Egyptian Rheumatologist最新文献

{"title":"Implications of blood indices in systemic lupus erythematosus patients: Two feasible determinants of disease activity and lupus nephritis","authors":"Samar A. Aldakhakhny ,&nbsp;Hossam A. Hodeeb ,&nbsp;Nagat M. El-Gazzar ,&nbsp;Shereen Elwan","doi":"10.1016/j.ejr.2023.04.006","DOIUrl":"https://doi.org/10.1016/j.ejr.2023.04.006","url":null,"abstract":"<div><h3>Aim of the work</h3><p>To investigate whether or not neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) may by indicators of disease activity in systemic lupus erythematosus (SLE) with and without lupus nephritis (LN).</p><p>Patients and methods</p><p>This research was carried out on 40 adult SLE patients (20 with LN and 20 without) and 20 controls. The NLR and PLR were calculated. The SLE disease activity index (SLEDAI) was assessed.</p><p>Results</p><p>The mean age of the patients was 36.2 ± 7.6 years, 38 females and 2 males (F:M 19:1), with a disease duration of4.3 ± 1.2 years. The mean SLEDAI was 15.1 ± 4.7 being significantly higher in those with LN (17.5 ± 3.5) compared to those without (12.6 ± 4.6) (p = 0.001). The mean NLR (6.1 ± 2.1) and PLR (236.6 ± 86.9) were significantly increased in patients compared to the control (2.7 ± 1.2 and 125.2 ± 38.8 respectively) (p &lt; 0.001). The NLR and PLR were both significantly related to the serum creatinine (r = 0.35, p = 0.03 and r = 0.5, p = 0.001) and SLEDAI (r = 0.36, p = 0.03 and r = 0.34, p = 0.03 respectively). NLR can significantly predict activity of SLE at cut off 5.6 with a sensitivity 80%, specificity 65% (p = 0.007) and PLR at cut off 217 with sensitivity 75%, specificity 65% (p = 0.035). The NLR can significantly predict LN at cut off 3.6 (sensitivity 80%, specificity 40%; p = 0.007) and PLR at cut off 186 (sensitivity 70%, specificity 60%; p = 0.035).</p><p>Conclusion</p><p>There is a remarkable link between PLR and NLR with SLEDAI. Thus, both may serve as promising affordable indicators of inflammation in SLE. The notable relation to LN may signal renal involvement in patients with SLE.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49790448","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":"AFF1 and STAT4 genes polymorphism in Egyptian systemic lupus erythematosus patients: Association with disease development and activity","authors":"Alaa A. Awad ,&nbsp;Abeer A. Fikry ,&nbsp;Dalia Shaheen ,&nbsp;Hisham Habib","doi":"10.1016/j.ejr.2023.03.008","DOIUrl":"https://doi.org/10.1016/j.ejr.2023.03.008","url":null,"abstract":"<div><p><strong>Aim of the work:</strong> To assess the possible association of ALF transcription elongation factor 1 (AFF1)(rs340630) and signal transducer and activator of transcription 4 (STAT4)(rs7582694) genes polymorphism in Egyptian systemic lupus erythematosus (SLE) cases and their relation with disease activity. <strong>Patients and methods:</strong> The study included 103 SLE patients and 103 matched controls. SLE disease activity index (SLEDAI-2 K) was assessed. Genotyping was implemented with amplification refractory mutation system polymerase chain reaction (PCR) for AFF1 and allele-specific multiplex PCR for STAT4. <strong>Results:</strong> The median age of the patients was 38 years, disease duration was 7 years and were 97 females and 6 males (F:M 16.2:1). The median SLEDAI-2 K was 5. AFF1 ‘G’ allele was associated with SLE at 1.52 higher odds ratio (p = 0.042). AFF1 genotypes showed no significant association with existence of SLE (p = 0.08). In SLE patients with A/A genotype, seizures (28.6 %), pleurisy (42.9 %), consumed C3 (85.7 %) and consumed C4 (71.4 %) was significantly more frequent compared to G/A (5.7 %,7.5 %, 56.6 % and 39.6 %) and G/G (0 %, 9.3 %, 39.5 % and 14 % respectively; p = 0.01,p = 0.046,p = 0.04 and p = 0.001). There was a significant association between STAT4 gene polymorphism and the 'C' allele with the occurrence of SLE (p = 0.005 and p &lt; 0.001 respectively). No significant difference was found in clinical manifestations, laboratory investigations or disease activity among STAT4 genotypes. <strong>Conclusion:</strong> STAT4 polymorphism revealed a significant association with increased SLE risk. However, AFF1 ‘polymorphism showed no significant association with existence of SLE. No significant difference was found in the proportions of AFF1 and STAT4 genotypes among activity grades of SLE.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49790447","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":"Calcinosis cutis in a patient with systemic lupus erythematosus: Case-based review","authors":"Ivan R. Jeremic ,&nbsp;Bojana Simeunovic ,&nbsp;Slavica Pavlov Dolijanovic ,&nbsp;Emilija Manojlovic Gacic","doi":"10.1016/j.ejr.2023.09.003","DOIUrl":"https://doi.org/10.1016/j.ejr.2023.09.003","url":null,"abstract":"<div><h3>Background</h3><p>Dystrophic calcinosis cutis (CC) is rarely observed in systemic lupus erythematosus (SLE).</p></div><div><h3>Aim of the work</h3><p>To present a case of SLE with a rare cutaneous complication of generalised form of dystrophic CC, most prominent in right infragluteal region, which led to abscess formation.</p><p>Case presentation</p><p>A 36-years old female with SLE was admitted to the Institute of rheumatology in Belgrade due to worsening of her condition and post-coronavirus disease 2019 (COVID-19) neck vein thrombosis. She was febrile (up to 38.5 °C) and had fatigue, extensive erythema, livedo reticularis and palpable “orange-peel” skin indurations extending symmetrically to infragluteal, suprapatellar, suprapubic and calf regions. Right infragluteal region had skin inflammation signs with fluctuating central lesion. Her laboratory findings were significant for markedly elevated acute phase reactants. Skin ultrasound showed signs of panniculitis with hypodermal hyperechogenicity and posterior acoustic attenuation. Radiography findings were significant for extensive calcifications in the buttock and knee soft tissue areas and it was confirmed on histopathology of the biopsy. She was started with triple antibiotics (cephtriaxone, ciprofloxacin and metronidazole), high corticosteroids, low molecular weight heparin (LMWH) and the abscess was incised. After resolution of skin infection her immunosuppressive therapy was modified considering her SLE condition, vein thrombosis and calcinosis cutis<em>.</em></p></div><div><h3>Conclusion</h3><p>Calcinosis cutis is a serious skin complication of SLE as it could predispose to infection. Various pharmacological therapeutic approaches are applied with modest success.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49790359","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":"Double risk of interleukin-37 rs3811047 A allele polymorphism with lupus nephritis in an Egyptian population","authors":"Samah I. Nasef ,&nbsp;Hamdy H. Omar ,&nbsp;Alia Ellawindy ,&nbsp;Hanan H. Omar ,&nbsp;Asmaa A. Hashem ,&nbsp;Noha M. Abd El-Fadeal ,&nbsp;Marwa G. Tawfik","doi":"10.1016/j.ejr.2023.08.005","DOIUrl":"https://doi.org/10.1016/j.ejr.2023.08.005","url":null,"abstract":"<div><h3>Aim of the work</h3><p>To investigate the association of interleukin-37 (IL-37)(rs3811047) polymorphism with lupus nephritis (LN) in systemic lupus erythematosus (SLE) patients.</p></div><div><h3>Patients and methods</h3><p>The case-control study included 206 SLE patients, 97 with LN and 109 without LN, and 240 healthy controls. SLE disease activity index (SLEDAI) was assessed. Genotyping of the IL-37 (rs3811047) polymorphism was done using real time polymerase chain reaction (PCR). A bioinformatic analysis of IL-37 was also performed.</p></div><div><h3>Results</h3><p>The mean ages of SLE patients were 32.82 ± 10.43 years and female: male was 195:11 (F:M 17.7:1). The SLEDAI was significantly higher in the patients with LN (7.9 ± 6.6) compared to those without (1.9 ± 1.8) (p &lt; 0.001). The AA genotype was more frequently represented in patients with LN (21.6%) compared to those without (7.3%) (p = 0.007), and carriers of AA genotype had four times increased susceptibility to acquire LN compared to GG and GA (OR: 4.1). Likewise, the A allele was more represented in patients with LN (43%) than in those without (30%)(p = 0.004), and the carriers of the A allele had nearly two times more risk of developing LN compared to carriers of G allele (OR: 1.79).The AA genotype was associated with LN susceptibility under the recessive genetic model (p = 0.002). Regression analyses revealed that A allele is an independent risk factor of proteinuria (p &lt; 0.001), disease activity (p &lt; 0.001), consumed C3 (p &lt; 0.001) and C4 (0.003).</p></div><div><h3>Conclusion</h3><p>The AA genotype of the IL-37 (rs3811047) SNP contributes to the development of SLE in Egyptian patients with a doubled risk of acquiring LN in carriers of the allele A.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49790389","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":"Coronavirus disease 2019 (COVID-19) infection in patients with rheumatic diseases: Clinical characteristics and relation to anti-rheumatic therapy","authors":"Fatma M. Aboud ,&nbsp;Shaimaa S. Yousef ,&nbsp;Mona M. El Bably ,&nbsp;Rasha N. Thabet","doi":"10.1016/j.ejr.2023.08.003","DOIUrl":"https://doi.org/10.1016/j.ejr.2023.08.003","url":null,"abstract":"<div><h3>Background</h3><p>Rheumatic disease (RD) patients are risky to severe coronavirus disease-2019 (COVID-19) infection, however, antirheumatic drugs may treat the infection and improve the outcome.</p></div><div><h3>Aim of the work</h3><p>To describe the clinical manifestations of COVID-19 infection in patients with rheumatic diseases and to investigate the relationship with antirheumatic therapy.</p></div><div><h3>Patients and methods</h3><p>The study included 215 RD patients. Patients' clinical characteristics and medications received were recorded as well as history of COVID-19 infection.</p></div><div><h3>Results</h3><p>The RD patients had systemic lupus erythematosus (SLE) (40.5%), rheumatoid arthritis (35.8%), psoriatic arthritis (PsA) (7.4%), ankylosing spondylitis (AS) (5.1%), gout (4.2%), systemic sclerosis (SSc) (3.3%), dermatomyositis (1.9%), Behςets disease (1.4%) and adult-onset Stills disease (0.5%). COVID-19 infection was reported in 124 (57.7%) RD patients. Body-ache was the commonest manifestation (n = 116;93.5%) followed by headache (n = 97;78%), fever (n = 90;72.5%). Infected patients were significantly older, with higher frequency of diabetes and hypertension without significant difference regarding type of RD or treatment except for lower frequency of biologics (n = 7;5.7%) compared to noninfected (n = 22;24.2%)(p &lt; 0.001) patients. 95(76.6%) received home treatment, 27(21.7%) were hospitalized and 2(1.6%) needed intensive care. Hospitalized patients were significantly older (p &lt; 0.001), had longer disease duration (p = 0.017), higher frequency of diabetes/hypertension (p &lt; 0.001) and lower frequency of azathioprine intake (p &lt; 0.034). Recovery period significantly correlated with disease duration (r = 0.197,p = 0.028) and age (r = 0.392,p &lt; 0.001).</p></div><div><h3>Conclusion</h3><p>Body-aches, headache and fever were the commonest symptoms of COVID-19 infection in RD patients. Most infections were mild. Severe infection was related to older age, longer disease duration, diabetes and hypertension. The RDs and therapy were not associated with COVID-19 infection outcome.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49790358","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 features, radiological characteristics, and outcome of coronavirus disease-2019 (COVID-19) infection among hospitalized patients with autoimmune and rheumatic diseases: A multicenter study","authors":"Samar Tharwat ,&nbsp;Gehad A. Saleh ,&nbsp;Haidy Ali Mohammed ,&nbsp;Mohammed Kamal Nassar ,&nbsp;Marwa Saleh ,&nbsp;Esraa Jamal ,&nbsp;Shaimaa El-Ashwah","doi":"10.1016/j.ejr.2023.09.004","DOIUrl":"https://doi.org/10.1016/j.ejr.2023.09.004","url":null,"abstract":"<div><h3>Background</h3><p>A general comprehension of coronavirus disease-2019 (COVID-19) characteristics in patients with autoimmune and/or rheumatic diseases (ARDs) is required</p></div><div><h3>Aim of the work</h3><p>To identify COVID-19 infection characteristics in hospitalized patients with ARDs and identify factors contributing to mortality in this population.</p></div><div><h3>Patients and methods</h3><p>This study enrolled symptomatic ARD patients with COVID-19 infection and a control group of COVID-19 infected subjects matched in age and gender. Clinical and laboratory data were obtained, and chest computerized tomography images were analyzed for severity using COVID-19 Reporting and Data System (CO-RADS) and CT total severity score (CT-TSS).</p></div><div><h3>Results</h3><p>The study included 50 ARD patients and 29 controls with COVID-19 infection. The ARD patients mean age was 49.8 ± 16.3 years and demonstrated a significant association with fever (p = 0.004), fatigue (p = 0.007), cough (p &lt; 0.001), higher levels of serum bilirubin (p = 0.003), serum creatinine (p = 0.051) and D-dimer (p = 0.001). ARD patients were more frequently admitted to the intensive care unit (40% vs 10.3%, p = 0.005) and tended to have a higher mortality rate (32% vs 13.8%, p = 0.11). Ground glass opacity was the predominant pattern in ARD patients (74% vs 37.9%), while consolidation was predominant in the control (55.2% vs 20%). The respiratory rate (p = 0.002), oxygen saturation (p = 0.005), ICU admission (&lt;0.001) and pulmonary consolidation (p &lt; 0.001), CO-RADS (p = 0.03) and CT-TSS (p &lt; 0.001) were significant predictors of mortality. CO-RADS predicts at cut off 4.5 (sensitivity 56.3%, specificity 70.6%) and CT-TSS at cut off 7.5 (sensitivity 75%, specificity 82.4%).</p></div><div><h3>Conclusions</h3><p>In-hospital mortality is high in COVID-19 patients with ARDs and many predictors are determined.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49790360","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 and electrophysiological characteristics of peripheral neuropathy in Cuban systemic lupus erythematosus patients","authors":"Elena Noris-García ,&nbsp;Yanaisy Alvarez ,&nbsp;Bárbara A. Hernández ,&nbsp;Carlos O. Mitjáns ,&nbsp;María A. Robinson-Agramonte ,&nbsp;Diego O. Souza ,&nbsp;Carlos A. Gonçalves","doi":"10.1016/j.ejr.2023.06.002","DOIUrl":"https://doi.org/10.1016/j.ejr.2023.06.002","url":null,"abstract":"<div><h3>Background</h3><p>Peripheral neuropathy (PN) is one of the most heterogeneous and poorly understood or characterized manifestations in systemic lupus erythematosus (SLE). The aim of this study was to describe the clinical and electrophysiological features, and neuropathic disease associations, in Cuban SLE patients.</p></div><div><h3>Patients and methods</h3><p>One hundred and two consecutive SLE patients admitted to the Psychoneuroimmunology service at the National Institute of Nephrology were included in the study. Patients with other disorders known to cause neuropathy were excluded. Demographic, clinical and laboratory data were obtained using a pre-defined questionnaire. Nerve conduction studies were carried out in both upper and lower limbs. Neuropathy was defined as the presence of clinical symptoms and/or signs and bilateral abnormal nerve conduction study parameters.</p></div><div><h3>Results</h3><p>The 102 patients were 99 females and 3 males with mean age of 46 ± 12 years and disease duration 8 ± 9 years. PN was found in 55/102 (53.9%) patients; 48 (87.3%) had clinical peripheral neuropathy manifestations and 7 (12.7%) were asymptomatic. Nerve conduction studies suggested asymmetric axonal-demyelination neuropathy pattern. Mixed sensory-motor neuropathy was the most common involvement in 23(41.8%) cases. The most frequent pattern was polyneuropathy. Compared to those without neuropathy, SLE-related polyneuropathy patients were significantly older, but had no other significant associations with demographic, disease duration or serological/immunological data.</p></div><div><h3>Conclusion</h3><p>Peripheral nervous system manifestations are common in SLE; may be related to an increased susceptibility of peripheral nerves to effects of aging. Nerve conduction studies are recommended, therefore, for inclusion in the follow-up of SLE patients especially in the older population.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49790385","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":"Contraceptive use in women of childbearing ability with rheumatoid arthritis: A university hospital-based survey","authors":"Ibtisam M.A. Jali","doi":"10.1016/j.ejr.2023.09.005","DOIUrl":"https://doi.org/10.1016/j.ejr.2023.09.005","url":null,"abstract":"<div><h3>Aim of the work</h3><p>The study aimed to determine the pattern of contraceptive use in rheumatoid arthritis (RA) patients in Saudi Arabia.</p></div><div><h3>Patients and methods</h3><p>This study was conducted among women with RA and childbearing ability who were seen at rheumatology clinics in King Abdul-Aziz University Hospital (KAUH) through a survey on the medications received and contraceptive method used.</p></div><div><h3>Results</h3><p>Their mean age was 27.5 ± 4.6 years and had disease duration of 3.6 ± 0.9 years. Rheumatoid factor and anti-cyclic citrullinated peptide are positive. 29.2% of the patients were illiterate and only 8.2% attended high school. Of the 158 women, 36 (86.1%) were Saudis. Methotrexate was received alone (19.6%) or in various combinations in the rest of the patients (80.4%). 109 (69%), used combined oral pills, 38 (24%) used intra-uterine device (IUD) while 7 (11%) used non-medical methods of contraception such as using condoms, withdrawal and abstinence. Using combined oral pills were used significantly more among Saudis (72.1% vs 50%) as well as IUDs (27.2% vs 4.5%)(p &lt; 0.0001), and those who attended middle school significantly used more combined oral pills (80.4%) while those with high school used more IUDs (38.5%) (p = 0.01).</p></div><div><h3>Conclusion</h3><p>The commonest contraceptive method was oral contraceptives in female RA patients. However, a considerable percentage used IUD. There is a need for effective contraceptive counseling as part of routine chronic disease care and that will improve childbearing women’s contraceptive knowledge and contraceptive choice. This could be the key to decrease unintended pregnancies among these women.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49790391","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":"Rheumatological manifestations in patients with malignancies: Relation to immune modulation therapy","authors":"Nouran M. Elshahat ,&nbsp;Howaida E. Mansour ,&nbsp;Amina BadrEldin ,&nbsp;Maryam A. Abdel Rahman ,&nbsp;Lobna R. Ezz El Arab ,&nbsp;Nermeen N. Aziz","doi":"10.1016/j.ejr.2023.09.001","DOIUrl":"https://doi.org/10.1016/j.ejr.2023.09.001","url":null,"abstract":"<div><p>Background: The relation between malignancies and rheumatic diseases (RDs) is complex with commonly shared symptoms. Rheumatological manifestations of malignancies may present as paraneoplastic syndromes and could follow chemotherapy. Aim of the work: to investigate rheumatic manifestations of patients with hematologic or solid malignancies and the relation to immune-modulation therapy. Patients and methods: The study included 25 patients with hematological and another 25 with solid malignancies. Patients were subjected to medical history, recording medications received, musculoskeletal examination and laboratory assessment. Results: The mean age and F:M of patients with hematological (43.7 ± 16.04 y and F:M 1.5:1) was significantly lower than those with solid (53.6 ± 14.3 y and F:M 7.3:1) malignancies (p = 0.025 and p = 0.024). Rheumatological manifestations as the first presentation was significantly higher in patients with haematological (60%) compared to solid (20%) malignancies (p = 0.004). Articular involvement was the commonest rheumatological manifestation (72%) followed by mucocutaneous (18%), oral/genital ulcers (10%), thromboembolic events (10%), Raynauds (8%), dry eyes (8%), myositis (6%) and myalgia (4%). The total leucocytic count and serum uric acid were significantly lower in patients with solid tumors (p = 0.045 and p = 0.026 respectively) and autoimmune markers were similar. Dry eye (16.7%), oral/genital ulcers (20.8%) and Raynaud‘s (16.7%) was present only in patients receiving anti-cancer treatment (n = 24). Paradoxically, arthritis was more frequent in those not receiving chemotherapy (n = 17) while myalgia (25%) was evident in those receiving checkpoint inhibitors (n = 8). Conclusion: Rheumatological manifestations occur with solid and hematological malignancies before or throughout the disease course and the most frequent was articular. Myalgia was associated with checkpoint inhibitors.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49790393","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":"Vitamin D level in ankylosing spondylitis male patients: A potential association with the functional status and platelet count","authors":"Esra M. Al-Naggar ,&nbsp;Shereen S. El-Sawy ,&nbsp;Doaa M Abdo ,&nbsp;Doaa H. Attia ,&nbsp;Wael S ElSawy","doi":"10.1016/j.ejr.2023.07.001","DOIUrl":"https://doi.org/10.1016/j.ejr.2023.07.001","url":null,"abstract":"<div><h3>Introductions</h3><p>Ankylosing spondylitis (AS), spondyloarthritis (SpA) prototype characteristically involves the axial skeleton and enthesis. The pathogenesis of AS is multifactorial, however it has been reported that one important factor that might contribute is vitamin D deficiency. Vitamin D and platelets share specific roles in immune response, bone health and mineral metabolism.</p></div><div><h3>Aim of the work</h3><p>To evaluate the serum vitamin D levels in AS patients and to study the relationship to clinical manifestations, disease activity, mobility and functionality.</p></div><div><h3>Patients and methods</h3><p>The study included 33 male AS patients and 33 matched control. Bath AS metrology index (BASMI), Bath AS disease activity index (BASDAI) and Bath AS functional index (BASFI) were evaluated. Serum 25-hydroxy vitamin D3 level was measured.</p></div><div><h3>Results</h3><p>The 33 patients had a mean age of 37.2 ± 10.7 years, disease duration of 12.7 ± 6.8 years. 3 were ex-smokers, 15 currently and 15 never smoke. The mean BASDAI was 4.2 ± 2.1, 19 (57.6%) had BASDAI score ≥ 4 (active). The BASMI was 5.7 ± 1.4 and BASFI was 5.3 ± 2.6. Patient’s vitamin D level (7.2 ± 5.2 ng/ml) was lower significantly than in the control (21.3 ± 10.1 ng/ml) (p &lt; 0.001). There were no differences in the level of vitamin D according to the smoking status (p = 0.9). A significant inverse relation was detected between vitamin D level and BASFI (r = -0.35, p = 0.045) and a significant correlation with the platelet level (r = 0.38, p = 0.027).</p></div><div><h3>Conclusion</h3><p>Low vitamin D level may contribute significantly to the pathogenesis of AS. It is significantly related to the impaired function in the disease and to low platelet count.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49790449","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}