Egyptian Rheumatologist最新文献

{"title":"Demographic, clinical and imaging characteristics of axial spondyloarthritis patients","authors":"Nashwa A Morshedy ,&nbsp;Mohamed S Abdelbaky ,&nbsp;Sameh A Hassan ,&nbsp;Noha MG Mohey Eldeen ,&nbsp;Mohamed G Hassan ,&nbsp;Alshymaa M Farouk","doi":"10.1016/j.ejr.2024.04.002","DOIUrl":"https://doi.org/10.1016/j.ejr.2024.04.002","url":null,"abstract":"<div><h3>Background</h3><p>Axial spondyloarthritis (axSpA) is a chronic, immune-mediated inflammatory disorder involving the sacroiliac (SI) joints, spine, entheses and peripheral joints. It encompasses both radiographic (r-axSPA) and non-radiographic (nr-axSPA) axial SpA according to the presence or absence of radiographic sacroiliitis.</p></div><div><h3>Aim of the work</h3><p>To study the demographic features, clinical manifestations and imaging characteristics of axSpA and to assess the differences between r-axSpA and nr-axSpA.</p></div><div><h3>Patients and methods</h3><p>This study was conducted on 80 axSpA patients. All Patients were subjected to detailed medical history, assessment of disease activity, functional status, laboratory investigations and imaging.Bath AS Disease Activity Index (BASDAI), AS disease activity score (ASDAS), Bath AS Functional Index (BASFI) were assessed. Radiographic sacroiliitis was assessed using the Stoke Ankylosing Spondylitis Spinal Score (mSASSS).</p></div><div><h3>Results</h3><p>The 80 axSpA patients were 59 (73.8 %) nr-axSpA and 21 (26.3 %) with r-axSpA. The mean age of the patients was 35 ± 8.6 (18–55 years). 43 (53.8 %) were males and 37 (46.3 %) females and the median disease duration was 6.5 years (0.5–22 years). Human leucocytic antigen was positive in 16.3 % and psoriasis was present in 13.8 %. Smoking (61.9 % vs 20.3 %; p &lt; 0.0001, hip arthritis (47.6 % vs 13.6 %;p = 0.001), ASDAS (3.03 ± 0.64 vs 2.59 ± 0.79; p = 0.02), BASDAI (3.4 ± 1.1 vs 2.7 ± 1.3;p = 0.03), BASFI (4.7 ± 1.1 vs 3.1 ± 1.3; p &lt; 0.0001) and mSASSS (17 vs 0) were significantly higher in r-axSpA.</p></div><div><h3>Conclusion</h3><p>Characteristics of axSpA of Egyptian patients are comparable with those of other patients across the world. By comparing r-axSpA and nr-axSPA patients, both groups are significantly different regarding sex, smoking, hip arthritis, disease activity scores and mSASSS.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140641241","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":"Role of musculoskeletal ultrasonography in the assessment of disease activity in juvenile idiopathic arthritis children","authors":"Tasneem E. El Naggar ,&nbsp;Samah I. Nasef ,&nbsp;Mohsen H. Elshahaly ,&nbsp;Kareem M. El Ashry ,&nbsp;Aziza S. Omar","doi":"10.1016/j.ejr.2024.04.004","DOIUrl":"https://doi.org/10.1016/j.ejr.2024.04.004","url":null,"abstract":"<div><h3>Aim of the work</h3><p>To assess synovitis and disease activity by musculoskeletal ultrasound (MSUS) and clinical examination in children with juvenile idiopathic arthritis (JIA).</p></div><div><h3>Patients and methods</h3><p>Forty-one JIA patients underwent clinical examination of the joints, juvenile arthritis disease activity score (JADAS-27) assessment, and laboratory investigations. Twenty-four joints for each patient were evaluated by MSUS, including knees, wrists, 10 proximal interphalangeal, and 10 metacarpophalangeal. The parameters evaluated were synovial effusion, hypertrophy, effusion plus hypertrophy, tenosynovitis, and subclinical synovitis based on the Outcome Measures in Rheumatology definitions.</p></div><div><h3>Results</h3><p>The mean age of children was 11.7 ± 3.2 years, the disease duration was 4.2 ± 2.6 years and they were polyarticular (n = 22), oligoarticular (n = 12), systemic onset (n = 6) and one had ERA. They were 29 females and 12 males. The mean JADAS27 was 7.7 ± 6.9. The total number of joints assessed clinically and by MSUS was 984. 107 (10.9 %) joints showed clinical findings, while 135 (13.7 %) showed ultrasonographic features of synovitis. On clinical examination, 17 (15.9 %) joints had limited range of motion, and 90 (84 %) joints were tender including 38 (35.5 %) swollen. On MSUS examination, 28 (20.7 %) joints showed synovial effusion, 79 (58.5 %) hypertrophy, and 28 (20.7 %) had both synovial effusion and hypertrophy. Power Doppler signals were detected in 27 joints. MSUS detected subclinical synovitis in 60 (6.1 %) joints. Synovial effusion plus hypertrophy showed moderate concordance with joint swelling (k = 0.42).</p></div><div><h3>Conclusion</h3><p>The MSUS examination has a significant role in the detection of synovitis and the evaluation of disease activity in JIA patients. It is more sensitive than clinical examination.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140604717","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":"Expression of hsa-let-7f-5p and serum levels of interleukin-10, cystatin-C and transforming growth factor-beta in systemic lupus erythematosus patients with lupus nephritis","authors":"Dina M. Mekawy ,&nbsp;Manar M. Abdel-Aziz ,&nbsp;Raghda E. Ibrahim ,&nbsp;Shaimaa A.K. Rady ,&nbsp;Mohamed T. Hegazy ,&nbsp;Reham A. Dwedar ,&nbsp;Reham M. Raafat Hamed","doi":"10.1016/j.ejr.2024.04.005","DOIUrl":"https://doi.org/10.1016/j.ejr.2024.04.005","url":null,"abstract":"<div><h3>Aim of the work</h3><p>To investigate the impact of mi-RNA (hsa-let-7f-5p) expression, levels of cystatin C, serum interleukin-10 (IL-10), and transforming-growth-factor-beta (TGF-β) in systemic lupus erythematosus (SLE) patients with and without lupus nephritis (LN).</p></div><div><h3>Patients and methods</h3><p>The work included 60 SLE patients: thirty with and thirty without LN, along with thirty matched controls. The SLE disease activity index (SLEDAI) was assessed. Enzyme-linked-immunosorbent-assay (ELISA) was used to evaluate serum levels of TGF-β, IL-10, and Cystatin-C and expression of mi-RNA Let-7f-5p quantified using real-time polymerized-chain-reaction (PCR).</p></div><div><h3>Results</h3><p>The mean age of LN patients was 31.6 ± 8.4 years, twenty-eight females and 2 males. mi-RNA Let-7f-5p, serum TGFβ, IL10, and cystatin C were significantly higher in those with LN (4.4 ± 2, 357.6 ± 50.8 ng/mL, 173.1 ± 18 pg/mL and 8.03 ± 1.96 ng/mL) compared to case without (2.5 ± 0.92, 319.7 ± 44.4 ng/mL, 108.8 ± 22.8 pg/mL, and 3.43 ± 1.1 ng/mL) and control (1.03 ± 0.07, 210.3 ± 18.6 ng/mL, 56 ± 18.5 pg/mL and 2.53 ± 1.1 ng/ml)(p &lt; 0.001). In LN, mi-RNA Let-7f-5p and IL10 were significantly different in those with oral ulcers (n = 8)(p = 0.03, and p = 0.01 respectively). mi-RNA Let-7f-5p and TGF-β were significantly lower in those with headache (n = 3)(p &lt; 0.001, and p = 0.04 respectively). In patients without LN, TGF-β was significantly lower in those with malar rash (n = 10)(p = 0.04) and serum cystatin-C was lower in those with arthritis (n = 12)(p = 0.02). In LN, IL-10 significantly correlated with disease duration (r = 0.38,p = 0.04) and cystatin-C inversely with platelets (r = -0.42,p = 0.02), Cystatin-C correlated with mi-RNA Let-7f-5p (r = 0.45,p = 0.01) and inversely with SLEDAI (r = -0.44,p = 0.01).</p></div><div><h3>Conclusion</h3><p>The potential role of mi-RNA Let-7f-5p on LN with the possible involvement of TGFβ, IL10, and cystatin-C in the pathophysiology of both SLE and LN.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140618611","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":"Clinical characteristics of systemic lupus erythematosus in Al Qassim region of Saudi Arabia","authors":"Ahmad AlShomar ,&nbsp;Idris Sula ,&nbsp;Hussam A. Alsulmi ,&nbsp;Mohamed Mahmoud Bakr","doi":"10.1016/j.ejr.2024.04.003","DOIUrl":"https://doi.org/10.1016/j.ejr.2024.04.003","url":null,"abstract":"<div><h3>Aim of the work</h3><p>The aim of the study is to explore the clinical manifestations, laboratory findings, and management of systemic lupus erythematosus (SLE) patients in Al Qassim region of Saudi Arabia.</p></div><div><h3>Patients and methods</h3><p>The clinical data, laboratory investigations, medications received and co-morbidities from SLE patients in Al Qassim region of Saudi Arabia were recorded.</p></div><div><h3>Results</h3><p>The 96 SLE patients were 87 (90.63 %) Saudi. 83 (86.5 %) were females and 13 (13.5 %) males (F:M 6.3:1). The mean age of the patients was 37.4 ± 11.9 years; at time of diagnosis was 32.3 ± 11.1 years, disease duration 5.1 ± 5.8 years. 9.3 % were hypertensive. The most common clinical manifestations were musculoskeletal (79 %) and constitutional (77 %) followed by mucocutaneous (42 %). Lupus nephritis was diagnosed in 25 % of patients and was confirmed by renal biopsy in 13.5 %. 4.2 % had thromboembolic disorders. Co-morbidities were present in 25 % and pregnancy complications were reported in 18 % of the females. Anemia was present in 63.5 %, leukopenia in 20 % and thrombocytopenia in 15 %. All patients tested positive for antinuclear antibodies, 80 % positive for anti-double-stranded deoxyribonucleic acid and 42.7 % anti-Smith. Antiphospholipid antibodies were detected in 46 % of patients and rheumatoid factor in 15.6 %. 93.8 % of patients received hydroxychloroquine, 76 % received steroids, 29.2 % mycophenolate mofetil, 4 patients received rituximab and 3 belimumab.</p></div><div><h3>Conclusion</h3><p>The most common clinical disease profile in SLE patients from AlQassim was musculoskeletal and constitutional symptoms. 25 % of the patients had LN and 25 % had co-morbidities. Anemia is a common laboratory finding, and hydroxychloroquine is the most common treatment.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140604716","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":"Pattern of uveitis in Behçet’s disease patients from a highly specialized university hospital-based tertiary care eye unit","authors":"Radwa Elzanaty ,&nbsp;Amr M.A. Wassef ,&nbsp;Mina Seif ,&nbsp;Mariam Fadel","doi":"10.1016/j.ejr.2024.04.001","DOIUrl":"https://doi.org/10.1016/j.ejr.2024.04.001","url":null,"abstract":"<div><h3>Aim of the work</h3><p>To determine the frequency and pattern of ocular manifestations including uveitis associated with Behcet’s disease (BD) in patients referred to a hospital-based tertiary care eye unit.</p></div><div><h3>Patients and methods</h3><p>This study included BD patients referred to the Uveitis Clinic, Cairo University Hospitals. Patterns of systemic and ocular disease were documented. Treatment and complications occurring during follow-up were added.</p></div><div><h3>Results</h3><p>The study included 113 patients (208 eyes). 86 % were males and 14 % females. Their mean age was 32.1 ± 9.5 years. Time lapse from diagnosis to referral was 3.8 ± 4.9 years. 15.9 % had unilateral eye involvement and 84.1 % bilateral. Most common presentation was panuveitis in 64.4 % of eyes, whereas 22.6 % presented with isolated posterior uveitis and 12 % with anterior uveitis. Vasculitis was a common finding at presentation in 27.4 %. During the course of ocular disease the most frequent complication was cataract in 27.4 % and 33 % of patients did not develop complications. At presentation, 47.6 % of eyes were worsening despite treatment, 28.8 % were stationary, 16.3 % were controlled and 7.2 % were improving. The mean best corrected visual acuity dropped from 0.48 ± 2.36 to 0.29 ± 0.32 between presentation and last follow up. Visual acuity was significantly reduced in those with panuveitis and optic neuritis (p &lt; 0.001). End-stage eye disease was present in 7.2 % at presentation.</p></div><div><h3>Conclusion</h3><p>Ocular Behcet’s is a frequent finding, especially panuveitis. Retinal vasculitis is not uncommon. Delayed referral to tertiary care eye unit remains a loop hole in the health care system. Cataract is a common complication during the course of the disease.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140557745","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":"Transforming growth factor-β1 gene polymorphism in systemic lupus erythematosus female patients","authors":"Maha A. AbouelAzm ,&nbsp;Samia M.H. Fadda ,&nbsp;Noha A. Doudar ,&nbsp;Shaimaa A.K. Rady","doi":"10.1016/j.ejr.2024.03.002","DOIUrl":"https://doi.org/10.1016/j.ejr.2024.03.002","url":null,"abstract":"<div><h3>Aim of the work</h3><p>To investigate whether transforming growth factor beta-1 (TGF-β1) (rs1800469) single nucleotide polymorphism (SNP) is associated with systemic lupus erythematosus (SLE) susceptibility and/or activity in Egyptian patients.</p></div><div><h3>Patients and methods</h3><p>This work included 70 SLE female SLE and 70 matched control. The SLE disease activity index (SLEDAI) and systemic lupus international collaborative clinics damage index (SLICC-DI) were assessed. The Taq Man allelic discrimination technique was applied for the genotyping of TGF-β1 (rs1800469) (SNP).</p></div><div><h3>Results</h3><p>The mean age of the patients was 29.9 ± 9 years, disease duration 4.29 ± 4.33 years and 4 (5.7 %) cases were juvenile. The antinuclear antibody was positive in all patients, anti-double stranded deoxyribonucleic acid in 57.1 %, the SLEDAI was 15.6 ± 7.8 (4–38) and SLICC-DI 0.3 ± 0.6 (0–3). Frequency of the AA genotype (n = 9) was higher in patients with discoid rash (n = 3, 33.3 %) than the GG genotype (n = 4/34, 11.7 %)(p = 0.01). Patients had a comparable frequency of the GG (48.6 % vs 50 %), GA (38.6 % vs 37.1 %) and AA (12.9 % vs 12.9 %) genotypes compared to the control (p = 0.98). There was no significant difference detected regarding the distribution of genotypes according to the SLEDAI (p = 0.66) and SLICC-DI (p = 0.96).</p></div><div><h3>Conclusion</h3><p>There was no association between the TGF-β1 gene (rs1800469) A/G SNP and disease activity and damage. The carriers of the GG variant of TGF-β1 rs1800469 SNP may be at higher risk of developing specific clinical manifestations such as discoid rash.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140557746","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":"Sleep disorders in rheumatoid arthritis patients","authors":"Mouna Brahem ,&nbsp;Azer Chebil ,&nbsp;Hayfa Abid ,&nbsp;Olfa Jomaa ,&nbsp;Rihab Sarraj ,&nbsp;Besma Jebali ,&nbsp;Sirine Abdellatif ,&nbsp;Amani ben Salem ,&nbsp;Haifa Hachfi ,&nbsp;Khalifa Mighri ,&nbsp;Mohamed Younes","doi":"10.1016/j.ejr.2024.03.001","DOIUrl":"https://doi.org/10.1016/j.ejr.2024.03.001","url":null,"abstract":"<div><h3>Aim of the work</h3><p>To determine the frequency of sleep disturbances in patients with rheumatoid arthritis (RA) and to identify associated factors.</p></div><div><h3>Patients and methods</h3><p>This study included 100 RA patients. The disease activity score (DAS28), tender joint count (TJC), swollen joint count (SJC), Visual Analog Scale (VAS)-pain and Health Assessment Questionnaire (HAQ) were assessed. Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI) were used to assess sleep quality.</p></div><div><h3>Results</h3><p>The patients were 89 females and 11 males, mean age 53.2 ± 11.2 years (21–76 years) and disease duration was 11.1 ± 8.9 years (1–40 years).The meanTJC was 8.5 ± 7.9 (0–24), SJC 4 ± 4.8 (0–24) and VAS 51 ± 21 mm (10–90 mm). Their mean DAS28 was 3.9 ± 1.1 (1–6.15) and HAQ 1.3 ± 0.7 (0–2.9). The ESS was 7.9 ± 5.6 (0–24). 28 % of patients had signs of daytime sleepiness (ESS ≥ 11 points) with a significant association with female sex (p = 0.03), TJC (p = 0.03), SJC (p = 0.02), DAS28 (p = 0.05), VAS (p = 0.04) and HAQ (p &lt; 0.01). The mean Pittsburgh score was 6.9 ± 5.1 (0–19). 51 % of patients had disturbed sleep (PSQI &gt; 5.5 points). The most disturbed components were respectively sleep latency (1.5 ± 1.1), subjective sleep quality (1.25 ± 0.8) and sleep disorders (1.19 ± 0.8). Disturbed sleep assessed by PSQI had a significant association with TJC (p &lt; 0.01), SJC (p &lt; 0.01), C-reactive protein, nocturnal awakening (p &lt; 0.01), DAS28 (p &lt; 0.01), VAS-pain (p &lt; 0.01), HAQ (p &lt; 0.01), and corticosteroid intake (p = 0.01).</p></div><div><h3>Conclusion</h3><p>Half of the patients had sleep disorders with a significant association with disease activity parameters which underline the importance of ensuring remission or low level of activity to improve the quality of sleep of patients.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140533878","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":"Rheumatoid arthritis presentation in elderly patients: How different from the usual presentation?","authors":"Rahma A. Elziaty ,&nbsp;Aya M. Sayed ,&nbsp;Ahmed A. Khalifa","doi":"10.1016/j.ejr.2024.02.004","DOIUrl":"https://doi.org/10.1016/j.ejr.2024.02.004","url":null,"abstract":"<div><h3>Aim of the work</h3><p>This work aimed to compare the outcomes between elderly- and younger-onset rheumatoid arthritis (EORA and YORA, respectively).</p></div><div><h3>Patients and methods</h3><p>This study included 140 RA patients recruited from the rheumatology outpatient clinic of Ain Shams University Hospitals. The study included 70 EORA (&gt;60 years) patients and a similar number of YORA (&lt;60 years) cases. Both groups were compared based on demographic data, clinical manifestations, disease activity markers, and drug history.</p></div><div><h3>Results</h3><p>Large joint arthritis and myalgia were higher in the EORA group (p &lt; 0.0001) while small joint arthritis was higher in the YORA (p &lt; 0.0001). The frequency of interstitial lung disease (ILD), rheumatoid nodules, and deformities was higher in the YORA group (p = 0.03, p = 0.03, and p = 0.02 respectively). Anti-citrullinated protein antibody (ACPA) positivity and erythrocyte sedimentation rate (ESR) were higher in YORA (p = 0.01). The disease activity scores (DAS28, SDAI, and CDAI) were higher in the YORA than in the EORA (p &lt; 0.0001). YORA were significantly receiving sulfasalazine (34.3 %) and hydroxychloroquine (84.3 %) at a higher frequency than EORA (67.1 % and 8.6 %, p &lt; 0.0001 and p = 0.02 respectively) while EORA were more receiving leflunomide (57.1 % vs 40 %; p = 0.04). Biologic therapy was received only by YORA patients.</p></div><div><h3>Conclusion</h3><p>EORA presents with distinct features from YORA, including a more insidious onset with myalgia and large joint affection making the diagnosis more challenging. EORA has a lower severe course with less deformities and disease activity with a tendency to be controlled by a single DMARD rather than combinations or biologics.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140069425","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":"Estrogen receptor ß is high in the minor salivary glands of female patients with primary Sjögren's syndrome","authors":"Ahmet Kor ,&nbsp;Aydan Kılıçarslan","doi":"10.1016/j.ejr.2024.02.005","DOIUrl":"https://doi.org/10.1016/j.ejr.2024.02.005","url":null,"abstract":"<div><h3>Aim of the work</h3><p>This study aimed to investigate the expression levels of estrogen receptor (ER) beta (ß) and alpha (α) in the minor salivary gland tissues of patients with primary Sjögren's syndrome (pSS), which has a female predominance and reaches its highest incidence at menopause.</p></div><div><h3>Patients and methods</h3><p>Sixty-six female pSS patients and 23 matched control were studied. The ER ß and α expressions from salivary gland tissues were immunohistochemically evaluated. The European League Against Rheumatism (EULAR) Sjögren's syndrome disease activity index was assessed.</p></div><div><h3>Results</h3><p>The 66 female pSS patients had a mean age of 50.1 ± 13.4 years. The ESSDAI was 7 (9–13). The ER ß expressions of the salivary gland were significantly higher in pSS patients than in control both ductal (B: 0.68, OR 1.97, 95 %CI 1.34–2.88, p = 0.001) and acinar (B: 2.18, OR 8.87, 95 %CI 2.34–33.6, p = 0.001). Lymphocytes in the salivary gland infiltrate of pSS cases expressed high levels of ER ß (8, 6–8). Expression of ERα was not detected in the minor salivary gland ductal and acini epithelium and lymphocytes of pSS and control. No significant relationship was found between ER ß expression levels and complement, rheumatoid factor, immunoglobulin G, anti-nuclear antibody, the ESSDAI and the presence of menopause in pSS patients.</p></div><div><h3>Conclusion</h3><p>pSS patients have higher salivary gland ER ß expression (ductal and acinar epithelial) than controls, and lymphocytes infiltrating the salivary gland in pSS express high levels of ER ß. This study showed that salivary gland ER expression levels in pSS are different from controls, regardless of disease activity.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140014336","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":"Retinal vasculitis in two patients with rheumatoid arthritis: A case-based review","authors":"Saoussen Miladi,&nbsp;Ons Boudriga,&nbsp;Alia Fazaa,&nbsp;Hiba Boussaâ,&nbsp;Kawther Ben Abdelghani,&nbsp;Ahmed Laatar","doi":"10.1016/j.ejr.2024.02.006","DOIUrl":"https://doi.org/10.1016/j.ejr.2024.02.006","url":null,"abstract":"<div><h3>Background</h3><p>Rheumatoid arthritis (RA) is a systemic autoimmune disease that can be associated with extra-articular manifestations including vasculitis that occurs exceptionally in the retina.</p></div><div><h3>Aim of the work</h3><p>To present two active RA cases with retinal vasculitis (RV) and compare them to similar cases presented worldwide.</p></div><div><h3>Case presentations</h3><p>The first case was a 44-year-old male patient with seropositive and erosive RA with a sudden bilateral blurred vision and myodesopsias and developed bilateral occlusive venous RV. It occurred concomitantly with an increased disease activity (disease activity score 4.4) that was treated with high doses of prednisolone. Then the patient had a recurrence of RV with another flare-up of his RA disease. Workup of RV included markers of infection, antinuclear antibody (ANA) and anti-neutrophil cytopasmic antibody (ANCA) and all were negative. The patient received pulse intravenous corticosteroids and was transitioned to oral steroids with the addition of methotrexate 20 mg/week with a favorable outcome. The second case was a 33-year-old female with history of bilateral retinal detachment treated surgically, followed for seronegative non-erosive RA. She presented with left RV complicated by a preretinal hemorrhage. Workup of RV included markers of infection and autoimmune markers were negative. A magnetic resonance imaging (MRI) hands showed bony erosions at the metacarpophalangeal joints with bilateral active synovitis. Systemic steroids were initiated with articular and visual improvement.</p></div><div><h3>Conclusion</h3><p>The retina should be examined for evidence of vasculitis in RA and RV should be kept in mind as an<!--> <!-->ocular complication or association.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140014335","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}