Egyptian Rheumatologist最新文献

{"title":"Risk of dose-dependent methotrexate therapy on renal functions in patients with rheumatoid arthritis","authors":"Dalia M. Gamal ,&nbsp;Ghada Maged ,&nbsp;Marwa Abdo ,&nbsp;Reem M. Elsharabasy ,&nbsp;Sara F. Samaan","doi":"10.1016/j.ejr.2025.06.004","DOIUrl":"10.1016/j.ejr.2025.06.004","url":null,"abstract":"<div><h3>Aim of the work</h3><div>To study the dose-dependent effects of methotrexate (MTX) on renal functions and estimated glomerular filtration rate (eGFR<strong>)</strong> after 1 and 3 years of MTX therapy in rheumatoid arthritis (RA) patients.</div></div><div><h3>Patients and methods</h3><div>Medical records of 360 RA patients were reviewed. Disease activity score (DAS28) was recorded. Doses of MTX, concomitant therapies, and estimated glomerular filtration rate (eGFR) were reviewed at baseline, after 1 and 3 years of therapy.</div></div><div><h3>Results</h3><div>The mean age of patients was 44.6 ± 13.7 years, 80.6 % were females and disease duration was 9.9 ± 6.5 years. 36.4 % had moderate disease activity, 26.1 % high, 21.4 % low and 16.1 % in remission. There was a significant decline in eGFR after 1and 3 years of MTX therapy (p &lt; 0.001) where at baseline it was 100.2 ± 22.6, after 1 year 91.5 ± 23.7 and after 3 years 82 ± 18.7. eGFR was similar in patients receiving MTX doses &lt; 10 mg, 10–15 and &gt; 15 mg/week (after 1 year p = 0.1, after 3 years p = 0.36). On regression, after 3 years, age and MTX therapy were significantly associated with decline in eGFR (p = 0.001 and p = 0.034) respectively. Seventeen patients (4.7 %) developed renal impairment (eGFR &lt; 60 ml/min) after 1 year of MTX versus 9 (3.4 %) after 3 years. At cut off dose 18 mg/week, sensitivity 70.6 % and specificity 53.4 %, MTX could predict renal impairment after 1 year (p = 0.102) and at 15 mg/week after 3 years, sensitivity 82.4 % and specificity 36.1 % (p = 0.068).</div></div><div><h3>Conclusion</h3><div>Low dose MTX has a potential nephrotoxic effect, mandating close monitoring of renal functions for patients on MTX therapy.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"47 4","pages":"Pages 182-186"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522527","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":"The role of fibrinogen to albumin ratio in patients with systemic lupus erythematosus: Relation with disease characteristics","authors":"Noha H. Shedid,&nbsp;Hanan M. Farouk,&nbsp;Esraa M. Ahmed,&nbsp;Mohammed M. Mohammed","doi":"10.1016/j.ejr.2025.06.006","DOIUrl":"10.1016/j.ejr.2025.06.006","url":null,"abstract":"<div><h3>Aim of the work</h3><div>to investigate the role of fibrinogen to albumin ratio (FAR) in systemic lupus erythematosus (SLE) patients and its relationship with disease characteristics.</div></div><div><h3>Patients and methods</h3><div>This study included 45 SLE patients with activity and another 45 without as well as 45 controls. The clinical, laboratory data including FAR measurement and SLE disease activity index 2000 (SLEDAI-2K) were assessed.</div></div><div><h3>Results</h3><div>The patients were 83.3% females, with a median (IQR) age of 30.5 (23–41) years and disease duration of 4 (2–7) years. The median FAR value was significantly higher in patients (1.4, 0.6–1.8) compared to control (0.6, 0.5–0.8) and in active (1.6, 1.2–2.1) compared to inactive (0.7, 0.5–1.7) patients (both p&lt; 0.0001). Higher FAR values were significantly associated with receiving disease modifying antirheumatic drugs (DMARDs) (n= 82) (1.4, 0.7–2 vs 0.4, 0.15–1.1) (p= 0.01). FAR significantly correlated with the erythrocyte sedimentation rate (ESR) (r= 0.3, p= 0.004), anti-double stranded deoxyribonucleic acid (anti-dsDNA) (r= 0.28, p= 0.008) and urinary protein/creatinine (r= 0.48, p&lt; 0.0001) while inversely with complement (C3: r= -0.41, p&lt; 0.0001 and C4: r= -0.31, p= 0.003). Anti-dsDNA was the most significant factor affecting the values of FAR (β= 0.24, p= 0.04). The best cut-off value of FAR to discriminate SLE from controls and active from inactive patients were 1.1 and 0.8, with a diagnostic sensitivity of 58.9% and 86.7% and specificity of 95.6% and 55.6%, p&lt; 0001 and p&lt; 0.001, respectively.</div></div><div><h3>Conclusion</h3><div>The FAR was significantly increased in SLE patients and was linked with disease activity particularly renal. FAR can be used as an inflammatory biomarker to monitor SLE disease activity.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"47 4","pages":"Pages 172-176"},"PeriodicalIF":1.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513821","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":"Cognitive impairment in radiographic axial spondyloarthritis patients and its relation to disease characteristics","authors":"Hania S. Zayed ,&nbsp;Radwa S. ELbahnasy ,&nbsp;Shirin M. El-Makawi ,&nbsp;Suzan S. Al-Adle","doi":"10.1016/j.ejr.2025.06.005","DOIUrl":"10.1016/j.ejr.2025.06.005","url":null,"abstract":"<div><h3>Aim of the work</h3><div>Cognitive involvement in patients with radiographic axial spondyloarthritis (r-axSpA) has not been sufficiently studied. This study aimed to assess cognitive functions in these patients and their relation to disease characteristics.</div></div><div><h3>Patients and methods</h3><div>Sixty r-axSpA patients and 60 age, sex- and education-matched healthy controls were enrolled. Disease activity was assessed by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and functional impairment by the Bath Ankylosing Spondylitis Functional Index (BASFI). Patients and controls were assessed by the Depression, Anxiety and Stress scale (DASS) and the Montreal Cognitive Assessment (MoCA) Basic test.</div></div><div><h3>Results</h3><div>The mean age of the patients was 35.8 ± 8.6 years, median disease duration of 10 years, 52 (86.7 %) were males and the educational attainment was 13.4 ± 4.7 years. The median BASDAI was 4.45 (3.75– 5.65) and BASFI was 5.1 (3.5–6.7). The patients experienced different grades of depression (78.4 %), anxiety (71.7 %) and stress (76.7 %) compared to 15 %, 31.7 %, and 30 % of the control, respectively (p &lt; 0.001). Eighteen (30 %) patients showed impaired cognitive functions on the MoCA B test (score &lt; 26) versus none of the controls (p &lt; 0.001). Executive function, immediate recall, fluency, abstraction and visuoperception were more frequently involved in patients (p = 0.001, p = 0.022, p = 0.011, p = 0.001 and p = 0.001, respectively). Impaired MoCA was significantly associated with older age (p = 0.029), lower education levels (p = 0.003), and higher BASFI (p = 0.003), but not with disease duration, BASDAI or DASS scores.</div></div><div><h3>Conclusion</h3><div>Cognitive impairment is frequent among r-axSpA patients and is associated with older age, lower educational attainment, and more functional limitations.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"47 4","pages":"Pages 177-181"},"PeriodicalIF":1.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513822","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":"Biologic of choice after secukinumab failure in psoriatic arthritis patient: Ixekizumab or interleukin-23 inhibitors – A retrospective study","authors":"P.S. Ong ,&nbsp;P.J. Lee ,&nbsp;C.R. Ng ,&nbsp;Fariz Yahya ,&nbsp;S.S. Chng ,&nbsp;S.A. Maulana","doi":"10.1016/j.ejr.2025.06.003","DOIUrl":"10.1016/j.ejr.2025.06.003","url":null,"abstract":"<div><h3>Aim of the work</h3><div>This study aimed to compare the clinical response to ixekizumab versus interleukin-23 inhibitors (IL23i) in psoriatic arthritis (PsA) patients who failed secukinumab treatment.</div></div><div><h3>Patients and methods</h3><div>A retrospective multi-center study included active PsA patients who experienced treatment failure with secukinumab and were subsequently treated with either ixekizumab or IL23i. Baseline demographics, including disease duration<strong>,</strong> domains involved and duration of secukinumab therapy were recorded. The disease activity in PsA (DAPSA) score and body surface area (BSA) were used to assess the effectiveness of the biologics in PsA.</div></div><div><h3>Results</h3><div>The mean age of the 25 patients was 49.4 ± 12.4 years, 15 females and 10 males with secukinumab failure were enrolled. 14 (56 %) patients switched to IL23i and 11 (44 %) to ixekizumab. The median duration of secukinumab exposure was 85.7 ± 56.2 weeks. The primary reason for switching was worsening joint and skin symptoms (52 %). Complete resolution of dactylitis (7/7) and enthesitis (5/5) was achieved with ixekizumab or IL23i. Patients with primary secukinumab failure showed PsA improvements regardless the treatment switch. Multivariate analysis identified comedication with conventional synthetic DMARDs and baseline DAPSA as predictors for achieving treatment targets in the ixekizumab group.</div></div><div><h3>Conclusion</h3><div>This study found that after secukinumab failure, the response to ixekizumab and IL23i was comparable, regardless of the type of therapeutic failure. By comparing these alternatives, it offers valuable insights into the evolving landscape of PsA management. Further prospective studies with larger sample sizes are needed to validate these findings and guide the selection of the optimal biologic therapy.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"47 4","pages":"Pages 168-171"},"PeriodicalIF":1.0,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511009","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":"Calprotectin in patients with axial spondyloarthritis: Clinical features, disease activity and imaging","authors":"Noha H. Shedid,&nbsp;Noran O. El-Azizi,&nbsp;Maha A. El-Serwy,&nbsp;Zainab A. Khodary,&nbsp;Safaa A. Hussein","doi":"10.1016/j.ejr.2025.06.001","DOIUrl":"10.1016/j.ejr.2025.06.001","url":null,"abstract":"<div><h3>Aim of the work</h3><div>The aim of the current study was to examine both serum and fecal calprotectin (sCal and fCal) levels in patients with axial spondyloarthritis (axSpA) and to evaluate their potential relations to clinical features, disease activity and imaging.</div></div><div><h3>Patients and methods</h3><div>This study included 40 axSpA patients and 18 controls. Disease activity using AS disease activity score (ASDAS), sacroiliac joints radiography and magnetic resonance imaging (MRI) were assessed. sCal and fCal were measured.</div></div><div><h3>Results</h3><div>The axSpA patients were 57.5 % males, with a mean age of 39.8±11.5 years and a median disease duration (IQR) of 4.5 (1.7–11.5) years. The median sCal and fCal levels were significantly higher in axSpA patients compared to controls (p&lt; 0.001). There were no differences in median sCal and fCal levels in axSpA patients concerning demographic data, HLA-B27, extra-articular manifestations, intestinal symptoms and biologics treatment (p&gt; 0.05). A significant increase in median sCal and fCal levels along with the increase in clinical disease activity grade was found (p&lt; 0.0001 and p= 0.003, respectively). Both sCal and fCal were significantly correlating with each other (p= 0.003), with ASDAS score (p= 0.003 and p= 0.01, respectively) and negatively with hemoglobin (p= 0.01 and p= 0.009, respectively). An increase in median sCal levels was observed along with the increase in grade severity of sacroiliitis on MRI (p= 0.06).</div></div><div><h3>Conclusion</h3><div>Serum and fecal calprotectin levels were significantly increased in axSpA patients and associated with disease activity. Both were having good specificity and sensitivity as potential diagnostic biomarkers for the disease.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"47 4","pages":"Pages 161-167"},"PeriodicalIF":1.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144470333","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":"Antineutrophil cytoplasmic antibodies (ANCA) in lupus nephritis patients and its relation to disease activity and histopathological features","authors":"Sarah MS El-Rabbat ,&nbsp;Mohamed M Alwakd ,&nbsp;Walaa Ibrahim ,&nbsp;Marwa Abdel Nasser ,&nbsp;Wael S El-Sawy","doi":"10.1016/j.ejr.2025.04.010","DOIUrl":"10.1016/j.ejr.2025.04.010","url":null,"abstract":"<div><h3>Aim of the work</h3><div>To describe the frequency of antineutrophil cytoplasmic antibodies (ANCA) in lupus nephritis (LN) patients at the time of renal biopsy and to study the relation to the disease activity and histopathological features in renal biopsy.</div></div><div><h3>Patients and methods</h3><div>Eighty adult LN patients with activity defined by the renal domains of the assessed SLE disease activity index (SLEDAI) and indicated for renal biopsies were enrolled. Clinical manifestations and systemic lupus international collaborating clinics damage index (SLICC-DI) were assessed. Serum level of cytoplasmic (c-ANCA) and perinuclear (p-ANCA) was measured using enzyme linked immunosorbent assay. Histopathological features of renal biopsy including activity (AI) and chronicity (CI) indices were assessed according to the modified national institute of health (NIH).</div></div><div><h3>Results</h3><div>The mean age of patients was 30.9 ± 8.8 years, disease duration 4.2 ± 4.1 years and 73 were females. The mean SLEDAI was 10.6 ± 4.8 and SLICC-DI was 1.2 ± 1.2. Twelve (15 %) patients had positive ANCA; 41.7 % anti-MPO, 33.3 % anti-PR3 and 25 % having double positivity. Class IV was significantly higher in ANCA negative (p = 0.04), while class V was significantly higher in ANCA positive (p = 0.019). The AI and CI were comparable between ANCA positive and negative patients (p &gt; 0.05). A significant correlation was found between SLEDAI and AI (r = 0.35,p = 0.005) and between SLICC-DI and CI (r = 0.29,p = 0.019). Hyaline deposits (r = 0.83,p = 0.04) and interstitial inflammation (r = -0.85,p = 0.03) significantly correlated with the anti-myeloperoxidase level in positive cases.</div></div><div><h3>Conclusion</h3><div>Presence of ANCA affects the histopathological class of LN. Clinical activity and damage in LN correlate with activity and chronicity respectively in renal biopsy.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"47 3","pages":"Pages 156-160"},"PeriodicalIF":1.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071106","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":"Pulmonary complications in children with systemic lupus erythematosus (SLE): A review of the literature","authors":"Ahlam Mazi","doi":"10.1016/j.ejr.2025.05.001","DOIUrl":"10.1016/j.ejr.2025.05.001","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary involvement affects 20–90% of children with systemic lupus erythematosus (SLE), presenting as manifestations ranging from mild pleuritis to life-threatening conditions like diffuse alveolar hemorrhage (DAH) and pulmonary hypertension (PH).</div></div><div><h3>Aim of the work</h3><div>This review aims to broadly explore pulmonary involvement in childhood-onset SLE (cSLE), examining the spectrum of respiratory manifestations that contribute significantly to morbidity and mortality in this vulnerable population.</div></div><div><h3>Review of the literature</h3><div>This review provides a comprehensive analysis of the literature with up-to-date evidence on the pathophysiology, clinical presentations, diagnostic approaches and management strategies for pulmonary complications in c-SLE. The underlying pathophysiology involves antigen–antibody complex deposition, autoantibody-driven tissue damage, endothelial dysfunction and inflammatory cytokine imbalance. Manifestations include pleuritis, acute lupus pneumonitis (ALP), and interstitial lung disease (ILD), while severe sequelae such as DAH, PH as well as shrinking lung syndrome occur less frequently but carry significant mortality risk. Diagnostic evaluation relies on high-resolution computed tomography (HRCT), pulmonary function tests (PFTs), bronchoalveolar lavage (BAL) and echocardiography. Management involves a multidisciplinary approach centered on corticosteroids and immunomodulatory agents like cyclophosphamide and mycophenolate mofetil, with biologic agents including rituximab and belimumab showing promise in refractory cases. Emerging biomarkers such as type-I interferon surrogates and B-cell activating factor-related cytokines offer potential for earlier detection. Despite advancements in understanding pulmonary complications in cSLE, significant research gaps remain regarding pediatric-specific epidemiology, treatment outcomes and prognosis. Early recognition and targeted intervention remain crucial to improving outcomes for these children, highlighting the need for continued research to optimize diagnostic and therapeutic approaches.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"47 3","pages":"Pages 148-155"},"PeriodicalIF":1.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912128","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":"Herpes zoster infection in adults with rheumatic diseases in Colombia: A real world-data analysis","authors":"Néstor Correa-Gonzalez ,&nbsp;Daniel G. Fernández-Ávila ,&nbsp;Diana Sandoval ,&nbsp;Diego Rosselli","doi":"10.1016/j.ejr.2025.04.007","DOIUrl":"10.1016/j.ejr.2025.04.007","url":null,"abstract":"<div><h3>Aim of the work</h3><div>To determine the prevalence of herpes zoster (HZ) infection in adults over 18 years old in Colombia and its association with immune-mediated diseases or rheumatic diseases (RDs).</div></div><div><h3>Patients and methods</h3><div>The official database of the Ministry of Health of Colombia was analyzed for a period of five years. Information was taken from people over 18 years of age who consulted the system due to HZ infection. To estimate the prevalence per thousand inhabitants, the total number of individuals treated during that five-year period was used as the denominator. To calculate the prevalence ratio (PR), the prevalence of HZ in individuals with each associated immune-mediated disease or RDs was taken as the numerator, over the prevalence in individuals of the same sex and age group without the associated disease.</div></div><div><h3>Results</h3><div>The unadjusted prevalence of HZ infection per 1000 adults was 7.15 (7.87 in women, 6.3 in men). In those aged 65 and older, the prevalence was 12.63/1000 (13.57 in women, 11.46 in men). In the adult general population, one in 127 women and one in 159 men will suffer an HZ infection, with the risk increasing to one in 64 in women and one in 87 men in those over 65-years-of-age. Overall, with all conditions combined, the risk increases three-fold if the patient has any of the associated conditions.</div></div><div><h3>Conclusions</h3><div>A high prevalence of HZ infection was found in immune-mediated diseases and RDs. This information should be considered by decision makers to improve the prevention of HZ infection.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"47 3","pages":"Pages 143-147"},"PeriodicalIF":1.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864677","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":"Cardiac involvement in patients with polymyositis and dermatomyositis","authors":"Dahlia Abdel Mohsen ,&nbsp;Nagia A Fahmy ,&nbsp;Rasha N Thabet ,&nbsp;Husniya M Adam ,&nbsp;Nermeen Samy","doi":"10.1016/j.ejr.2025.04.008","DOIUrl":"10.1016/j.ejr.2025.04.008","url":null,"abstract":"<div><h3>Aim</h3><div><strong>of the work:</strong> To evaluate cardiac involvement in a cohort of idiopathic immune myopathy (IIM) patients not known to have cardiac involvement.<strong>Patients and methods:</strong> This study included 40 IIM patients. All patients underwent electrocardiography (ECG), echocardiography (ECHO) and laboratory investigations, including muscle enzymes, myositis autoantibody panel, serum troponin-I, and pro-B-type natriuretic peptide (pro-BNP). <strong>Results:</strong> Sixty-five percent of the patients were female. The mean age was 39.5 ± 15.97 years, and mean disease duration 3.2 ± 3.6 years. Palpitations and chest pain were reported in 25 % of patients, while 7.5 % had hypertension.Raynaud’swas present in 4 patients (10 %). ECG and ECHO abnormalities, primarily left ventricular hypertrophy and diastolic dysfunction, were observed in 20 % of patients. Elevated troponin-I was found in 17.5 %, and high pro-BNP levels were detected in 32.5 %. The meanejection fraction (EF%) was 66.4 ± 7.7. Patients with ECHO abnormalities were older (54.6 ± 12.4 vs 35.7 ± 14.6 years; p = 0.002), had a higher frequency of hypertension (n = 2, 25 %) vs 1, 3.1 %; p = 0.036), and were more likely to be smokers (n = 4, 50 %) vs 4, 12.5 %; p = 0.018). Troponin-I showed an inverse correlation with EF% (r = -0.32, p = 0.046) and CRP (r = -0.38,p = 0.016). Elevated serum pro-BNP was significantly associated with Raynaud’s phenomenon (p = 0.002). <strong>Conclusion:</strong> ECG and ECHO abnormalities were notably observed in IIM patients, together with elevated troponin-I and pro-BNP levels. Old age, smoking and hypertension were significantly associated with ECHO abnormalities. Troponin-I showed an inverse correlation with EF% and CRP.Initial cardiac evaluation with baseline ECG and ECHO is recommended for all IIM patients and serum troponin-I and pro-BNP may help detect subclinical cases.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"47 3","pages":"Pages 137-142"},"PeriodicalIF":1.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143860487","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":"Identifying the unmet reproductive health needs for women with rheumatic diseases in Kuwait","authors":"Ghaydaa Aldabie ,&nbsp;Anwar Albasri ,&nbsp;Mohammad Khudadah","doi":"10.1016/j.ejr.2025.04.006","DOIUrl":"10.1016/j.ejr.2025.04.006","url":null,"abstract":"<div><h3>Background</h3><div>Women with rheumatic diseases (RDs) face unique challenges when it comes to family planning and pregnancy. These chronic conditions can significantly impact fertility, maternal health, and fetal outcomes.</div></div><div><h3>Aim</h3><div>of the work.</div><div>To better understand the specific reproductive health needs of women with RDs in Kuwait.</div></div><div><h3>Patients and methods</h3><div>The study was conducted in the outpatient rheumatology departments in two hospitals in Kuwait using an anonymized electronic survey. The survey consisted of 20 questions measuring patients’ demographics, rates of pregnancy counselling, and patient perceptions regarding pregnancy and breastfeeding in relation to their RD and medications. Non-pregnant females aged 21–49 with a confirmed RD diagnosis were enrolled.</div></div><div><h3>Results</h3><div>The mean age of the patients was 36 ± 7.5 years. Out of the 150 participants, the majority had rheumatoid arthritis (RA)(40 %) or systemic lupus erythematosus (SLE)(37.3 %). Half of the respondents were hoping to get pregnant in the future. About 63.3 % were advised about the importance of controlling their disease before pregnancy, but only 26 % had received guidance on contraception from their rheumatologists (regardless of their disease activity or treatment, including teratogenic medications). Many expressed a willingness to continue their rheumatic medications during pregnancy (64.7 %) and breastfeeding (57.3 %) if they were deemed safe. 57.5 % of patients were counselled regarding the need for regular antenatal follow-up once pregnancy is confirmed.</div></div><div><h3>Conclusion</h3><div>Significant gaps in the reproductive health counselling for women with RDs in Kuwait are revealed. Further research is needed to understand the barriers that prevent rheumatologists from providing this important guidance to their patients.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"47 3","pages":"Pages 131-136"},"PeriodicalIF":1.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143844718","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}