumatology (CQR).</p></div><div><h3>Results</h3><p>GCs were significantly perceived as harmful and of low benefit by the control (p &lt; 0.001, p &lt; 0.001, respectively), a beneficial drug by SLE patients, while RA patients had significantly higher harm scores (p = 0.015 and p = 0.003 respectively). Most of SLE and RA patients were non-adherent (57.1% and 65.7%, respectively). Higher general-BMQ harm scores were significantly associated with a lower odd of adherence (OR: 0.25, 95%CI: 0.1–0.63). Reduced OR of <em>necessity &gt; concern</em> was associated with higher socioeconomic standards and maximum oral GCs dose (OR:0.09 and 0.96, respectively). Increased OR of high necessity was significantly associated with number of currently used disease modifying anti-rheumatic drugs (DMARDs) (OR:5.54, p = 0.025). High OR of harm perception was significantly associated with higher socioeconomic standards (OR: 5.12, p = 0.016).</p></div><div><h3>Conclusion</h3><p>GCs are perceived as pillars in management by SLE and RA patients. Concerns about side effects and dependency are still troublesome. Improvement of patients’ GCs perception impacts level of adherence to treatment.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"45 2","pages":"Pages 159-164"},"PeriodicalIF":0.9,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49792269","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}
引用次数: 0
Effectiveness of direct-acting antiviral (DAA) agents on hepatitis C virus-related mixed cryoglobulinemia syndrome: One-year follow-up 直接作用抗病毒(DAA)药物治疗丙型肝炎病毒相关混合冷球蛋白血症综合征的疗效:一年随访
IF 0.9
Egyptian Rheumatologist Pub Date : 2023-04-01 DOI: 10.1016/j.ejr.2022.12.004
Hala L. Fayed , Sohair M. Abd El Ghany , Abeer M. Nasser , Naglaa A. El-gendy
{"title":"Effectiveness of direct-acting antiviral (DAA) agents on hepatitis C virus-related mixed cryoglobulinemia syndrome: One-year follow-up","authors":"Hala L. Fayed ,&nbsp;Sohair M. Abd El Ghany ,&nbsp;Abeer M. Nasser ,&nbsp;Naglaa A. El-gendy","doi":"10.1016/j.ejr.2022.12.004","DOIUrl":"https://doi.org/10.1016/j.ejr.2022.12.004","url":null,"abstract":"<div><h3>Background</h3><p>Mixed cryoglobulinemia syndrome (MCS) is a systemic vasculitis involving skin, joints, kidneys, and peripheral nerves. Hepatitis C virus (HCV) is a well-known etiologic agent. Therapy for HCV has been revolutionized by the approval of direct-acting antiviral (DAA) agents.</p></div><div><h3>Aim of the work</h3><p>To evaluate the effect of the new DAA treatment on MCS in HCV-infected patients. A prospective study with one year follow-up after induction therapy was undergone.</p></div><div><h3>Patients and methods</h3><p>Sixty patients with HCV-infection having ≥ 1 extrahepatic manifestations and attending the Rheumatology outpatient at Kasr Alainy for treatment of immune-mediated disease were included. Patients were examined at baseline (before receiving HCV treatment), after six months, and after one year following receiving HCV treatment by sofosbuvir based regimen in specialized centers. All patients were treatment-naïve; Assessment for arthritis, vasculitis and nephritis was performed.</p></div><div><h3>Results</h3><p>Patients’ mean age was 51.1 ± 8.8 (30–68) years; 44 females and 16 males (F:M 2.8:1). Arthritis was present in 43 (71.6 %), cutaneous vasculitis in 30 (50 %): purpura in 19 (31.7 %), skin ulcers in 18 (30 %), peripheral neuropathy in 16 (26.7 %), and nephritis in 14(23.3 %) patients. Absolute viral clearance was sustained up to one year follow-up. The frequency of patients affected with MCS-related manifestations arthritis, cutaneous vasculitis, peripheral neuropathy, and nephritis tended to decrease. CDAI significantly decreased at six months compared to baseline (p = 0.04). BVAS, numeric rating scale (NRS) for neuropathic pain/paresthesia and proteinuria insignificantly changed from baseline at six months and at one-year (p = 0.28, p = 0.58 and p = 0.96 respectively).</p></div><div><h3>Conclusion</h3><p>Clinical and immunological responses for MCS-related manifestations were less satisfactory than the virologic response.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"45 2","pages":"Pages 139-143"},"PeriodicalIF":0.9,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49792640","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}
引用次数: 2
Methylation of receptor activator of nuclear factor kappa ligand (RANKL) gene in rheumatoid arthritis patients 类风湿性关节炎患者核因子-κ配体受体激活因子(RANKL)基因甲基化
IF 0.9
Egyptian Rheumatologist Pub Date : 2023-04-01 DOI: 10.1016/j.ejr.2023.01.004
Manal Ramzy , Ola M. Gharbia , Amal K. Seleem , Karima Mohamed , Rehab E. Marzouk
{"title":"Methylation of receptor activator of nuclear factor kappa ligand (RANKL) gene in rheumatoid arthritis patients","authors":"Manal Ramzy ,&nbsp;Ola M. Gharbia ,&nbsp;Amal K. Seleem ,&nbsp;Karima Mohamed ,&nbsp;Rehab E. Marzouk","doi":"10.1016/j.ejr.2023.01.004","DOIUrl":"https://doi.org/10.1016/j.ejr.2023.01.004","url":null,"abstract":"<div><h3>Background</h3><p>Rheumatoid arthritis (RA) is an autoimmune inflammatory disease characterized by synovitis, cartilage damage and bone resorption. Methylation of deoxyribonucleic acid plays a crucial role in repressing gene expression. Receptor activator of nuclear factor-kappa ligand (RANKL) controls bone homeostasis.</p></div><div><h3>Aim of the work</h3><p>To assess the serum level of RANKL and its gene promoter methylation in RA patients and to determine its association with clinical characteristics and disease activity.</p></div><div><h3>Patients and methods</h3><p>The study included 40 RA patients and 40 control. The disease activity score (DAS28) was assessed. Frequency of RANKL gene promoter methylation was determined by quantitative methylation specific PCR (QMSP) and serum RANKL level by enzyme linked immunosorbant assay (ELISA).</p></div><div><h3>Results</h3><p>Patients mean age was 46.8 ± 10.6 years, 36 females and 4 males (F:M 9:1) with median disease duration 4.5 years. Positive rheumatoid factor, anti-cyclic citrullinated peptide and C-reactive protein were present in 65 %, 75 % and 55 % of cases. Methylation percentage of RANKL gene promoter was significantly lower in patients (3.4 %) than in controls (3.7 %)(p = 0.035) while serum level was significantly increased in patients (9.1 ng/ml,5.3–11.8 ng/ml) than in controls (5.7 ng/ml, 4.5–8 ng/ml)(p = 0.003). RANKL methylation frequency was inversely associated with serum level (rs = -0.21,p = 0.06). There was no significant correlation of RANKL serum level and methylation with DAS28 (r = 0.03,p = 0.87 and r = 0.06,p = 0.73 respectively). RANKL serum level (&gt;9.5 ng/ml) and methylation percentage (≤9%) significantly discriminate RA cases from control (sensitivity 47.5 %, specificity 91.9 %; p = 0.001 and sensitivity 100 %, specificity 40 %; p = 0.03 respectively).</p></div><div><h3>Conclusion</h3><p>RA patients expressed elevated serum RANKL with low methylation.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"45 2","pages":"Pages 171-176"},"PeriodicalIF":0.9,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49792642","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}
引用次数: 0
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