Egyptian Rheumatologist最新文献

{"title":"Comparative assessment of hepatitis C virus-related arthritis and rheumatoid arthritis: Relation to clinical, serologic and ultrasonographic characteristics","authors":"Hala L. Fayed ,&nbsp;Amira A. Shahin ,&nbsp;Abo El-Magd M. El-Bohy ,&nbsp;Sahar S. Younis","doi":"10.1016/j.ejr.2023.03.006","DOIUrl":"https://doi.org/10.1016/j.ejr.2023.03.006","url":null,"abstract":"<div><h3>Background</h3><p>Extrahepatic manifestations of hepatitis C virus (HCV) infection includes HCV-related arthritis (HCV-A) that may mimic rheumatoid arthritis (RA). Musculoskeletal ultrasound (MSUS) can aid in discriminating both conditions.</p></div><div><h3>Aim of the work</h3><p>To study the clinical, serological and imaging (Xray, MSUS) characteristics of HCV-A and compare them to RA.</p></div><div><h3>Patients and methods</h3><p>The study included 30 patients with HCV-A and 30 age- and sex-matched RA patients negative for HCV. Ritchie articular index (RAI), tender joint count (TJC) and swollen joint count (SJC) assessed arthritis. Patient global health assessment (PGHA) and modified health assessment questionnaire (MHAQ) were evaluated. The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP) and serum cryoglobulins were measured. Radiologic assessment included short Larsen score (SLS) and MSUS using 7-joint ultrasound score (US7).</p></div><div><h3>Results</h3><p>The mean age of the HCV-A patients was 45.8 ± 4.7 years; RA was 43.3 ± 5.6 years; F:M was 27:3 in HCV-A patients; 29:1 in RA; HCV-A patients had no subcutaneous nodules, joint deformities or bone erosions. US7 showed that Gray-Scale (GS)/Power Doppler (PD) synovitis and tenosynovitis had higher mean values in RA versus HCV-A patients (p &lt; 0.001; p &lt; 0.001; p = 0.011; p = 0.008 respectively). A significant correlation was found between SJC with GS and PD synovitis in both groups.</p></div><div><h3>Conclusion</h3><p>HCV-A differ from RA features as being non nodular, non-deforming, non-erosive and aid in the predilection of HCV-A diagnosis. MSUS can offer a useful imaging modality elucidating inflammatory components of HCV-A and highlighting the spectrum of the condition.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"45 3","pages":"Pages 213-218"},"PeriodicalIF":0.9,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49819191","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 artery pseudoaneurysms (PAPs) in Hughes-Stovin syndrome (HSS) as an emerging concept for a potentially fatal course","authors":"Tubig C. Joy ,&nbsp;Juljani Sherwina ,&nbsp;Ayuyao Fernando ,&nbsp;Ma E Limpin ,&nbsp;Ma Paz Mateo ,&nbsp;Khalid Alhusseiny","doi":"10.1016/j.ejr.2023.03.004","DOIUrl":"https://doi.org/10.1016/j.ejr.2023.03.004","url":null,"abstract":"<div><h3>Introduction</h3><p>Hughes-Stovin syndrome (HSS) is a systemic vasculitis characterized by pulmonary artery aneurysms (PAA) and widespread venous and arterial thrombosis. Fatalities in HSS resulted from unforeseeable fatal suffocating hemoptysis. It is critical to early detect pulmonary involvement to take timely measures against inevitable serious life-threatening complications.</p></div><div><h3>Case presentation</h3><p>A 27 year old Filipino male patient presented to the emergency department with an acute attack of massive hemoptysis. The markers of inflammation were elevated with anemia and a normal coagulation profile. The patient had bilateral lower limb edema with tender calf muscles. Color Doppler ultrasound revealed bilateral deep vein thrombosis. Importantly, an urgent computerized tomography pulmonary angiography (CTPA) revealed bilateral large PAAs which matched the pattern of pseudoaneurysms described by the HSS international study group (HSSISG). There was no history of iridocyclitis, recurrent oral or genital ulcers. Accordingly, the patient was diagnosed with HSS. The patient received intravenous pulse methylprednisolone (1 g/3 days), then oral prednisone (1 mg/kg/d/3 months), and monthly pulse cyclophosphamide (1 g) for three months. The patient remained symptom-free, yet on the third pulse of cyclophosphamide; he patient contracted corona virus disease-2019 (COVID-19) infection and died three weeks later from a fatal episode of massive hemoptysis. The case was discussed and the recent literature was reviewed relative to fatal hemoptysis associated with pulmonary artery pseudoaneurysms (PAPs) pattern in HSS</p></div><div><h3>Conclusion</h3><p>HSS presenting with massive hemoptysis could be lifethreatening and the PAPs are considered a double edged sword. Detailed description of such rare cases is warranted for optimum future management.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"45 3","pages":"Pages 209-212"},"PeriodicalIF":0.9,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49792926","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":"Juvenile clinically amyopathic dermatomyositis (CADM): Case-based review","authors":"Wahinuddin Sulaiman ,&nbsp;Farisya Mohd Lepatoni ,&nbsp;Jyi Jong Tang ,&nbsp;Nurul Bahiyah Baharudin","doi":"10.1016/j.ejr.2023.03.005","DOIUrl":"https://doi.org/10.1016/j.ejr.2023.03.005","url":null,"abstract":"<div><h3>Background</h3><p>Clinically amyopathic dermatomyositis (CADM) is rare as the classical cutaneous features are present with absence of myopathy and the serum creatinine kinase, electromyographic examination and muscle biopsy are usually normal.</p></div><div><h3>Aim of the work</h3><p>To report a young girl with juvenile CADM who responded to corticosteroid and mycophenolate mofetil, without progressing to myopathy and other systemic complications over a 3-year period.</p></div><div><h3>Case presentation</h3><p>An 11-year-old Malay girl was afebrile and presented with debilitating polyarthritis and classical cutaneous manifestations of dermatomyositis which was confirmed by histological findings, but without myopathy and systemic involvement. The anti-nuclear antibody (ANA) was positive 1:160, with speckled pattern and anti-p155/140 antibodies (anti-transcriptional intermediary factor 1, anti-TIF1γ antibody) were positive. Skin biopsy revealed typical histological findings consistent with dermatomyositis including vacuolar changes of the basal layer, increased lymphocytic infiltrate and increased mucin deposition in the dermis. She received pulse methylprednisolone (250 mg/day/3 days) followed by oral prednisolone 1 mg/kg/day tapered until her cutaneous lesions showed marked improvement. Hydroxychloroquine (HCQ) (200 mg/day) and oral methotrexate (10 mg/week) were added. Six months after initial treatment, mycophenolate mofetil (MMF) 1 g/day was added in view of the slow improvement of her cutaneous lesions and was discontinued a year later as she demonstrated favourable outcome. Besides the skin lesions, her arthritis also responded well to treatment.</p></div><div><h3>Conclusion</h3><p>Juvenile CADM is rare but with early recognition and treatment, the prognosis is good especially in children as this may reduce the risk of systemic complications and progression to myopathy.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"45 3","pages":"Pages 203-207"},"PeriodicalIF":0.9,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49792927","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":"High frequency ultrasound assessment of skin in systemic sclerosis patients","authors":"Mervat Abo Gabal,&nbsp;Mohamed R. Mohamed,&nbsp;Mohamed A. Moawed,&nbsp;Caroline S. Morad","doi":"10.1016/j.ejr.2023.04.005","DOIUrl":"https://doi.org/10.1016/j.ejr.2023.04.005","url":null,"abstract":"<div><h3>Aim of the work</h3><p>To evaluate the role of high frequency ultrasound (HFU) in assessing skin changes in terms of thickness and echogenicity in systemic sclerosis (SSc) patients with early and late changes.</p></div><div><h3>Patients and methods</h3><p>Twenty-three SSc patients were enrolled along with 21 matched controls. Skin thickness was assessed using modified Rodnan skin score (mRSS) and HFU.</p></div><div><h3>Results</h3><p>Patients had mean age of 41.8 ± 9.1 years, 91.3% were females, mean disease duration 6.0 ± 4.6 years, 11 patients had early (&lt;5 years) and 12 late (≥5 years) disease, 8 patients had limited (lcSSc) and 15 diffuse (dcSSc) cutaneous SSc. Antinuclear antibody was positive in 17 (73.9%) and antiscleroderma-17 in 18 (78.3%). Patients had significantly thicker skin between second and third metacarpophalangeal joint (L = 1.52 ± 0.35 mm vs 1.25 ± 0.35 mm; p = 0.017 and T = 1.48 ± 0.34 mm vs 1.26 ± 0.33 mm; p = 0.038 respectively). Patients with early disease had thicker skin than those with late disease. HFU dermal thickness showed no significant difference according to gender, subtypes, presence and absence of clinical manifestations or autoantibody positivity. There was significant higher dermal thickness in patients with reflux (p = 0.009) and was lower in patients with interstitial pulmonary fibrosis (p &lt; 0.05). There was negative correlation between US dermal thickness and disease duration (p &lt; 0.05). mRSS showed no correlation with HFU dermal thickness in all areas.</p></div><div><h3>Conclusion</h3><p>HFU is useful in assessing skin pathologic changes (even subclinical changes) in terms of thickness and echogenicity in SSc patients. Moreover, it could be a potential screening tool in differentiating normal from pathologic skin thickness.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"45 3","pages":"Pages 241-246"},"PeriodicalIF":0.9,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49819193","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":"Avascular necrosis in systemic lupus erythematosus patients: Analysis of the demographics, clinical manifestations, management and outcomes","authors":"Asadullah Khan ,&nbsp;Roshila Shamim ,&nbsp;Abrar A Wagan ,&nbsp;Sheikh M Khan ,&nbsp;Syed Nazeer Ahmed ,&nbsp;Muhammad Haroon","doi":"10.1016/j.ejr.2023.05.002","DOIUrl":"https://doi.org/10.1016/j.ejr.2023.05.002","url":null,"abstract":"<div><h3>Background</h3><p>Avascular necrosis (AVN) is a rare complication of systemic lupus erythematosus (SLE) that may develop from the disease or its treatment.</p></div><div><h3>Aim of the work</h3><p>To present the clinical characteristics, management and outcomes of SLE patients with AVN.</p></div><div><h3>Patients and methods</h3><p>The SLE patients with AVN on X-ray or magnetic resonance imaging (MRI) following up at Fatima Memorial Hospital College of Medicine and Dentistry Shadman, Lahore, Pakistan were studied. Detailed medical history, clinical examination, laboratory investigations, treatment details and outcomes were recorded.</p></div><div><h3>Results</h3><p>Out of 230 SLE patients, 20 (8.6%) had AVN; 80% females, F:M 4:1 with a mean age at onset of SLE 19.8 ± 6.5 years, and mean duration till occurrence of AVN 3.9 ± 2.3 years. AVN developed within 4 years of onset in 80% of patients. Mucocutaneous symptoms were the most common presentation (95%) and 65% had positive antiphospholipid antibodies. Until AVN development, all patients received a mean of 3.5 ± 0.7 g pulse steroid and a mean cumulative oral steroid dose of 18.6 ± 6.2 g. AVN was in the hip joint in 95% of cases, 80% were bilateral. AVN was grade II in 45% patients, grade III in 25% (n = 5), I in 20% (n = 4) and grade IV in 10% (n = 2). Grade I and II had preserved joint function and didn't need any surgery compared to stage III and IV.</p></div><div><h3>Conclusions</h3><p>In SLE patients, AVN is a relatively early complication occurring within 4 years of illness in patients with a young age at onset, and have a better outcome when detected at earlier stages.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"45 3","pages":"Pages 261-265"},"PeriodicalIF":0.9,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49792899","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":"Molecular typing of HLA-class II alleles reveals an association with autoantibodies and disease subsets of systemic sclerosis in a North Indian (Kashmir) population","authors":"Sakeena Ayub ,&nbsp;Zafar Shah ,&nbsp;Tabasum Shafi ,&nbsp;Fayaz Sofi ,&nbsp;Imtiyaz Bhat ,&nbsp;Roohi Rasool ,&nbsp;Mushtaq Dangroo ,&nbsp;Shahid Baba ,&nbsp;Nasia Ismail ,&nbsp;Nahidah Majid","doi":"10.1016/j.ejr.2023.04.007","DOIUrl":"https://doi.org/10.1016/j.ejr.2023.04.007","url":null,"abstract":"<div><h3>Aim of the work</h3><p>To identify specific human leukocyte antigen (HLA)-Class II (DRB/DQB1/DPB1) alleles associated with systemic sclerosis (SSc) and to explore their relation with SSc autoantibodies, clinical manifestations, and disease subsets.</p></div><div><h3>Patients and methods</h3><p>HLA-class II alleles (DRB1/DRB3/DRB4/DRB5/DQB1) were determined by DNA typing in 80 SSc cases and 60 matched controls and HLA-DPB1 in 40 SSc patients and 30 controls by allele-specific-polymerase chain reaction with sequence-specific primers (PCR-SSP).</p></div><div><h3>Results</h3><p>The mean age of SSc patients was 36.9 ± 9.4 years; 76 females and 4 males (F:M 19:1) and a disease duration of 5.3 ± 3.3 years, they were 43(53.7%) limited and 37(46.2%) diffuse subtypes. SSc was significantly associated with DRB1*11, DRB1*01, DQB1*04, and DQB1*03*03 in a &gt;4-fold manner, whereas DPB1*04 had a &gt;7-fold increased risk compared to controls. There was a strong association between DRB1*11 (p = 0.04), DQB1*03*03 (p = 0.005), and DPB1*13 (p = 0.009) with anti-topoisomerase I (anti-topoI) whereas the frequency of DRB1*01 (p &lt; 0.0001) was increased in patients with anti-centromere (ACA) positive SSc compared those negative (56% vs 25%; p &lt; 0.0001). DRB1*03, DRB1*15, and DQB1*03*01 were SSc protective alleles in patients with positive ACA. Anti-topo I was associated with interstitial lung disease (ILD) (p &lt; 0.01), whereas ACA with pulmonary arterial hypertension (PAH) (p = 0.01) and protection against ILD (p &lt; 0.001). In addition, HLA-DRB1*03, DQB1*03*01and DPB1*03 were more frequent in patients with ILD than in patients without.</p></div><div><h3>Conclusion</h3><p>Associations between specific HLA-class II alleles with certain SSc-specific autoantibodies (anti-topo I and ACA) were identified. Specific HLA associations with clinical and serological subtypes could serve as biomarkers of disease severity and progression in SSc.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"45 3","pages":"Pages 247-253"},"PeriodicalIF":0.9,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49819194","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":"Leukocytoclastic vasculitis induced by adalimumab biosimilar in an elderly female with rheumatoid arthritis: A case-based review","authors":"Dena Mohamadzadeh ,&nbsp;Shirin Assar ,&nbsp;Faraneh Farsad","doi":"10.1016/j.ejr.2023.04.001","DOIUrl":"https://doi.org/10.1016/j.ejr.2023.04.001","url":null,"abstract":"<div><h3>Background</h3><p>Adalimumab is one of the most frequently used tumor necrosis factor (TNF) inhibitors considered in the treatment of several autoimmune diseases including rheumatoid arthritis (RA). There have been reports of being adversely associated with the development of lupus and vasculitis. Leukocytoclastic vasculitis (LCV) is the most common form of cutaneous vasculitis that could be associated with different medications including TNF inhibitors.</p></div><div><h3>Case presentation</h3><p>A 64-year-old Iranian female with RA for 11 years presented to the rheumatology clinic, Imam Reza Hospital, Kermanshah University, complaining of erythematous patches, plaques, and erosions on her lower extremities for 20-days. She had been receiving methotrexate (MTX) for 11 years (on 5 mg/week) and adalimumab biosimilar 40 mg every other week for nine months prior to developing the skin lesions. There were no signs of RA activity. The routine laboratory tests and immunological workup including anti-nuclear antibodies (ANA), anti-neutrophil cytoplasmic antibody (ANCA) and serum complements were within normal limits. Abdominopelvic sonography showed no pathological finding. A skin biopsy confirmed the diagnosis of LCV. Adalimumab and MTX were discontinued and she was started on prednisolone (5 mg/day) and mycophenolate mofetil (2 g/day). Gradual improvement was observed. Similar reported cases of adalimumab-related LCV are presented.</p></div><div><h3>Conclusion</h3><p>Leukocytoclastic vasculitis could be a possible adverse event of TNF inhibitors. Complete improvement occurs after withdrawal of the culprit drug in most cases while corticosteroids and immunosuppressive medications are required in some cases. LCV associated with adalimumab biosimilar should raise the awareness of rheumatologists about this possible complication for appropriate management.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"45 3","pages":"Pages 225-228"},"PeriodicalIF":0.9,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49819189","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":"Pain neuroscience education versus transcutaneous vagal nerve stimulation in the management of patients with fibromyalgia","authors":"Asmaa M. Abdel-Baset ,&nbsp;Maii A. Abdellatif ,&nbsp;Haydy H.S. Ahmed ,&nbsp;Nashwa K. El Shaarawy","doi":"10.1016/j.ejr.2023.03.001","DOIUrl":"https://doi.org/10.1016/j.ejr.2023.03.001","url":null,"abstract":"<div><h3>Aim of the work</h3><p>To evaluate the effectiveness of pain neuroscience education (PNE) and transcutaneous vagal nerve stimulation (tVNS) for fibromyalgia (FM) patients, as one of the chronic pain treatment modalities.</p></div><div><h3>Patients and methods</h3><p>The study was conducted on 99 patients that were divided into 3 groups (n = 33 each): Patients in group A received 6 sessions of tVNS twice weekly (25 Hz for 30 min), group B received 6 sessions of tVNS twice weekly (25 Hz for 30 min) and 3 sessions of PNE once weekly (for 30 min) and group C received 3 sessions of PNE once weekly (for 30 min). The follow up done immediately after the end of the sessions by Visual Analogue Scale score, Fibromyalgia Impact Questionnaire (FIQ), Pain catastrophizing scale questionnaire (PCS-Q, Pain DETECT questionnaire (PD-Q) and state trait anxiety inventory (STAI Q) self-reported questionnaire.</p></div><div><h3>Results</h3><p>The mean age of patients was 33.3 ± 8.2 years and they were 86 females and 13 males (F:M 6.6: 1) and the 3 groups were matched for age (p = 0.15) and gender (p = 0.13). During the procedures no side effects were encountered. The 3 groups showed significant improvement of FM symptoms assessed by VAS, FIQ, PCS-Q, PD-Q and STAI-Q (state and trait), but group B showed the best results percentage of improvement (60%, 34.4%, 54.2%, 40%, 51.1% and 52,2% respectively).</p></div><div><h3>Conclusion</h3><p>Combined tVNS and PNE are more effective than PNE alone or VNS alone in management of FM. Further studies with long term follow up to assess the long-term effect of tVNS or PNE.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"45 3","pages":"Pages 191-195"},"PeriodicalIF":0.9,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49835222","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":"Potential value of collagen triple helix repeat containing-1 (CTHRC1) in systemic lupus erythematosus (SLE) patients with arthritis detected clinically or by musculoskeletal ultrasound","authors":"Reem El-Mallah ,&nbsp;Dina A. Farrag ,&nbsp;Nesma Ahmed Safwat","doi":"10.1016/j.ejr.2023.03.002","DOIUrl":"https://doi.org/10.1016/j.ejr.2023.03.002","url":null,"abstract":"<div><h3>Aim of the work</h3><p>Is to measure collagen triple helix repeat containing 1 (CTHRC1) in systemic lupus erythematosus (SLE) patients and assessing its value as a marker of arthritis.</p></div><div><h3>Patients and methods</h3><p>This study included 44 female SLE patients and 44 matched healthy controls. All patients underwent hand and wrist Ultrasound (US) examination. Patients were divided into those with arthritis either clinically or sub-clinically by Ultrasound (A) and second one without arthritis. Serum level of CTHRC1 was measured using Enzyme linked immunosorbent assay. Disease activity was assessed using SLEDAI-2 K and joint activity using swollen to tender ratio (STR).</p></div><div><h3>Results</h3><p>Serum CTHRC1 level was significantly higher in patients compared to controls (52.3 ± 25.7 ng/ml and 14.5 ± 3.9 ng/ml respectively, p &lt; 0.001). It was significantly higher in renal patients with nephritis and active arthritis by STR compared to those without (p = 0.04 and p = 0.003 respectively). Arthritis was detected in 68% of patients and they showed significantly higher CTHRC1 levels compared to those without (p = 0.037). Serum CTHRC1 showed positive significant correlation with STR (P = 0.007), CRP (p &lt; 0.001), SLEDAI-2 K (p = 0.01) but not US findings. The STR showed significant association with CTHRC1 on regression analysis (p = 0.034). There was a fair ability for CTHRC1 to predict clinical and sub-clinical arthritis among SLE patients with sensitivity 56.7, specificity 85.7 at cut off value &gt;55 ng/ml and area under curve 0.67.</p></div><div><h3>Conclusion</h3><p>Serum CTHRC1 level was significantly higher in SLE patients with nephritis and arthritis. It was significantly related to arthritis activity, inflammatory markers and disease activity. However, it showed fair performance for detecting arthritis.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"45 3","pages":"Pages 197-202"},"PeriodicalIF":0.9,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49835224","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":"Association between periodontitis and cardiovascular health in rheumatoid arthritis patients: Prospective effect of periodontal treatment on cardiovascular risk","authors":"Shaimaa Salah ,&nbsp;Nevin Hammam ,&nbsp;Mohamed Raouf Abdel Razek ,&nbsp;Nadia M. Ismail ,&nbsp;Ahmed Mortada Fikry ,&nbsp;Wageeh A. Ali ,&nbsp;Essam A. Abda","doi":"10.1016/j.ejr.2023.05.001","DOIUrl":"https://doi.org/10.1016/j.ejr.2023.05.001","url":null,"abstract":"<div><h3>Background</h3><p>Rheumatoid arthritis (RA) patients are more likely to develop cardiovascular disease (CVD), which increases the risk of morbidity and mortality.<!--> <!-->Periodontitis is known to be associated with CVD, yet its relationship with CVD in RA is limited.</p></div><div><h3>Aim of the work</h3><p>To examine the relationship between<!--> <!-->periodontitis with subclinical atherosclerosis and with long term CVD risk. Examining if periodontitis treatment can be associated with CVD improvement was well thought out.</p></div><div><h3>Patients and methods</h3><p>This prospective interventional study included 49 adults with RA. Demographic, clinical and therapeutic data and laboratory markers were assessed. Dental examination for periodontitis was performed. The carotid intima media thickness (CIMT) and Framingham risk score (FRS) were evaluated. Medical treatment was provided to RA patients with periodontitis, and assessments were repeated after 6 months.</p></div><div><h3>Results</h3><p>The mean age of the patients was 46.4 ± 12.4 years, disease duration 10.9 ± 5.4 years and 79.6% were females. 25 (51%) patients had subclinical atherosclerosis, 30 (61.2%) had periodontitis and 25 (51%) had both. RA patients with subclinical atherosclerosis had higher clinical attachment loss (CAL) (3.12 ± 1.45) and higher probing depth (PD) (4.96 ± 1.37) compared to those without (p &lt; 0.001). CAL (β = 0.01, 95 %CI: 0–0.01, p &lt; 0.001), and PD (β = 0.01, 95% CI: 0–0.01; p &lt; 0.001) were independently associated with CIMT. The 30 patients after treatment of periodontitis showed an average improvement in the mean CIMT (0.14 mm, p &lt; 0.001).</p></div><div><h3>Conclusion</h3><p>Periodontitis is associated with subclinical atherosclerosis in RA. Treatment of periodontitis could improve the cardiovascular health in RA patients and prompts physicians to early diagnose and treat periodontitis.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"45 3","pages":"Pages 255-260"},"PeriodicalIF":0.9,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49819195","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}