Egyptian Rheumatologist最新文献

{"title":"Cognitive function impairment in patients with antiphospholipid syndrome: Association with clinical, laboratory and brain magnetic resonance imaging findings","authors":"Noha A. Azab ,&nbsp;Esraa Soliman ,&nbsp;Nehal Mostafa ,&nbsp;Doaa A. Teleb","doi":"10.1016/j.ejr.2025.04.005","DOIUrl":"10.1016/j.ejr.2025.04.005","url":null,"abstract":"<div><h3>Background</h3><div>Cognitive dysfunction is frequent in patients with antiphospholipid syndrome (APS) although not included in the classification criteria.</div></div><div><h3>Aim of the work</h3><div>To assess the cognitive function in APS patients and to study any relation to clinical, laboratory and brain magnetic resonance imaging (MRI) findings.</div></div><div><h3>Patients and methods</h3><div>This study was conducted on 113 patients: 30 with primary APS, 44 secondary APS and 39 systemic lupus erythematosus (SLE) patients without APS. Cognitive function was assessed using Mini-Mental State Examination (MMSE) and Montreal cognitive assessment-Basic (MOCA-B). APS clinical manifestations, disease damage indices, APS immunological profile and MRI abnormalities were recorded.</div></div><div><h3>Results</h3><div>Of the 74 APS patients, 70 (94.6 %) were females. Their mean age was 32.3 ± 8 years and mean disease duration was 9.4 ± 5.9 years. Cognitive impairment was significantly higher in APS patients (n = 44, 59.9 %) than in SLE patients without APS (n = 2, 5.1 %) when assessed by MOCA-B (p &lt; 0.001). There was no significant difference between primary and secondary APS subtypes as regards cognitive impairment assessed by MMSE (0 vs 3) and MOCA-B (17 vs 27p = 0.81). The presence of cognitive impairment was associated with neuropsychiatric manifestations (p &lt; 0.0001); seizures (p = 0.01), TIAs (p = 0.04), migraine/headache (p = 0.03), ACL (p = 0.02), anti-β2GP (p &lt; 0.001), triple positivity of APL (p = 0.002), abnormal brain MRI (p = 0.002) and brain infarcts. A significant negative correlation was found between MOCA-B and cumulative damage of APS (r = 0.5, p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Cognitive impairment was detected in APS patients especially those with neuropsychiatric manifestations, positive ACL, anti- β2GP and triple positivity of APL or abnormal brain MRI.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"47 3","pages":"Pages 122-126"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143826204","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":"Fractional excretion ratio of activated leukocyte cell adhesion molecule (ALCAM) as a potential biomarker in lupus nephritis patients","authors":"Mona I. Nabih ,&nbsp;Dina Mahmoud ,&nbsp;Marwa A. Mohamed ,&nbsp;Mohamed H. Tarabay ,&nbsp;Sarah A. Hassan","doi":"10.1016/j.ejr.2025.04.003","DOIUrl":"10.1016/j.ejr.2025.04.003","url":null,"abstract":"<div><h3>Aim of the work</h3><div>To investigate the use of fractional excretion ratio (FE) of activated leukocyte cell adhesion molecule (ALCAM) in patients with lupus nephritis (LN) and whether, in comparison to the absolute urine levels, they demonstrate improved diagnostic performance.</div></div><div><h3>Patients and methods</h3><div>42 systemic lupus erythematosus (SLE) patients; Group 1: 14 inactive SLE patients, Group 2: 14 active non-renal SLE, Group 3: 14 active lupus nephritis. All participants were evaluated as regards the following: Thorough medical history and clinical evaluation, disease activity and renal activity assessment using the SLE disease activity index 2000 (SLEDAI-2 K), LN histological class, activity and chronicity index were evaluated using International Society of Nephrology/Renal Pathology Society Criteria (ISN/RPS). Serum and urine ALCAM levels were assayed using ELISA. FE ratio was calculated as follows: (urinary biomarker/urinary creatinine)/ (serum biomarker/serum creatinine).</div></div><div><h3>Results</h3><div>The mean age of the patients was 26.6 ± 10.4 years and were 36 females and 6 males (F:M 6:1). Groups were comparable for age (p = 0.65) and gender (p = 1). Active LN patients had a greater FE of ALCAM (0.08 ± 0.04) compared to inactive (0.01 ± 0.01) and active non-renal (0.02 ± 0.02) (p &lt; 0.001). FE significantly correlated with 24-hour urinary proteins (r = 0.67, p &lt; 0.001), erythrocyte sedimentation rate (r = 0.51, p &lt; 0.001) and SLEDAI-2 K (r = 0.71, p &lt; 0.001), negatively with both C3 and C4 (r = -0.52 and r = -0.56, p &lt; 0.001) and with hemoglobin (p = 0.008). They had 100 % sensitivity and 92.2 % specificity for detection of active LN.</div></div><div><h3>Conclusion</h3><div>The FE ratio provides a potentially diagnostic value in LN assessment, since the FE of ALCAM performed better in active LN and is significantly related to the disease activity.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"47 3","pages":"Pages 104-109"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143820504","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":"2025-06-01","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":"Sleep, depression, anxiety and quality of life in patients with systemic lupus erythematosus","authors":"Leonardo W. Franco,&nbsp;Isabela S. Bauer,&nbsp;Thiago A.F.G. dos Santos,&nbsp;Renato Nisihara,&nbsp;Thelma L. Skare","doi":"10.1016/j.ejr.2025.04.001","DOIUrl":"10.1016/j.ejr.2025.04.001","url":null,"abstract":"<div><h3>Aim of the work</h3><div>To study the frequency of sleep quality in a cohort of Brazilian Systemic lupus erythematosus (SLE) patients and to investigate its associations with clinical characteristics, disease activity, mood disorders (anxiety and depression) and quality of life (QoL).</div></div><div><h3>Patients and methods</h3><div>A sample of 59 SLE patients and 76 controls answered the Pittsburg Sleep Quality Index (PSQI), Center for epidemiological studies-depression (CES-D) questionnaire, Hamilton rating scale for anxiety (HAM-A), and the 12-item short form (SF-12) survey for QoL. Clinical characteristics, SLEDAI (SLE disease activity index) and comorbidities were recorded.</div></div><div><h3>Results</h3><div>The mean age of the patients was 42.3 ± 12.6 years and 55 were females (F:M 13.8:1). 62.7 % were Caucasian, 23.7 % were tobacco exposed, 30.5 % hypertensive, 22 % had dyslipidemia, 16.9 % hypothyroid and 10.1 % diabetic. The median SLEDAI was 0 (0–2), CES-D 17 (14–25), HAM-A 20.6 ± 10.2, SF-12 physical component was 38.4 (30.1–52.2) and mental 42.4 ± 12.3. 78.2 % (43/59) of patients were poor sleepers <em>vs</em> 50 % (38/76) of controls (p = 0.01). PSQI correlated with HAM-A (p = 0.0006), CES-D (p = 0.0005) and SF-12 (both components: mental p = 0.009 and physical p = 0.004) but not with SLEDAI (p = 0.25). Regarding Pittsburg domains, a significant correlation was found with between HMA-A and subjective sleep (r = 0.38; p = 0.03), sleep disturbances (r = 0.44 and p = 0.0004) and daytime dysfunction (r = 0.48; p = 0.0005) and between CES-D and sleep latency (r = 0.38; p = 0.02), sleep disturbances (r = 0.3; p = 0.01) and day time dysfunction (r = 0.5; p &lt; 0.0001).</div></div><div><h3>Conclusion</h3><div>There is a high frequency of sleep disturbances in the SLE group that was worse in individuals with depression and anxiety, suggesting a reduction in QoL.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"47 3","pages":"Pages 113-116"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143820506","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":"Effect of probiotic supplementation on disease activity in rheumatoid arthritis patients","authors":"Ahmed A. Khalifa,&nbsp;Sabrina M. Hany,&nbsp;Nashwa A. Morshedy,&nbsp;Adel M. Elsayed","doi":"10.1016/j.ejr.2025.04.009","DOIUrl":"10.1016/j.ejr.2025.04.009","url":null,"abstract":"<div><h3>Background</h3><div>Rheumatoid arthritis (RA) is the most prevalent inflammatory arthritis. Alterations in the typical gastrointestinal microflora and dysregulation of the mucosal immune response to these pathogens may contribute to autoimmune diseases like RA. <strong>Aim of the work:</strong> To assess the effects of probiotic supplementation on the clinical status and disease activity of patients with RA.</div></div><div><h3>Patients and methods</h3><div>This randomized clinical trial was conducted on 60 RA patients receiving methotrexate (MTX); 30 patients also received 1 daily capsule of probiotic (Group A), and the other 30 were on MTX only (Group B). Disease activity score (DAS28), clinical disease activity index (CDAI); and simplified disease activity index (SDAI) were assessed.</div></div><div><h3>Results</h3><div>The mean age of the patients was 44.7 ± 9.3 years; they were 51 females and 9 males with a median disease duration of 7 (4.5–14.5) years. Following an eight-week intervention, the ESR significantly decreased in both groups (Group A: 48.6 ± 21.7 to 42.9 ± 23.2; p = 0.01 and (Group B: 45.5 ± 17.1 to 37.6 ± 15.3; p &lt; 0.0001). The median tender joint count (TJC) and swollen joint count significantly decreased in group A (10 to 8; p &lt; 0.0001 and 4 to 2; p &lt; 0.0001, respectively). The reduction in median TJC was significantly greater in group A compared to group B (−2 vs 0; p = 0.01). No significant changes in activity scores were observed in either group following the intervention.</div></div><div><h3>Conclusion</h3><div>The use of probiotic therapy has no clear benefit as an add-on therapy to the standard of care in patients with RA. However, a notable improvement in TJC was observed, suggesting a potential avenue for future research.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"47 3","pages":"Pages 127-130"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834517","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":"Distinct capillaroscopic findings in a patient with systemic sclerosis: Possible association with a benign disease course","authors":"Angelo Nigro ,&nbsp;Dell’Edera Domenico ,&nbsp;Nicoletti Giuseppe","doi":"10.1016/j.ejr.2025.04.002","DOIUrl":"10.1016/j.ejr.2025.04.002","url":null,"abstract":"<div><h3>Background</h3><div>Systemic sclerosis (SSc) is an autoimmune disease characterized by vascular abnormalities and fibrosis. Capillaroscopy is a key tool for assessing microvascular changes in SSc, often revealing characteristic patterns with prognostic significance. While the presence of a “scleroderma pattern” is well-documented, its localization to a single digit without systemic involvement is an unusual finding.</div></div><div><h3>Aim of the work</h3><div>This report highlights a unique capillaroscopic presentation in a patient with anti-centromere antibody-positive SSc, emphasizing its potential prognostic significance.</div></div><div><h3>Case report</h3><div>A 66-year-old Caucasian female was diagnosed with anti-centromere antibody-positive SSc six years ago. The diagnosis was supported by ANA positivity (1:1280, centromeric pattern), Raynaud’s phenomenon, and transient hand edema. Capillaroscopic examination revealed a “scleroderma pattern” with prominent megacapillaries exclusively on the second finger of the right hand, with no microhemorrhages. The remaining fingers showed a non-specific capillaroscopic pattern. Clinically, the patient has a benign disease course, with no skin sclerosis, digital ulcers, or systemic involvement.</div></div><div><h3>Conclusion</h3><div>This case highlights the relevance of localized capillaroscopic abnormalities in SSc. The absence of systemic involvement despite the capillaroscopic findings raises questions about their prognostic significance. Further research is needed to clarify their implications.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"47 3","pages":"Pages 110-112"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143820505","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":"2025-06-01","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":"Clinical, immunological features and relation to clinical phenotypes in patients with antiphospholipid syndrome","authors":"Adel M. Ali ,&nbsp;Eman A. Hafez ,&nbsp;Shafica I. Ibrahim ,&nbsp;Mahmoud F. Mahmoud ,&nbsp;Noha H. Shedid","doi":"10.1016/j.ejr.2025.03.001","DOIUrl":"10.1016/j.ejr.2025.03.001","url":null,"abstract":"<div><h3>Aim of the work</h3><div>To analyze the clinical and immunologic manifestations of antiphospholipid syndrome (APS) in a cohort of patients and to evaluate the possible clinical-immunologic association of individual antiphospholipid antibodies (aPL) with clinical phenotypes.</div></div><div><h3>Patients and methods</h3><div>The clinical and immunologic features of APS in 70 patients (17 with primary and 53 with secondary APS) were analyzed. The association between the different aPL and APS clinical phenotypes (venous thrombosis, arterial thrombosis, obstetric morbidity, thrombocytopenia, livedo reticularis) was investigated.</div></div><div><h3>Results</h3><div>The APS patients were 63 (90%) females, with a mean age of 28.6±6.9 years and a mean disease duration of 3.1±2.6 years. Of the females only 55 were pregnant. Obstetric morbidity was the most common clinical manifestation (87.2%), particularly late fetal death (54.6%), followed by deep venous thrombosis (48.6%), constitutional manifestations (48.6%), thrombocytopenia (24.3%), stroke (15.7%) and livedo reticularis (15.7%). Anticardiolipin (ACL) antibodies were the most common aPL detected (82.9 %). Patients with primary APS had significantly more frequent late abortion/stillbirth (76.5% vs. 44.7%, p= 0.03) compared to secondary APS patients. Lupus anticoagulant (LA) and anti-β2 glycoprotein-I antibodies were significantly associated with arterial thrombosis (p= 0.009 and p&lt; 0.001, respectively), thrombocytopenia (p= 0.01 and p= 0.02, respectively) and livedo reticularis (p= 0.02 and p&lt; 0.001, respectively), while only LA was significantly associated with obstetric complications (p= 0.004). Triple aPL positivity was significantly associated with arterial thrombotic events (p&lt; 0.001) and obstetric complications (p= 0.01).</div></div><div><h3>Conclusion</h3><div>Patients with APS demonstrated a high frequency of pregnancy complications. Detection of aPL may help in the identification of different clinical phenotypes in APS.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"47 3","pages":"Pages 99-103"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792032","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":"2025-06-01","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}

{"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":"2025-06-01","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}