Egyptian Rheumatologist最新文献

{"title":"Serum amyloid a level and musculoskeletal ultrasound in assessment of disease activity in rheumatoid arthritis patients","authors":"Mai A. El Kosaier ,&nbsp;Reham M. Shaat ,&nbsp;Mohammed M. El.Arman ,&nbsp;Abd El-Moaaty A. Afifi","doi":"10.1016/j.ejr.2023.01.001","DOIUrl":"https://doi.org/10.1016/j.ejr.2023.01.001","url":null,"abstract":"<div><h3>Aim of the work</h3><p>To assess serum amyloid A (SAA) level and study its relation to musculoskeletal ultrasound (MSUS) findings and to clinical disease activity indices in rheumatoid arthritis (RA) patients.</p></div><div><h3>Patients and methods</h3><p>60 RA patients and 60 matched controls were enrolled. Disease activity score-C-reactive protein (DAS-28-CRP) and simplified disease activity index (SDAI) and clinical disease activity Index (CDAI) were determined. MSUS evaluation was done using 12 -joint power Doppler ultrasound (PDUS) score. SAA was analyzed using an enzyme-linked immunosorbent assay.</p></div><div><h3>Results</h3><p>SAA levels were highly significant in patients (35.1 ± 3.6 mg/l) than in controls (1.6 ± 0.12 mg/l)(p &lt; 0.001). There was significantly higher SAA level among steroid users (56.7 %)(p = 0.001) and a lower level among leflunomide users (30 %)(p = 0.04). SAA and PDUS significantly increased in patients with low disease activity (n = 13) compared to those in remission (n = 10)(p &lt; 0.001). SAA significantly correlated with disease duration (p = 0.004), morning stiffness duration, swollen joint count, tender joint count, rheumatoid factor, anti-cyclic citrullinated peptide, DAS-28-CRP, SDAI, CDAI, erythrocyte sedimentation rate, CRP and total 12-joint PDUS score (p &lt; 0.001). The highest discriminatory ability of active RA and remission was attributed to the combination of SAA, PDUS and CRP (accuracy = 96.7 %, AUC = 0.99; sensitivity 96 % and specificity 100 %).</p></div><div><h3>Conclusion</h3><p>RA patients have a significantly increased level of SAA which indicates a key pathogenic role in the disease. SAA level is a potentially effective biomarker in the assessment of disease activity in RAand allied to PDUS. Combining SAA, PDUS and CRP provide the highest sensitivity and specificity in discrimination of active RA from remission.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49792258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency of fibromyalgia syndrome and anxiety post-corona virus disease-2019 (COVID-19) in patients attending the rheumatology clinic","authors":"Soha Senara ,&nbsp;Hisham Salah ,&nbsp;Wafaa Abdel Wahed ,&nbsp;Ahmed Yehia","doi":"10.1016/j.ejr.2022.11.007","DOIUrl":"https://doi.org/10.1016/j.ejr.2022.11.007","url":null,"abstract":"<div><h3>Aim of the work</h3><p>To screen for the new development of fibromyalgia syndrome (FMS) and anxiety in rheumatic diseases (RDs) patients and control who recovered from coronavirus disease 2019 (COVID-19).</p></div><div><h3>Patients and methods</h3><p>The study included 200 RDs patients and 100 matched controls with no previous history of FMS and who recovered from COVID-19. The patients’ RDs included rheumatoid arthritis (RA) (n = 50), systemic lupus erythematosus (SLE) (n = 50), juvenile idiopathic arthritis (JIA) (n = 40) and spondyloarthritis (SpA) (n = 60). The fibromyalgia symptom scale (FS), fibromyalgia impact questionnaire (FIQ) and Hamilton Anxiety rating scale were assessed.</p></div><div><h3>Results</h3><p>The mean age of patients was 35.9 ± 8.5 years with female: male 2.6:1. Fibromyalgia and anxiety were significantly higher in cases than control (22.5 % <em>vs</em> 12 % and 27 % <em>vs</em>16 %, p = 0.002, p = 0.03 respectively). Hypertension, obesity, anxiety, severe COVID-19, frequency of SLE and SpA were significantly higher in patients with FMS compared to those without (31.1 % <em>vs</em> 11.6 %, 68.9 % <em>vs</em> 21.9 %, 84.4 % <em>vs</em> 10.3 %, 48.9 % <em>vs</em> 16.8 %, 31.1 % <em>vs</em> 23.2 % and 40 % <em>vs</em> 27.1; p = 0.002, p &lt; 0.001, p &lt; 0.001, p &lt; 0.001, p = 0.014, p = 0.004 respectively).Severity of COVID-19, diabetes and anxiety were significant predictors of FMS(β = 1.1, p = 0.007; β = 3.03, p = 0.001 and β = 4.44, p &lt; 0.001 respectively). Fibromyalgia increases with increase anxiety grade; the percentage of fibromyalgia was 4.7 %, 50 %, 90 % and 100 % among patients with no anxiety, mild, moderate, and severe anxiety respectively (p &lt; 0.001).</p></div><div><h3>Conclusion</h3><p>Fibromyalgia is common in RDs patients post-COVID-19. Diabetes, COVID-19 infection severity and anxiety predict the risk of developing post-COVID-19 fibromyalgia. Post-COVID-19 fibromyalgia occurred more in hypertensive, obese, anxious and patients with severe COVID infection.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49792639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical significance of peripheral nervous system involvement in systemic lupus erythematosus patients: Relation to disease activity and damage index","authors":"Marwa H. Niazy ,&nbsp;George N. Fakhry ,&nbsp;Samar M. Fawzy","doi":"10.1016/j.ejr.2023.01.005","DOIUrl":"https://doi.org/10.1016/j.ejr.2023.01.005","url":null,"abstract":"<div><h3>Background</h3><p>Despite its potential impact on disease outcome, peripheral nervous (PN) system involvement in systemic lupus erythematosus (SLE) has received little attention.</p></div><div><h3>Aim of the work</h3><p>To assess the frequency and clinical features of PN system involvement in SLE patients.</p></div><div><h3>Patients and methods</h3><p>The medical records of 100 patients were revised. Cases with diabetes, hepatitis, vitamin B12 deficiency or carpal tunnel syndrome were excluded. Detailed history, clinical examination and laboratory investigations were recorded. PN events were documented. The SLE disease activity index (SLEDAI) and systemic lupus international collaborating clinics damage index (SLICC-DI) were evaluated<em>.</em></p></div><div><h3>Results</h3><p>Patients were 88 females and 12 males (F:M 7.3:1), mean age was 34.2 ± 8.3 years and disease duration 12.7 ± 5.4 years. The frequency of PN system involvement was 8 %; polyneuropathy (n = 5), mononeuritis multiplex (n = 2) and Guillain-Barré syndrome (n = 1). PN was associated with a significantly higher frequency of musculoskeletal (100 %), neuropsychiatric (100 %), pulmonary (62.5 %) and cardiovascular (37.5 %) manifestations as well as Raynaud's phenomenon (37.5 %) and secondary vasculitis (50 %) compared to those without (56.5 %,7.6 %,26.1 %,7.6 %,7.6 % and 12 %;p = 0.02,p &lt; 0.001,p = 0.04,p = 0.03,p = 0.03,p = 0.017 respectively).anti-nuclear antibodies (87.5 % vs 92.4 %) and anti-double stranded DNA (71.4 % vs 69.6 %) positivity were comparable (p &gt; 0.05). SLEDAI and SLICC-DI were significantly increased in patients with PN (26.5 ± 6.36 and 3.75 ± 0.98) compared to those without (11.5 ± 4.76 and 0.61 ± 0.56;p &lt; 0.001 each).</p></div><div><h3>Conclusion</h3><p>SLE patients with PN involvement had a higher frequency of musculoskeletal, neuropsychiatric, pulmonary and cardiovascular manifestations in addition to Raynaud's and vasculitis. There is a potential association with disease activity and damage. Careful neurological assessment should be included in the workup of SLE patients.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49871779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of perception of glucocorticoids on compliance of treatment in patients with rheumatoid arthritis and systemic lupus erythematosus","authors":"Walaa Abdelrahman,&nbsp;Arwa Al-Shaarawy,&nbsp;Bassel El-Zorkany","doi":"10.1016/j.ejr.2023.01.002","DOIUrl":"https://doi.org/10.1016/j.ejr.2023.01.002","url":null,"abstract":"<div><h3>Background</h3><p>Glucocorticoids (GCs) are alleged as hazardous medications among Egyptian patients and their relatives.</p></div><div><h3>Aim of the work</h3><p>To highlight the beliefs held about GCs and the effect of these beliefs on adherence to GCs treatment.</p></div><div><h3>Patients and methods</h3><p>The study included 70 systemic lupus erythematosus (SLE) patients, 70 rheumatoid arthritis (RA) patients and 140 GC-naïve subjects as the control. The demographic and socioeconomic standards of the patients and control as well as the GCs use experience in patients were recorded. GCs perception was assessed by Beliefs about medication Questionnaire (BMQ). Adherence was assessed by Compliance Questionnaire of Rheumatology (CQR).</p></div><div><h3>Results</h3><p>GCs were significantly perceived as harmful and of low benefit by the control (p &lt; 0.001, p &lt; 0.001, respectively), a beneficial drug by SLE patients, while RA patients had significantly higher harm scores (p = 0.015 and p = 0.003 respectively). Most of SLE and RA patients were non-adherent (57.1% and 65.7%, respectively). Higher general-BMQ harm scores were significantly associated with a lower odd of adherence (OR: 0.25, 95%CI: 0.1–0.63). Reduced OR of <em>necessity &gt; concern</em> was associated with higher socioeconomic standards and maximum oral GCs dose (OR:0.09 and 0.96, respectively). Increased OR of high necessity was significantly associated with number of currently used disease modifying anti-rheumatic drugs (DMARDs) (OR:5.54, p = 0.025). High OR of harm perception was significantly associated with higher socioeconomic standards (OR: 5.12, p = 0.016).</p></div><div><h3>Conclusion</h3><p>GCs are perceived as pillars in management by SLE and RA patients. Concerns about side effects and dependency are still troublesome. Improvement of patients’ GCs perception impacts level of adherence to treatment.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49792269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of direct-acting antiviral (DAA) agents on hepatitis C virus-related mixed cryoglobulinemia syndrome: One-year follow-up","authors":"Hala L. Fayed ,&nbsp;Sohair M. Abd El Ghany ,&nbsp;Abeer M. Nasser ,&nbsp;Naglaa A. El-gendy","doi":"10.1016/j.ejr.2022.12.004","DOIUrl":"https://doi.org/10.1016/j.ejr.2022.12.004","url":null,"abstract":"<div><h3>Background</h3><p>Mixed cryoglobulinemia syndrome (MCS) is a systemic vasculitis involving skin, joints, kidneys, and peripheral nerves. Hepatitis C virus (HCV) is a well-known etiologic agent. Therapy for HCV has been revolutionized by the approval of direct-acting antiviral (DAA) agents.</p></div><div><h3>Aim of the work</h3><p>To evaluate the effect of the new DAA treatment on MCS in HCV-infected patients. A prospective study with one year follow-up after induction therapy was undergone.</p></div><div><h3>Patients and methods</h3><p>Sixty patients with HCV-infection having ≥ 1 extrahepatic manifestations and attending the Rheumatology outpatient at Kasr Alainy for treatment of immune-mediated disease were included. Patients were examined at baseline (before receiving HCV treatment), after six months, and after one year following receiving HCV treatment by sofosbuvir based regimen in specialized centers. All patients were treatment-naïve; Assessment for arthritis, vasculitis and nephritis was performed.</p></div><div><h3>Results</h3><p>Patients’ mean age was 51.1 ± 8.8 (30–68) years; 44 females and 16 males (F:M 2.8:1). Arthritis was present in 43 (71.6 %), cutaneous vasculitis in 30 (50 %): purpura in 19 (31.7 %), skin ulcers in 18 (30 %), peripheral neuropathy in 16 (26.7 %), and nephritis in 14(23.3 %) patients. Absolute viral clearance was sustained up to one year follow-up. The frequency of patients affected with MCS-related manifestations arthritis, cutaneous vasculitis, peripheral neuropathy, and nephritis tended to decrease. CDAI significantly decreased at six months compared to baseline (p = 0.04). BVAS, numeric rating scale (NRS) for neuropathic pain/paresthesia and proteinuria insignificantly changed from baseline at six months and at one-year (p = 0.28, p = 0.58 and p = 0.96 respectively).</p></div><div><h3>Conclusion</h3><p>Clinical and immunological responses for MCS-related manifestations were less satisfactory than the virologic response.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49792640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and reported adverse effects of coronavirus disease-2019 (COVID-19) vaccines in patients with rheumatic diseases","authors":"Fatma M. Aboud ,&nbsp;Rasha S. Hussein ,&nbsp;Rasha M. Hassan","doi":"10.1016/j.ejr.2022.12.003","DOIUrl":"10.1016/j.ejr.2022.12.003","url":null,"abstract":"<div><h3>Background</h3><p>Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Symptoms and severity of COVID19 are variable.</p></div><div><h3>Aim of the work</h3><p>To evaluate the effectiveness and to identify side effects of the COVID-19 vaccines among Egyptian patients with autoimmune rheumatic diseases (RDs).</p></div><div><h3>Patients and methods</h3><p>The study included 126 patients with various RDs and 200 control. Detailed medical history was recorded with special concern regarding COVID-19 vaccination, types, doses, side effects, post-vaccination infection and treatment.</p></div><div><h3>Results</h3><p>In patients, BBIBP-CorV (Sinopharm) was the most frequent vaccine 42.3 % (n = 52); CoronaVac (Sinovac) 22 % (n = 27); ChAdOx1 (AstraZeneca) 17.9 % (n = 22); BNT162 (Pfizer BioNTech) 14.6 % (n = 18); Sputnik V 1.6 % (n = 2) and Ad26.COV2-S (Johnson &amp; Johnson) 1.6 % (n = 2). Regarding the control, 34.4 % (n = 62) received AstraZeneca; 26.1 % (n = 47) Sinopharm; 16.7 % (n = 30) Pfizer; 11.7 % (n = 21) Sinovac; 6.7 % (n = 12) Sputnik; 3.3 % (n = 6) Johnson &amp; Johnson and 1.2 % (n = 2) mRNA1273 (Moderna). COVID-19 infection decreased after vaccination from 32 (25.4 %) to 7 (5.6 %), and from 162 (81.0 %) to 85 (42.7 %) in RD patients and the control respectively. ICU admission decreased from (6.3 %) among RD patients and from (1.3 %) in control to 0 % after vaccination in both groups. In RD patients, body ache was the commonest reported vaccine adverse effect (44.4 %). Pain at the injection site was the commonest among control (77 %). ChAdOx1 (AstraZeneca) had the highest incidence of side effects, mRNA1273 (Moderna) showed the lowest.</p></div><div><h3>Conclusion</h3><p>COVID-19 vaccine was effective in decreasing infection and disease severity in RDs patients and control, with similar, mild adverse effects.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9800813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9563078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methylation of receptor activator of nuclear factor kappa ligand (RANKL) gene in rheumatoid arthritis patients","authors":"Manal Ramzy ,&nbsp;Ola M. Gharbia ,&nbsp;Amal K. Seleem ,&nbsp;Karima Mohamed ,&nbsp;Rehab E. Marzouk","doi":"10.1016/j.ejr.2023.01.004","DOIUrl":"https://doi.org/10.1016/j.ejr.2023.01.004","url":null,"abstract":"<div><h3>Background</h3><p>Rheumatoid arthritis (RA) is an autoimmune inflammatory disease characterized by synovitis, cartilage damage and bone resorption. Methylation of deoxyribonucleic acid plays a crucial role in repressing gene expression. Receptor activator of nuclear factor-kappa ligand (RANKL) controls bone homeostasis.</p></div><div><h3>Aim of the work</h3><p>To assess the serum level of RANKL and its gene promoter methylation in RA patients and to determine its association with clinical characteristics and disease activity.</p></div><div><h3>Patients and methods</h3><p>The study included 40 RA patients and 40 control. The disease activity score (DAS28) was assessed. Frequency of RANKL gene promoter methylation was determined by quantitative methylation specific PCR (QMSP) and serum RANKL level by enzyme linked immunosorbant assay (ELISA).</p></div><div><h3>Results</h3><p>Patients mean age was 46.8 ± 10.6 years, 36 females and 4 males (F:M 9:1) with median disease duration 4.5 years. Positive rheumatoid factor, anti-cyclic citrullinated peptide and C-reactive protein were present in 65 %, 75 % and 55 % of cases. Methylation percentage of RANKL gene promoter was significantly lower in patients (3.4 %) than in controls (3.7 %)(p = 0.035) while serum level was significantly increased in patients (9.1 ng/ml,5.3–11.8 ng/ml) than in controls (5.7 ng/ml, 4.5–8 ng/ml)(p = 0.003). RANKL methylation frequency was inversely associated with serum level (rs = -0.21,p = 0.06). There was no significant correlation of RANKL serum level and methylation with DAS28 (r = 0.03,p = 0.87 and r = 0.06,p = 0.73 respectively). RANKL serum level (&gt;9.5 ng/ml) and methylation percentage (≤9%) significantly discriminate RA cases from control (sensitivity 47.5 %, specificity 91.9 %; p = 0.001 and sensitivity 100 %, specificity 40 %; p = 0.03 respectively).</p></div><div><h3>Conclusion</h3><p>RA patients expressed elevated serum RANKL with low methylation.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49792642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pattern of non-infectious uveitis and visual outcome in a tertiary care university-based hospital: A multidisciplinary approach","authors":"Aya H. Eldesouky ,&nbsp;Mariam R. Fadel ,&nbsp;Somaya A. Husein ,&nbsp;Dina O. Abdulazim","doi":"10.1016/j.ejr.2023.01.006","DOIUrl":"https://doi.org/10.1016/j.ejr.2023.01.006","url":null,"abstract":"<div><h3>Aim of the work</h3><p>To study the pattern of non-infectious uveitis (NIU) in different systemic autoimmune diseases and to determine the visual outcome and complications in relation to systemic immunomodulatory therapy.</p></div><div><h3>Patients and methods</h3><p>The study was conducted on 105 NIU patients with different autoimmune diseases: Behçet’s disease (BD), Vogt–Koyanagi–Harada (VKH), juvenile idiopathic arthritis (JIA), sarcoidosis, idiopathic uveitis and ankylosing spondylitis (AS). All patients were subjected to full ophthalmological examination.</p></div><div><h3>Results</h3><p>The frequency of NIU was highest in BD (n = 61;58.1 %) followed by VKH (n = 24;22.9 %), JIA (n = 8;7.6 %), sarcoidosis (n = 7;6.7 %), idiopathic uveitis (n = 4;3.8 %) and AS(n = 1;1%) and their mean age at NIU onset was 30 ± 12 years. Panuveitis (PanU) was identified in 84 (80 %), anterior uveitis (AU) in 11(10.5 %), posterior uveitis (PU) in 9 (8.6 %) and intermediate uveitis (IU) in one (1 %) patient. A chronic recurrent course was detected in 98 (93.3 %) patients and bilateral involvement was present in 86 (81.9 %). Laterality of eye affection (unilateral or bilateral) was not related to eye activity or type of uveitis. The most common complication was cataract (17.1 %). A significant relation was found between the control of eye activity and immunosuppression intake in the last 6 months (p = 0.002). 38 (36.2 %) patients were considered legally blind. A non-significant relation was found between legal blindness with type of uveitis (p = 0.82), immunosuppressives(p = 0.06) or biological therapy (p = 0.35).</p></div><div><h3>Conclusion</h3><p>The most common pattern of NIU in systemic autoimmune diseases was panuveitis. Behçet’s disease and VKH disease were the most frequent etiologies for NIU and cataract was the most common complication.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49834819","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":"Serum human β-defensin-1 (hBD-1) and -20G/A DEFB1 gene polymorphism in Behçet’s disease patients: Relation to clinical characteristics","authors":"Dalia El Gibaly ,&nbsp;Dalia A. Labib ,&nbsp;Hala L. Fayed ,&nbsp;Alia Eldash","doi":"10.1016/j.ejr.2022.12.002","DOIUrl":"https://doi.org/10.1016/j.ejr.2022.12.002","url":null,"abstract":"<div><h3>Aim of the work:</h3><p>Behçet’s disease (BD) is a multisystemic inflammatory disease of unknown cause. Beta defensins (β-defensins) are endogenous antimicrobial peptides that have the ability to kill or inactivate a wide spectrum of bacteria and fungi by changing their membranes stability. It also plays a significant role in inflammation owing to its chemotactic activity for T cells and immature dendritic cells. To explore whether β-defensins might be involved in BD pathogenesis, serum human β-defensin-1 (hBD-1) and defensin-β-1 (DEFB1)-20 G/A gene polymorphism were assessed in patients with BD.</p></div><div><h3>Patients and methods</h3><p>The study included 40 BD patients and 40 matched controls. Serum hBD-1 was assessed by enzyme-linked immunosorbent assay (ELISA) and the -20G/A genotypes (rs11362) were determined by restriction fragment length polymorphism-polymerase chain reaction<!--> <!-->(RFLP-PCR) analysis.</p></div><div><h3>Results</h3><p>The mean age of patients was 33.5 ± 10.8 years. They were 32 males and 8 females (M:F 4:1). Disease duration was 8.5 ± 7.3 years. In patients, the median serum hBD-1 concentration was 295.5 pg/ml (27.6–1776.6 pg/ml) and was significantly higher than in the control (median 129.6 pg/ml; 23.7–986.3 pg/ml) (<em>p</em> &lt; 0.001). Serum hBD-1 significantly correlated with C-reactive protein (r = 0.85, p = 0.001) and platelets (r = 0.4, p = 0.012). No significant difference was found between patients and control regarding genotyping of -20G/A DEFB1 (rs11362). Skin manifestations were significantly higher among patients with GA genotype 18/23 (78.2 %) than patients with AA genotype 7/16 (43.8 %)(<em>p</em> = 0.027). However, there was no association between serum hBD-1 and −20A/G polymorphism.</p></div><div><h3>Conclusions</h3><p>The hBD-1 is implicated in the pathogenesis of BD and may be a possible therapeutic target.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49834886","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":"Gender-related differences in axial spondyloarthritis (axSpA) patients","authors":"Samaher Almousa ,&nbsp;Nada Alshamaa ,&nbsp;Hala Wannous ,&nbsp;Kamar Khder ,&nbsp;Heba Qasem","doi":"10.1016/j.ejr.2022.08.003","DOIUrl":"https://doi.org/10.1016/j.ejr.2022.08.003","url":null,"abstract":"<div><h3>Aim of the work</h3><p>To explore the gender-related differences in axial spondyloarthritis (axSpA) patients.</p></div><div><h3>Patients and methods</h3><p>Seventy-six male and 38 female patients with axSpA were assessed regarding disease characteristics and treatment. Disease activity, functional and radiologic severity index were measured using the Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis functional index (BASFI), Bath ankylosing spondylitis radiology index (BASRI-s) respectively, and enthesitis was assessed using Maastricht Ankylosing Spondylitis Enthesitis Score (MASES).</p></div><div><h3>Results</h3><p>The mean age of the patients was 37.8 ± 10 years with a male: female ratio (2:1). Females had more delay in diagnosis (9.2 ± 3.9 years <em>vs</em> males 6.7 ± 3.4 years; p &lt; 0.001) and they had enthesitis, peripheral arthritis, widespread pain and fibromyalgia as initial presentations more often than males. The mean BASDAI and BASFI was higher in females (6.3 ± 1.3 <em>vs</em> 5.2 ± 1.4; p &lt; 0.001 and 6.1 ± 1.4 <em>vs</em> 5.3 ± 1.3; p = 0.003 respectively). Enthesitis increased in females (n = 18, 47% <em>vs</em> n = 12, 15.8%; p &lt; 0.001) with higher MASES than men (3.7 ± 4 <em>vs</em> 1.8 ± 2; p &lt; 0.001).Peripheral arthritis was markedly higher in females (n = 15, 39.5%<em>vs</em> n = 16, 21.1%; p = 0.03).Females more frequently used methotrexate and sulphasalazine (p = 0.003). BASRI-s and sacroiliitis grading were higher in males (7.2 ± 1.9 <em>vs</em> 4.6 ± 1.9; p &lt; 0.001 and 3 ± 0.6 <em>vs</em> 2 ± 0.3; p &lt; 0.001 respectively) with cervical syndesmophyte predominance in females (p = 0.005).</p></div><div><h3>Conclusion</h3><p>The clinical and initial presentations differ between the two genders and the disease activity, functional limitation, and enthesitis score are higher in females. While radiologic severity is worse in men, there is predominant cervical spine involvement in women.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49800610","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}