Egyptian Rheumatologist最新文献

英文中文

Clinical relevance of plasma soluble urokinase plasminogen activator receptor (suPAR) in Behçet’s disease 血浆可溶性尿激酶纤溶酶原激活剂受体（suPAR）与behaperet病的临床相关性

IF 1 Q4 RHEUMATOLOGY

Egyptian Rheumatologist

Pub Date : 2026-04-01 Epub Date: 2026-01-13 DOI: 10.1016/j.ejr.2026.01.003

Nada M. Gamal , Eman R. Badawy , Dalia Tohamy , Esraa A. Talaat

Background

Behçet’s disease (BD) is a chronic systemic vasculitis disease affecting many systems and presented with heterogeneous manifestations. No standard marker for BD diagnosis and monitoring its activity. The soluble urokinase plasminogen activator receptor (suPAR) is a membrane-bound glycoptotein that is primarily expressed on the surface of immunologically active cells; mirroring local inflammation and immune activation.

Aim

of the work.

To assess plasma suPAR in BD patients compared with healthy controls. In addition to analyze its association with BD clinical features, disease activity and damage index.

Patients and methods

The study included 50 BD patients and 40 controls, disease activity was assessed using an Arabic version of the Behçet’s Disease Current Activity Form (Ar-BDCAF). The damage events in BD patients were determined by Behçet’s disease damage index (BDI). Plasma suPAR level was measured by Enzyme linked immunosorbent assay (ELISA).

Results

The study included 50 BD patients; 41 males and 9 females, with a mean age of 34.9 ± 8.1 years and disease duration 6.8 ± 0.6 years. The mean Ar-BDCAF was 3.24 ± 0.42 (0–13) and BDI was 5.04 ± 0.48 (0–12). Plasma suPAR level in BD patients (0.97 ± 0.11; 0.55–4.86) ng/ml was significantly higher than in controls (0.53 ± 0.1; 0.32–0.69), p < 0.001. The optimum cut-off value for suPAR to predict BD was > 0.67 with accuracy 88 %, sensitivity 82 %, specificity 94 %, p < 0.001. There was a significant correlation between plasma suPAR level in BD patients and Ar-BDCAF (r = 0.81, p < 0.001).

Conclusion

Plasma suPAR level may serve as a promising marker that can be helpful in diagnosis and monitoring disease activity of BD patients.

背景behet病（BD）是一种累及多系统的慢性全身性血管炎，表现多样。没有标准的双相障碍诊断和监测其活性的标志物。可溶性尿激酶纤溶酶原激活物受体（suPAR）是一种主要表达于免疫活性细胞表面的膜结合糖蛋白；反映局部炎症和免疫激活。工作的目的。评估BD患者血浆suPAR与健康对照组的比较。并分析其与BD临床特征、疾病活动性及损伤指标的关系。患者和方法该研究包括50名BD患者和40名对照者，使用阿拉伯版本的behet疾病当前活动表（Ar-BDCAF）评估疾病活动性。采用behet疾病损害指数（BDI）测定BD患者的损伤事件。采用酶联免疫吸附试验（ELISA）检测血浆suPAR水平。结果纳入50例BD患者；男性41例，女性9例，平均年龄34.9±8.1岁，病程6.8±0.6年。平均Ar-BDCAF为3.24±0.42 (0-13)，BDI为5.04±0.48（0-12）。BD患者血浆suPAR水平（0.97±0.11;0.55-4.86）ng/ml显著高于对照组（0.53±0.1;0.32-0.69），p < 0.001。suPAR预测BD的最佳临界值为0.67，准确性88%，敏感性82%，特异性94%，p < 0.001。BD患者血浆suPAR水平与Ar-BDCAF有显著相关性（r = 0.81, p < 0.001）。结论血浆suPAR水平可作为BD患者诊断和监测疾病活动度的重要指标。

{"title":"Clinical relevance of plasma soluble urokinase plasminogen activator receptor (suPAR) in Behçet’s disease","authors":"Nada M. Gamal , Eman R. Badawy , Dalia Tohamy , Esraa A. Talaat","doi":"10.1016/j.ejr.2026.01.003","DOIUrl":"10.1016/j.ejr.2026.01.003","url":null,"abstract":"<div><h3>Background</h3><div>Behçet’s disease (BD) is a chronic systemic vasculitis disease affecting many systems and presented with heterogeneous manifestations. No standard marker for BD diagnosis and monitoring its activity. The soluble urokinase plasminogen activator receptor (suPAR) is a membrane-bound glycoptotein that is primarily expressed on the surface of immunologically active cells; mirroring local inflammation and immune activation.</div></div><div><h3>Aim</h3><div>of the work.</div><div>To assess plasma suPAR in BD patients compared with healthy controls. In addition to analyze its association with BD clinical features, disease activity and damage index.</div></div><div><h3>Patients and methods</h3><div>The study included 50 BD patients and 40 controls, disease activity was assessed using an Arabic version of the Behçet’s Disease Current Activity Form (Ar-BDCAF). The damage events in BD patients were determined by Behçet’s disease damage index (BDI). Plasma suPAR level was measured by Enzyme linked immunosorbent assay (ELISA).</div></div><div><h3>Results</h3><div>The study included 50 BD patients; 41 males and 9 females, with a mean age of 34.9 ± 8.1 years and disease duration 6.8 ± 0.6 years. The mean Ar-BDCAF was 3.24 ± 0.42 (0–13) and BDI was 5.04 ± 0.48 (0–12). Plasma suPAR level in BD patients (0.97 ± 0.11; 0.55–4.86) ng/ml was significantly higher than in controls (0.53 ± 0.1; 0.32–0.69), p < 0.001. The optimum cut-off value for suPAR to predict BD was > 0.67 with accuracy 88 %, sensitivity 82 %, specificity 94 %, p < 0.001. There was a significant correlation between plasma suPAR level in BD patients and Ar-BDCAF (r = 0.81, p < 0.001).</div></div><div><h3>Conclusion</h3><div>Plasma suPAR level may serve as a promising marker that can be helpful in diagnosis and monitoring disease activity of BD patients.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"48 2","pages":"Pages 101-105"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145957688","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}

引用次数: 0

The role of s100A8 protein as an inflammatory marker in patients with rheumatoid arthritis and its relation to clinical and radiological parameters s100A8蛋白作为类风湿关节炎患者炎症标志物的作用及其与临床和放射学参数的关系

IF 1 Q4 RHEUMATOLOGY

Egyptian Rheumatologist

Pub Date : 2026-04-01 Epub Date: 2026-02-02 DOI: 10.1016/j.ejr.2026.01.007

Marwa M. Abu Elinin, Mervat A. El Sergany, Amal S. El Bendary, Shereen A. Elwan

Aim of the work

To identify the serum level of S100A8 protein in patients with rheumatoid arthritis (RA) and to evaluate its relationship with different clinical, laboratory, and radiological parameters.

Patients and methods

This study included 60RA patients and 30matchedcontrols. Pain severity was assessed using the Visual Analog Scale (VAS), while functional status was evaluated using the Modified Health Assessment Questionnaire (MHAQ). Disease Activity Score (DAS28) was assessed. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), anti-cyclic citrullinated peptide antibodies (anti-CCP), and serum S100A8 levels were measured. Radiological evaluation was performed using plain X-ray imaging and assessed by the modified Larsen score.

Results

The mean age of the patients was 46.5 ± 10.6 years, with a female predominance (93.3%). The mean morning stiffness was 56.8 ± 32.1 min (15–120 min), mean DAS28 was 3.2 ± 0.12, MHAQ was 1.47 ± 0.11 and Larsen 43.9 ± 3.6. Serum S100A8 level was significantly higher in RA patients (723.5 ± 647.8 mg/dl) compared to the control (121.3 ± 96.6 mg/dl) (p < 0.001). Significant correlations were found between S100A8 levels and tender joint count (TJC)(p = 0.001), swollen joint count (SJC)(p = 0.01), VAS (p = 0.024), ESR (p < 0.001), CRP (p < 0.001), DAS28 (p < 0.001), MHAQ (p < 0.001), anti-CCP (p < 0.001) and Larsen score (p = 0.004). Linear regression analysis revealed that ESR, CRP, DAS28, MHAQ and anti-CCP were independent predictors of S100A8 levels (p < 0.001). S100A8 can significantly predict individuals with RA (p < 0.001, area under the curve AUC = 0.93) at a cut-off > 159 mg/dl, 85% sensitivity, 83.3% specificity.

Conclusions

The concentration of S100A8 was markedly elevated in RA patients with significant relation to disease activity, bone erosions and joint destruction.

目的探讨类风湿关节炎（RA）患者血清S100A8蛋白水平及其与临床、实验室及影像学指标的关系。患者和方法本研究包括60例ra患者和30例匹配的对照组。使用视觉模拟量表（VAS）评估疼痛严重程度，使用改良健康评估问卷（MHAQ）评估功能状态。评估疾病活动评分（DAS28）。检测红细胞沉降率（ESR）、c反应蛋白（CRP）、类风湿因子（RF）、抗环瓜氨酸肽抗体（anti-CCP）、血清S100A8水平。影像学评价采用x线平片成像，并采用改良Larsen评分进行评估。结果患者平均年龄46.5±10.6岁，女性居多（93.3%）。平均晨僵为56.8±32.1 min (15 ~ 120 min)，平均DAS28为3.2±0.12，MHAQ为1.47±0.11，Larsen为43.9±3.6。RA患者血清S100A8水平（723.5±647.8 mg/dl）明显高于对照组（121.3±96.6 mg/dl）（p < 0.001）。S100A8水平与压痛关节计数（TJC）（p = 0.001）、肿胀关节计数（SJC）（p = 0.01）、VAS （p = 0.024）、ESR （p < 0.001）、CRP （p < 0.001）、DAS28 （p < 0.001）、MHAQ （p < 0.001）、anti-CCP （p < 0.001）、Larsen评分（p = 0.004）具有显著相关性。线性回归分析显示ESR、CRP、DAS28、MHAQ和anti-CCP是S100A8水平的独立预测因子（p < 0.001）。S100A8能显著预测RA个体（p < 0.001，曲线下面积AUC = 0.93），截止值为159 mg/dl，敏感性85%，特异性83.3%。结论S100A8浓度在RA患者中明显升高，与疾病活动度、骨侵蚀和关节破坏有显著关系。

{"title":"The role of s100A8 protein as an inflammatory marker in patients with rheumatoid arthritis and its relation to clinical and radiological parameters","authors":"Marwa M. Abu Elinin, Mervat A. El Sergany, Amal S. El Bendary, Shereen A. Elwan","doi":"10.1016/j.ejr.2026.01.007","DOIUrl":"10.1016/j.ejr.2026.01.007","url":null,"abstract":"<div><h3>Aim of the work</h3><div>To identify the serum level of S100A8 protein in patients with rheumatoid arthritis (RA) and to evaluate its relationship with different clinical, laboratory, and radiological parameters.</div></div><div><h3>Patients and methods</h3><div>This study included 60RA patients and 30matchedcontrols. Pain severity was assessed using the Visual Analog Scale (VAS), while functional status was evaluated using the Modified Health Assessment Questionnaire (MHAQ). Disease Activity Score (DAS28) was assessed. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), anti-cyclic citrullinated peptide antibodies (anti-CCP), and serum S100A8 levels were measured. Radiological evaluation was performed using plain X-ray imaging and assessed by the modified Larsen score.</div></div><div><h3>Results</h3><div>The mean age of the patients was 46.5 ± 10.6 years, with a female predominance (93.3%). The mean morning stiffness was 56.8 ± 32.1 min (15–120 min), mean DAS28 was 3.2 ± 0.12, MHAQ was 1.47 ± 0.11 and Larsen 43.9 ± 3.6. Serum S100A8 level was significantly higher in RA patients (723.5 ± 647.8 mg/dl) compared to the control (121.3 ± 96.6 mg/dl) (p < 0.001). Significant correlations were found between S100A8 levels and tender joint count (TJC)(p = 0.001), swollen joint count (SJC)(p = 0.01), VAS (p = 0.024), ESR (p < 0.001), CRP (p < 0.001), DAS28 (p < 0.001), MHAQ (p < 0.001), anti-CCP (p < 0.001) and Larsen score (p = 0.004). Linear regression analysis revealed that ESR, CRP, DAS28, MHAQ and anti-CCP were independent predictors of S100A8 levels (p < 0.001). S100A8 can significantly predict individuals with RA (p < 0.001, area under the curve AUC = 0.93) at a cut-off > 159 mg/dl, 85% sensitivity, 83.3% specificity.</div></div><div><h3>Conclusions</h3><div>The concentration of S100A8 was markedly elevated in RApatients with significant relation to disease activity, bone erosions and joint destruction.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"48 2","pages":"Pages 126-129"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146189378","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}

引用次数: 0

Assessment of kinesiophobia in patients with rheumatoid arthritis and systemic lupus erythematosus and its association with disease activity, functional status, pain severity and depression 类风湿关节炎和系统性红斑狼疮患者运动恐惧症的评估及其与疾病活动性、功能状态、疼痛严重程度和抑郁的关系

IF 1 Q4 RHEUMATOLOGY

Egyptian Rheumatologist

Pub Date : 2026-04-01 Epub Date: 2026-01-18 DOI: 10.1016/j.ejr.2026.01.002

Aya H. Eldesouky , Yara M. Amin , Hanaa M. Rady

Aim of the work

To evaluate and compare the frequency of kinesiophobia in patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA), as well as its association with disease parameters.

Patients and methods

The study included 63 RA patients, 63 SLE patients, and 63 matched controls. The Tampa Kinesiophobia Scale (TKS) was assessed. The disease activity score (DAS28) in RA and SLE disease activity index 2000 (SLEDAI-2K) were evaluated. The health assessment questionnaire (HAQ) was used to assess functional status, the visual analogue scale (VAS) was used to assess pain severity, and depression was assessed using a validated Arabic version of the patient health questionnaire-9 (PHQ-9).

Results

The mean age of RA patients was 49.1 ± 10.2 years, 58 females and 5 males (F:M 11.6:1); SLE patients’ age was 34.5 ± 9.3 years, F:M 11.6:1. Kinesiophobia was significantly more frequent in RA compared to SLE (n = 46, 73 % vs. n = 42, 66.7 %; p = 0.44). The PHQ9 and VAS-pain were significantly higher in SLE patients (19 ± 8.07 and 5.2 ± 3.1) compared to RA (15.6 ± 9.1 and 4 ± 3.02 respectively, p = 0.03 and p = 0.027). TKS significantly correlated with DAS28 in RA (r = 0.422, p = 0.001) but not with SLEDAI-2K in SLE (r = 0.117, p = 0.36). TKS significantly correlated with HAQ, PHQ9, and VAS in RA (r = 0.49, p < 0.001; r = 0.33, p = 0.009 and r = 0.35, p = 0.004 respectively) and in SLE (r = 0.46, p < 0.001; r = 0.31, p = 0.013 and r = 0.35, p = 0.004 respectively) patients.

Conclusions

Both RA and SLE patients have a high frequency of kinesiophobia. It appears to be higher in RA patients and is associated with disease activity. It is critical to identify and treat kinesiophobia to lessen long-term effects.

目的评价和比较系统性红斑狼疮（SLE）和类风湿关节炎（RA）患者运动恐惧的频率及其与疾病参数的关系。患者和方法该研究包括63例RA患者，63例SLE患者和63例匹配的对照组。采用坦帕运动恐惧症量表（TKS）进行评估。评估RA患者疾病活动性评分DAS28和SLE患者疾病活动性指数2000 （SLEDAI-2K）。采用健康评估问卷（HAQ）评估功能状态，采用视觉模拟量表（VAS）评估疼痛严重程度，采用经验证的阿拉伯文版患者健康问卷-9 （PHQ-9）评估抑郁程度。结果RA患者平均年龄49.1±10.2岁，女性58例，男性5例（男∶女11.6:1）；SLE患者年龄34.5±9.3岁，F:M: 11.6:1。与SLE相比，RA患者的运动恐惧症明显更常见（n = 46, 73% vs. n = 42, 66.7%; p = 0.44）。SLE患者PHQ9评分（19±8.07）和VAS-pain评分（5.2±3.1）明显高于RA（15.6±9.1和4±3.02,p = 0.03和p = 0.027）。TKS与RA患者DAS28有显著相关性（r = 0.422, p = 0.001），与SLE患者SLEDAI-2K无显著相关性（r = 0.117, p = 0.36）。在RA （r = 0.49, p < 0.001; r = 0.33, p = 0.009, r = 0.35, p = 0.004）和SLE （r = 0.46, p < 0.001; r = 0.31, p = 0.013, r = 0.35, p = 0.004）患者中，TKS与HAQ、PHQ9、VAS显著相关。结论RA和SLE患者均有较高的运动恐惧发生率。在类风湿性关节炎患者中，它似乎更高，并且与疾病活动有关。识别和治疗运动恐惧症对于减少长期影响至关重要。

{"title":"Assessment of kinesiophobia in patients with rheumatoid arthritis and systemic lupus erythematosus and its association with disease activity, functional status, pain severity and depression","authors":"Aya H. Eldesouky , Yara M. Amin , Hanaa M. Rady","doi":"10.1016/j.ejr.2026.01.002","DOIUrl":"10.1016/j.ejr.2026.01.002","url":null,"abstract":"<div><h3>Aim of the work</h3><div>To evaluate and compare the frequency of kinesiophobia in patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA), as well as its association with disease parameters.</div></div><div><h3>Patients and methods</h3><div>The study included 63 RA patients, 63 SLE patients, and 63 matched controls. The Tampa Kinesiophobia Scale (TKS) was assessed. The disease activity score (DAS28) in RA and SLE disease activity index 2000 (SLEDAI-2K) were evaluated. The health assessment questionnaire (HAQ) was used to assess functional status, the visual analogue scale (VAS) was used to assess pain severity, and depression was assessed using a validated Arabic version of the patient health questionnaire-9 (PHQ-9).</div></div><div><h3>Results</h3><div>The mean age of RA patients was 49.1 ± 10.2 years, 58 females and 5 males (F:M 11.6:1); SLE patients’ age was 34.5 ± 9.3 years, F:M 11.6:1. Kinesiophobia was significantly more frequent in RA compared to SLE (n = 46, 73 % vs. n = 42, 66.7 %; p = 0.44). The PHQ9 and VAS-pain were significantly higher in SLE patients (19 ± 8.07 and 5.2 ± 3.1) compared to RA (15.6 ± 9.1 and 4 ± 3.02 respectively, p = 0.03 and p = 0.027). TKS significantly correlated with DAS28 in RA (r = 0.422, p = 0.001) but not with SLEDAI-2K in SLE (r = 0.117, p = 0.36). TKS significantly correlated with HAQ, PHQ9, and VAS in RA (r = 0.49, p < 0.001; r = 0.33, p = 0.009 and r = 0.35, p = 0.004 respectively) and in SLE (r = 0.46, p < 0.001; r = 0.31, p = 0.013 and r = 0.35, p = 0.004 respectively) patients.</div></div><div><h3>Conclusions</h3><div>Both RA and SLE patients have a high frequency of kinesiophobia. It appears to be higher in RA patients and is associated with disease activity. It is critical to identify and treat kinesiophobia to lessen long-term effects.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"48 2","pages":"Pages 106-109"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146039258","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}

引用次数: 0

Methotrexate intolerance in rheumatoid arthritis: Prevalence, risk factors and impact on treatment adherence 类风湿关节炎患者甲氨蝶呤不耐受：患病率、危险因素和对治疗依从性的影响

IF 1 Q4 RHEUMATOLOGY

Egyptian Rheumatologist

Pub Date : 2026-04-01 Epub Date: 2026-01-29 DOI: 10.1016/j.ejr.2026.01.006

Aya K. El-Hindawy, Hala A. Raafat, Marwa Magdy, Dina Ossama Abdulazim

Aim of the work

To assess methotrexate (MTX) intolerance in rheumatoid arthritis (RA) patients and to identify its predictors using validated Arabic version of the MTX Intolerance Severity Score (MISS).

Patients and methods

The study included 355 RA patients on MTX for at least three months. Detailed disease and drug history were recorded. MTX intolerance was assessed using a validated Arabic version of the MTX Intolerance Severity Score (MISS) and compliance assessed using the Arabic version of the 5-Item Compliance Questionnaire for Rheumatology (CQR5).

Results

50.7% of the patients were MTX intolerant while 66.2% were compliant on MTX. The mean age of the patients was 38.4 ± 12.1 years and 92.7% were females. Predictors of MTX intolerance using MISS were younger age at disease onset (p = 0.006), longer disease duration (p = 0.001), parenteral MTX administration (IM/oral p < 0.001, OR 3.95, SC/oral p < 0.001, OR 7.73), fixed morning dosing compared to divided or inconsistent schedule divided/morning p < 0.001, Inconsistent time/morning p = 0.014), receiving MTX before meals versus after meals (p = 0.007, OR 5.61), concomitant leflunomide use (p = 0.01, OR 1.88) and higher tender joint count (p = 0.03). While leflunomide intake (p = 0.002, OR 2.65) and parenteral MTX administration (IM/oral 0.002, OR 6.06, SC/oral < 0.001, OR 14.3) were the only predictors in multivariate logistic regression. MTX intolerant patients were receiving significantly lower number of cigarette pack/year (p = 0.007). However caffeine intake, folate adherence and dosage, disease activity, presence of extra-articular manifestations were not associated with MTX intolerance.

Conclusion

MTX intolerance is frequent in RA patients especially females. A significant association was found with parenteral route of administration and concomitant leflunomide intake.

研究目的：评估类风湿性关节炎（RA）患者的甲氨蝶呤（MTX）不耐受，并使用经过验证的阿拉伯版本MTX不耐受严重程度评分（MISS）来确定其预测因素。患者和方法该研究包括355名接受MTX治疗至少3个月的RA患者。详细记录疾病和用药史。使用经过验证的阿拉伯版MTX不耐受严重程度评分（MISS）评估MTX不耐受，使用阿拉伯版5项风湿病依从性问卷（CQR5）评估MTX依从性。结果50.7%的患者MTX不耐受，66.2%的患者MTX依从。患者平均年龄为38.4±12.1岁，女性占92.7%。使用MISS进行MTX不耐受的预测因子为发病年龄较小（p = 0.006）、病程较长（p = 0.001）、肠外给药（IM/口服p <； 0.001, OR 3.95， SC/口服p <； 0.001, OR 7.73）、固定的早晨给药与不一致的时间表（p < 0.001，不一致的时间/早晨p = 0.014）、餐前给药与餐后给药（p = 0.007, OR 5.61）、同时使用来氟米特(p = 0.01，OR 1.88)和更高的压痛关节计数（p = 0.03）。而来氟米特摄入量（p = 0.002, OR 2.65）和肠外给药MTX （IM/口服0.002,OR 6.06， SC/口服0.001,OR 14.3）是多因素logistic回归的唯一预测因素。甲氨蝶呤不耐受患者每年接受的卷烟包数明显减少（p = 0.007）。然而，咖啡因摄入量、叶酸依从性和剂量、疾病活动性、关节外表现的存在与MTX不耐受无关。结论甲氨蝶呤不耐受在RA患者中较为常见，尤其是女性患者。发现肠外给药途径和同时服用来氟米特有显著关联。

{"title":"Methotrexate intolerance in rheumatoid arthritis: Prevalence, risk factors and impact on treatment adherence","authors":"Aya K. El-Hindawy, Hala A. Raafat, Marwa Magdy, Dina Ossama Abdulazim","doi":"10.1016/j.ejr.2026.01.006","DOIUrl":"10.1016/j.ejr.2026.01.006","url":null,"abstract":"<div><h3>Aim of the work</h3><div>To assess methotrexate (MTX) intolerance in rheumatoid arthritis (RA) patients and to identify its predictors using validated Arabic version of the MTX Intolerance Severity Score (MISS).</div></div><div><h3>Patients and methods</h3><div>The study included 355 RA patients on MTX for at least three months. Detailed disease and drug history were recorded. MTX intolerance was assessed using a validated Arabic version of the MTX Intolerance Severity Score (MISS) and compliance assessed using the Arabic version of the 5-Item Compliance Questionnaire for Rheumatology (CQR5).</div></div><div><h3>Results</h3><div>50.7% of the patients were MTX intolerant while 66.2% were compliant on MTX. The mean age of the patients was 38.4 ± 12.1 years and 92.7% were females. Predictors of MTX intolerance using MISS were younger age at disease onset (p = 0.006), longer disease duration (p = 0.001), parenteral MTX administration (IM/oral p < 0.001, OR 3.95, SC/oral p < 0.001, OR 7.73), fixed morning dosing compared to divided or inconsistent schedule divided/morning p < 0.001, Inconsistent time/morning p = 0.014), receiving MTX before meals versus after meals (p = 0.007, OR 5.61), concomitant leflunomide use (p = 0.01, OR 1.88) and higher tender joint count (p = 0.03). While leflunomide intake (p = 0.002, OR 2.65) and parenteral MTX administration (IM/oral 0.002, OR 6.06, SC/oral < 0.001, OR 14.3) were the only predictors in multivariate logistic regression. MTX intolerant patients were receiving significantly lower number of cigarette pack/year (p = 0.007). However caffeine intake, folate adherence and dosage, disease activity, presence of extra-articular manifestations were not associated with MTX intolerance.</div></div><div><h3>Conclusion</h3><div>MTX intolerance is frequent in RA patients especially females. A significant association was found with parenteral route of administration and concomitant leflunomide intake.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"48 2","pages":"Pages 121-125"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146090355","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}

引用次数: 0

Inflammatory bowel disease among radiographic axial spondyloarthritis’ patients: Frequency and diagnostic value of fecal calprotectin 轴型脊柱关节炎患者的炎症性肠病：粪便钙保护蛋白的频率和诊断价值

IF 1 Q4 RHEUMATOLOGY

Egyptian Rheumatologist

Pub Date : 2026-04-01 Epub Date: 2026-01-28 DOI: 10.1016/j.ejr.2026.01.005

Ghada A. Ahmed , Fatma M. Aboud , Mohammad M.A. Alsawe , Alshymaa M.F. Motaher

Background

Inflammatory bowel disease (IBD) affects 5–10% of patients with axial spondyloarthritis (axSpA). Patients with axSpA and concurrent IBD may experience more severe disease and exhibit a lower prevalence of human leukocytic antigen-B27 (HLA-B27).

Aim of the work

To determine the frequency of IBD in patients with radiographic axSpA (r-axSpA) and to analyze the clinical characteristics associated with its presence.

Patients and methods

This study included 97 r-axSpA patients. Colonoscopy was performed in patients presenting with gastrointestinal symptoms suggestive of IBD. The ankylosing spondylitis disease activity score (ASDAS) and Bath ankylosing spondylitis disease activity index (BASDAI) were assessed.

Results

The mean age of patients was 36.9 ± 4.8 years, 59 females and 38 males (F:M 1.6:1). HLA-B27 was positive in 74 (76.3%). The mean ASDAS was 2.4 ± 0.94 and BASDAI 3.53 ± 1.5. Fifty (51.5%) patients had concurrent IBD and a significantly higher C-reactive protein (CRP)(57.5 ± 20.03 mg/dl) and erythrocyte sedimentation rate (ESR)(29.8 ± 13.5 mm/1^sthr) levels than those without IBD (1.66 ± 2.70 mg/dl and 7.55 ± 4.99 mm/1^sthr; p < 0.001for both). r-axSpA patients with IBD had significantly higher mean fecal calprotectin levels (522 ± 178.52 µg/g) compared to those without (232.57 ± 70.13 µg/g)(p < 0.001). No significant differences were detected between those with and without IBD regarding HLA-B27 positivity (p = 0.87), ASDAS (p = 0.18) and BASDAI (p = 0.32). Fecal calprotectin showed excellent diagnostic performance discriminating those with IBD at cut-off 353 µg/g.

Conclusion

There is clinical heterogeneity within the spectrum of r-axSpA and the significance of recognizing concurrent IBD is underscored, particularly in patients who present with gastrointestinal symptoms, elevated inflammatory markers, or increased fecal calprotectin levels.

背景炎性肠病（IBD）影响5-10%的轴性脊柱炎（axSpA）患者。axSpA合并IBD的患者可能会经历更严重的疾病，并表现出较低的人类白细胞抗原b27 （HLA-B27）患病率。研究目的：确定影像学axSpA （r-axSpA）患者IBD的发生频率，并分析其临床特征。患者和方法本研究纳入97例r-axSpA患者。对出现提示IBD的胃肠道症状的患者进行结肠镜检查。评估强直性脊柱炎疾病活动性评分（ASDAS）和巴斯强直性脊柱炎疾病活动性指数（BASDAI）。结果患者平均年龄36.9±4.8岁，女性59例，男性38例（男女比1.6:1）。HLA-B27阳性74例（76.3%）。平均ASDAS为2.4±0.94，BASDAI为3.53±1.5。50例（51.5%）患者同时患有IBD，其c反应蛋白（CRP）（57.5±20.03 mg/dl）和红细胞沉降率（ESR）（29.8±13.5 mm/ 1thr）水平明显高于非IBD患者（1.66±2.70 mg/dl和7.55±4.99 mm/ 1thr; p < 0.001）。r-axSpA合并IBD的患者粪钙保护蛋白水平（522±178.52µg/g）显著高于未合并IBD的患者（232.57±70.13µg/g）（p < 0.001）。IBD患者与非IBD患者HLA-B27阳性（p = 0.87）、ASDAS阳性（p = 0.18）、BASDAI阳性（p = 0.32）差异无统计学意义。粪钙保护蛋白在353µg/g的临界值上对IBD有很好的诊断效果。结论r-axSpA谱存在临床异质性，强调了识别并发IBD的重要性，特别是在出现胃肠道症状、炎症标志物升高或粪便钙保护蛋白水平升高的患者中。

{"title":"Inflammatory bowel disease among radiographic axial spondyloarthritis’ patients: Frequency and diagnostic value of fecal calprotectin","authors":"Ghada A. Ahmed , Fatma M. Aboud , Mohammad M.A. Alsawe , Alshymaa M.F. Motaher","doi":"10.1016/j.ejr.2026.01.005","DOIUrl":"10.1016/j.ejr.2026.01.005","url":null,"abstract":"<div><h3>Background</h3><div>Inflammatory bowel disease (IBD) affects 5–10% of patients with axial spondyloarthritis (axSpA). Patients with axSpA and concurrent IBD may experience more severe disease and exhibit a lower prevalence of human leukocytic antigen-B27 (HLA-B27).</div></div><div><h3>Aim of the work</h3><div>To determine the frequency of IBD in patients with radiographic axSpA (r-axSpA) and to analyze the clinical characteristics associated with its presence.</div></div><div><h3>Patients and methods</h3><div>This study included 97 r-axSpA patients. Colonoscopy was performed in patients presenting with gastrointestinal symptoms suggestive of IBD. The ankylosing spondylitis disease activity score (ASDAS) and Bath ankylosing spondylitis disease activity index (BASDAI) were assessed.</div></div><div><h3>Results</h3><div>The mean age of patients was 36.9 ± 4.8 years, 59 females and 38 males (F:M 1.6:1). HLA-B27 was positive in 74 (76.3%). The mean ASDAS was 2.4 ± 0.94 and BASDAI 3.53 ± 1.5. Fifty (51.5%) patients had concurrent IBD and a significantly higher C-reactive protein (CRP)(57.5 ± 20.03 mg/dl) and erythrocyte sedimentation rate (ESR)(29.8 ± 13.5 mm/1<sup>st</sup>hr) levels than those without IBD (1.66 ± 2.70 mg/dl and 7.55 ± 4.99 mm/1<sup>st</sup>hr; p < 0.001for both). r-axSpA patients with IBD had significantly higher mean fecal calprotectin levels (522 ± 178.52 µg/g) compared to those without (232.57 ± 70.13 µg/g)(p < 0.001). No significant differences were detected between those with and without IBD regarding HLA-B27 positivity (p = 0.87), ASDAS (p = 0.18) and BASDAI (p = 0.32). Fecal calprotectin showed excellent diagnostic performance discriminating those with IBD at cut-off 353 µg/g.</div></div><div><h3>Conclusion</h3><div>There is clinical heterogeneity within the spectrum of r-axSpA and the significance of recognizing concurrent IBD is underscored, particularly in patients who present with gastrointestinal symptoms, elevated inflammatory markers, or increased fecal calprotectin levels.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"48 2","pages":"Pages 116-120"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146090399","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}

引用次数: 0

Role of urinary biomarkers in the diagnosis of lupus cystitis in systemic lupus erythematosus patients: Relation to disease activity and lower urinary tract manifestations 尿生物标志物在系统性红斑狼疮患者狼疮性膀胱炎诊断中的作用：与疾病活动性和下尿路表现的关系

IF 1 Q4 RHEUMATOLOGY

Egyptian Rheumatologist

Pub Date : 2026-04-01 Epub Date: 2026-01-22 DOI: 10.1016/j.ejr.2026.01.004

Safaa A. Hussein , Dahlia Abdel Mohsen , Maryam A. Abdulrahman , Maha A. Elserwy , Khaled S. Soliman , Tasneem E. Mohammed , Amr M. Hawwash

Aim of the work: To assess the role of urinary biomarkers, macrophage inflammatory protein (MIP)-1β and chemokine (C-X-C motif) ligand 10 (CXCL10), in the diagnosis of lupus cystitis (LC) in systemic lupus erythematosus (SLE) patients, and to determine its relation to SLE disease activity and lower urinary tract symptoms (LUTS). Patients and methods: 72 SLE patients were studied. Modified British Isles Lupus Assessment Group (BILAG) index, BILAG-2004 index, was assessed. Lower urinary tract symptoms score (LUTSS) questionnaire was conducted. Urinary MIP-1β and CXCL10 levels were measured. Pelvic ultrasound was performed to assess urinary bladder wall thickness (BWT). Results: The 72 patients mean age was 30.54 ± 9.22 years; were 62 females, 10 males. Positive LUTSS was detected in 37 patients, with mean score 14.01 ± 6.7. The mean urinary BWT was 4.39 ± 1.29 mm, and 57 patients had thickened urinary bladder wall. MIP-1β was significantly high in patients with severe renal disease activity, albuminuria and pyuria. Both MIP-1β and CXCL10 were significantly high in patients with microscopic hematuria. MIP-1β significantly correlated with protein/creatinine ratio, and CXCL10 had positive correlation with erythrocyte sedimentation rate (ESR). MIP-1β was positively correlated with serum creatinine in patients with thickened urinary bladder wall. Conclusion: Lupus cystitis and LUTS are frequent in SLE patients. Lupus cystitis might be asymptomatic. Urinary bladder ultrasound plays an important role in the early recognition of LC. Lupus cystitis is possibly associated with SLE disease activity. Urinary MIP-1β and CXCL10 may have a potential role in the evaluation of SLE disease activity, particularly lupus nephritis.

研究目的：评估尿液生物标志物巨噬细胞炎症蛋白(MIP)-1β和趋化因子（C-X-C基序）配体10 （CXCL10）在系统性红斑狼疮（SLE）患者狼疮膀胱炎（LC）诊断中的作用，并确定其与SLE疾病活动性和下尿路症状（LUTS）的关系。患者与方法：对72例SLE患者进行研究。采用修正英伦三岛狼疮评估组（BILAG）指数，即BILAG-2004指数进行评估。采用下尿路症状评分（LUTSS）问卷。检测尿MIP-1β和CXCL10水平。盆腔超声评估膀胱壁厚度（BWT）。结果：72例患者平均年龄30.54±9.22岁；女性62人，男性10人。LUTSS阳性37例，平均评分14.01±6.7分。尿BWT平均值为4.39±1.29 mm， 57例患者膀胱壁增厚。MIP-1β在严重肾脏疾病活动性、蛋白尿和脓尿患者中显著升高。显微镜下血尿患者MIP-1β和CXCL10均显著升高。MIP-1β与蛋白/肌酐比值显著相关，CXCL10与红细胞沉降率（ESR）呈正相关。MIP-1β与膀胱壁增厚患者血清肌酐呈正相关。结论：狼疮性膀胱炎和LUTS是SLE患者的常见病。狼疮性膀胱炎可能无症状。膀胱超声对LC的早期识别具有重要作用。狼疮性膀胱炎可能与SLE疾病活动性有关。尿MIP-1β和CXCL10可能在SLE疾病活动性评估中具有潜在作用，特别是狼疮性肾炎。

{"title":"Role of urinary biomarkers in the diagnosis of lupus cystitis in systemic lupus erythematosus patients: Relation to disease activity and lower urinary tract manifestations","authors":"Safaa A. Hussein , Dahlia Abdel Mohsen , Maryam A. Abdulrahman , Maha A. Elserwy , Khaled S. Soliman , Tasneem E. Mohammed , Amr M. Hawwash","doi":"10.1016/j.ejr.2026.01.004","DOIUrl":"10.1016/j.ejr.2026.01.004","url":null,"abstract":"<div><div><em>Aim of the work:</em> To assess the role of urinary biomarkers, macrophage inflammatory protein (MIP)-1β and chemokine (C-X-C motif) ligand 10 (CXCL10), in the diagnosis of lupus cystitis (LC) in systemic lupus erythematosus (SLE) patients, and to determine its relation to SLE disease activity and lower urinary tract symptoms (LUTS). <em>Patients and methods:</em> 72 SLE patients were studied. Modified British Isles Lupus Assessment Group (BILAG) index, BILAG-2004 index, was assessed. Lower urinary tract symptoms score (LUTSS) questionnaire was conducted. Urinary MIP-1β and CXCL10 levels were measured. Pelvic ultrasound was performed to assess urinary bladder wall thickness (BWT). <em>Results:</em> The 72 patients mean age was 30.54 ± 9.22 years; were 62 females, 10 males. Positive LUTSS was detected in 37 patients, with mean score 14.01 ± 6.7. The mean urinary BWT was 4.39 ± 1.29 mm, and 57 patients had thickened urinary bladder wall. MIP-1β was significantly high in patients with severe renal disease activity, albuminuria and pyuria. Both MIP-1β and CXCL10 were significantly high in patients with microscopic hematuria. MIP-1β significantly correlated with protein/creatinine ratio, and CXCL10 had positive correlation with erythrocyte sedimentation rate (ESR). MIP-1β was positively correlated with serum creatinine in patients with thickened urinary bladder wall. <em>Conclusion:</em> Lupus cystitis and LUTS are frequent in SLE patients. Lupus cystitis might be asymptomatic. Urinary bladder ultrasound plays an important role in the early recognition of LC. Lupus cystitis is possibly associated with SLE disease activity. Urinary MIP-1β and CXCL10 may have a potential role in the evaluation of SLE disease activity, particularly lupus nephritis.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"48 2","pages":"Pages 110-115"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146039259","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}

引用次数: 0

Could coronal T2-weighted fat suppressed sequence of lumbar magnetic resonance imaging help identify findings suggestive of sacroiliitis in patients with chronic low back pain? Influence of age and gender 冠状t2加权脂肪抑制序列腰椎磁共振成像是否有助于识别慢性腰痛患者的骶髂炎？年龄和性别的影响

IF 1 Q4 RHEUMATOLOGY

Egyptian Rheumatologist

Pub Date : 2026-01-01 Epub Date: 2025-10-10 DOI: 10.1016/j.ejr.2025.10.001

Kemal Erol , Lütfiye Parlak , Halil İ. Şara , Mehmet S. Durmaz

Background

Chronic low back pain (CLBP) is a leading cause of pain globally and axial spondyloarthritis (AxSpA) is an important cause. Lumbar magnetic resonance imaging (MRI) is frequently used to diagnose CLBP.

Aim of the work

To determine the added value of coronal lumbosacral T2-weighted Short Tau Inversion Recovery (T2-STIR) sequence with routine lumbar MRI in detecting sacroiliitis in patients with CLBP in order to enable early referral for the diagnosis of AxSpA, and to evaluate the influence of age and gender.

Patients and methods

The lumbar MRI of 1000 patients aged 18-65 years with CLBP presenting to the Physical Medicine and Rehabilitation (PMR) outpatient clinics of Selcuk University, and following up for at least three months and have a lumbar MRI, were retrospectively evaluated, and the presence of active sacroiliitis in the coronal T2-STIR sequence was investigated by two experienced radiologists guided by the Assessment of SpondyloArthritis International Society (ASAS) criteria.

Results

The mean age of patients was 42.2±12.8 years. 691 (69.1%) were females and 309 (30.9%) males (F:M 2.2:1). Of all participants, 11.3% had active sacroiliitis and and 11.7% had non-specific bone marrow edema (BME). Active sacroiliitis was seen in 72 (13.1%) patients aged ≤45 and 41 (9.1%) aged >45 (p=0.046). 91 female (13.2%) and 22 males (7.1%) had active sacroiliitis (p=0.005).

Conclusion

In this study, radiographic active sacroiliitis was detected on lumbosacral coronal T2-STIR sequences in chronic low back pain patients, particularly in women and those aged ≤45 years. Further clinical evaluation and prospective studies are required to confirm the potential usefulness in earlier diagnosis or referral.

背景：慢性腰痛（CLBP）是全球疼痛的主要原因，而轴性脊柱炎（AxSpA）是一个重要原因。腰椎磁共振成像（MRI）常用于诊断CLBP。目的探讨冠状位腰骶t2加权短Tau反转恢复（T2-STIR）序列与常规腰椎MRI在CLBP患者骶髂炎检测中的附加价值，以便早期转诊诊断AxSpA，并评估年龄和性别的影响。患者和方法回顾性评估1000例18-65岁CLBP患者的腰椎MRI，这些患者在Selcuk大学物理医学和康复（PMR）门诊就诊，随访至少3个月，并进行腰椎MRI检查，并由两名经验丰富的放射科医生在国际脊椎关节炎评估协会（ASAS）标准的指导下调查冠状T2-STIR序列中是否存在活动性骶髂炎。结果患者平均年龄42.2±12.8岁。女性691例（69.1%），男性309例（30.9%）（男女比例为2.2:1）。在所有参与者中，11.3%患有活动性骶髂炎，11.7%患有非特异性骨髓水肿（BME）。活动性骶髂炎发生在≤45岁的72例（13.1%）和45岁的41例（9.1%）（p=0.046）。女性91例（13.2%），男性22例（7.1%）存在活动性骶髂炎（p=0.005）。结论在本研究中，慢性腰背痛患者，特别是女性和年龄≤45岁的患者，腰骶冠状T2-STIR序列可检测到活动性骶髂炎。需要进一步的临床评估和前瞻性研究来证实其在早期诊断或转诊中的潜在作用。

{"title":"Could coronal T2-weighted fat suppressed sequence of lumbar magnetic resonance imaging help identify findings suggestive of sacroiliitis in patients with chronic low back pain? Influence of age and gender","authors":"Kemal Erol , Lütfiye Parlak , Halil İ. Şara , Mehmet S. Durmaz","doi":"10.1016/j.ejr.2025.10.001","DOIUrl":"10.1016/j.ejr.2025.10.001","url":null,"abstract":"<div><h3>Background</h3><div>Chronic low back pain (CLBP) is a leading cause of pain globally and axial spondyloarthritis (AxSpA) is an important cause. Lumbar magnetic resonance imaging (MRI) is frequently used to diagnose CLBP.</div></div><div><h3>Aim of the work</h3><div>To determine the added value of coronal lumbosacral T2-weighted Short Tau Inversion Recovery (T2-STIR) sequence with routine lumbar MRI in detecting sacroiliitis in patients with CLBP in order to enable early referral for the diagnosis of AxSpA, and to evaluate the influence of age and gender.</div></div><div><h3>Patients and methods</h3><div>The lumbar MRI of 1000 patients aged 18-65 years with CLBP presenting to the Physical Medicine and Rehabilitation (PMR) outpatient clinics of Selcuk University, and following up for at least three months and have a lumbar MRI, were retrospectively evaluated, and the presence of active sacroiliitis in the coronal T2-STIR sequence was investigated by two experienced radiologists guided by the Assessment of SpondyloArthritis International Society (ASAS) criteria.</div></div><div><h3>Results</h3><div>The mean age of patients was 42.2±12.8 years. 691 (69.1%) were females and 309 (30.9%) males (F:M 2.2:1). Of all participants, 11.3% had active sacroiliitis and and 11.7% had non-specific bone marrow edema (BME). Active sacroiliitis was seen in 72 (13.1%) patients aged ≤45 and 41 (9.1%) aged >45 (p=0.046). 91 female (13.2%) and 22 males (7.1%) had active sacroiliitis (p=0.005).</div></div><div><h3>Conclusion</h3><div>In this study, radiographic active sacroiliitis was detected on lumbosacral coronal T2-STIR sequences in chronic low back pain patients, particularly in women and those aged ≤45 years. Further clinical evaluation and prospective studies are required to confirm the potential usefulness in earlier diagnosis or referral.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"48 1","pages":"Pages 11-15"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271301","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}

引用次数: 0

Pyoderma gangrenosum in a patient with rheumatoid arthritis treated with adalimumab: A case-based review 阿达木单抗治疗的类风湿性关节炎患者坏疽性脓皮病：基于病例的回顾

IF 1 Q4 RHEUMATOLOGY

Egyptian Rheumatologist

Pub Date : 2026-01-01 Epub Date: 2025-11-06 DOI: 10.1016/j.ejr.2025.11.001

Dilara B Gökten, Rıdvan Mercan

Background

Pyoderma gangrenosum (PG) is an uncommon neutrophilic dermatosis that may accompany systemic inflammatory diseases such as rheumatoid arthritis (RA). Owing to its nonspecific presentation and overlap with other ulcerative disorders, diagnosis is often delayed, and the optimal management, particularly in RA-associated PG, remains uncertain.

Aim of the work

To present a rare case of PG occurring in a seropositive RA patient successfully treated with adalimumab (ADA) and to provide a concise literature-based review of ADA use in similar contexts.

Case presentation

A 63-year-old female with seropositive RA, initially controlled on methotrexate (MTX) and low-dose corticosteroid, developed bilateral painful ulcerative thigh lesions. Histopathology revealed dense neutrophilic infiltration consistent with PG. High-dose corticosteroid therapy achieved only partial improvement; therefore, ADA 40 mg every two weeks was initiated after negative tuberculosis screening. Within three months, rapid ulcer healing and remission of joint symptoms were observed, allowing steroid withdrawal. At six months, complete epithelialization and stable control of RA were achieved without adverse events. A systematic search of PubMed, Scopus, Web of Science, and DOAJ identified seven studies reporting favorable outcomes with ADA in steroid-refractory or biologic-switched RA-related PG.

Conclusion

Treatment with ADA demonstrates potential dual efficacy in controlling both PG and RA, particularly in corticosteroid-resistant or anti-TNF-switched cases. Given the paucity of prospective data, further multicenter randomized studies are required to validate its long-term safety and therapeutic role in this rare overlap setting. Early recognition and targeted immunomodulation remain essential to prevent chronic ulceration and recurrence.

背景：坏疽性脓皮病（pyoderma gangrenosum， PG）是一种罕见的中性粒细胞性皮肤病，可伴随系统性炎症性疾病，如类风湿关节炎（RA）。由于其非特异性表现和与其他溃疡性疾病的重叠，诊断经常延迟，最佳治疗，特别是ra相关性PG，仍然不确定。本研究的目的是报道一例罕见的PG发生在一名血清阳性的RA患者中，该患者成功地接受了阿达木单抗（ADA）治疗，并提供了一份基于ADA在类似情况下使用的简明文献综述。一例63岁女性RA血清阳性，最初使用甲氨蝶呤（MTX）和低剂量皮质类固醇进行控制，出现双侧疼痛性大腿溃疡性病变。组织病理学显示致密的中性粒细胞浸润，与PG一致。大剂量皮质类固醇治疗仅部分改善；因此，在结核筛查呈阴性后，每两周开始服用ADA 40 mg。三个月内，观察到溃疡迅速愈合，关节症状缓解，允许类固醇停用。6个月时，完全的上皮化和稳定的RA控制实现无不良事件。通过对PubMed、Scopus、Web of Science和DOAJ的系统检索，我们发现了7项研究报告了ADA治疗类固醇难治性或生物开关RA相关的PG的有利结果。结论ADA治疗在控制PG和RA方面具有潜在的双重疗效，特别是在皮质类固醇耐药或抗tnf开关的病例中。鉴于前瞻性数据的缺乏，需要进一步的多中心随机研究来验证其在这种罕见的重叠情况下的长期安全性和治疗作用。早期识别和有针对性的免疫调节仍然是预防慢性溃疡和复发的必要条件。

{"title":"Pyoderma gangrenosum in a patient with rheumatoid arthritis treated with adalimumab: A case-based review","authors":"Dilara B Gökten, Rıdvan Mercan","doi":"10.1016/j.ejr.2025.11.001","DOIUrl":"10.1016/j.ejr.2025.11.001","url":null,"abstract":"<div><h3>Background</h3><div>Pyoderma gangrenosum (PG) is an uncommon neutrophilic dermatosis that may accompany systemic inflammatory diseases such as rheumatoid arthritis (RA). Owing to its nonspecific presentation and overlap with other ulcerative disorders, diagnosis is often delayed, and the optimal management, particularly in RA-associated PG, remains uncertain.</div></div><div><h3>Aim of the work</h3><div>To present a rare case of PG occurring in a seropositive RA patient successfully treated with adalimumab (ADA) and to provide a concise literature-based review of ADA use in similar contexts.</div></div><div><h3>Case presentation</h3><div>A 63-year-old female with seropositive RA, initially controlled on methotrexate (MTX) and low-dose corticosteroid, developed bilateral painful ulcerative thigh lesions. Histopathology revealed dense neutrophilic infiltration consistent with PG. High-dose corticosteroid therapy achieved only partial improvement; therefore, ADA 40 mg every two weeks was initiated after negative tuberculosis screening. Within three months, rapid ulcer healing and remission of joint symptoms were observed, allowing steroid withdrawal. At six months, complete epithelialization and stable control of RA were achieved without adverse events. A systematic search of PubMed, Scopus, Web of Science, and DOAJ identified seven studies reporting favorable outcomes with ADA in steroid-refractory or biologic-switched RA-related PG.</div></div><div><h3>Conclusion</h3><div>Treatment with ADA demonstrates potential dual efficacy in controlling both PG and RA, particularly in corticosteroid-resistant or anti-TNF-switched cases. Given the paucity of prospective data, further multicenter randomized studies are required to validate its long-term safety and therapeutic role in this rare overlap setting. Early recognition and targeted immunomodulation remain essential to prevent chronic ulceration and recurrence.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"48 1","pages":"Pages 67-70"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466733","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}

引用次数: 0

Assessment of the efficacy of beam irradiation in breast cancer patients with knee osteoarthritis 束照射治疗乳腺癌伴膝骨关节炎的疗效评价

IF 1 Q4 RHEUMATOLOGY

Egyptian Rheumatologist

Pub Date : 2026-01-01 Epub Date: 2025-10-11 DOI: 10.1016/j.ejr.2025.10.003

Dina F. El-Essawi , Ibrahim Elzawahry , Manal R. Mohammed , Asmaa Zohry , Hany William

Background

Knee osteoarthritis (OA) causes pain, stiffness, and reduced mobility, significantly impairing quality of life. Low-dose radiotherapy (LDRT) has emerged as a potential treatment due to its anti-inflammatory and immunomodulatory effects, but its efficacy in specific populations, such as breast cancer survivors, remains under studied.

Aim of the work

To evaluate the effectiveness and safety of LDRT in female breast cancer survivors with knee OA (grades II and III), focusing on pain relief, inflammation, joint function, and genotoxicity.

Patients and methods

Out of an initial 36 patients, 20 (aged 45–65) were divided into two groups: Group I received 0.5 Gy LDRT three times weekly for two weeks, while Group II received 0.5 Gy twice weekly for three weeks. Outcomes were assessed using the Western Ontario and McMaster Universities Arthritis (WOMAC) index, erythrocyte sedimentation rate (ESR), genotoxicity tests (Micronucleus and Comet assays), and magnetic resonance imaging (MRI) for cartilage thickness and joint space.

Results

Both the LDRT regimens significantly improved WOMAC, reduced pain, stiffness, and enhanced joint function. Inflammatory markers showed a non-significant decline, suggesting mild anti-inflammatory effects. Genotoxicity tests indicated minimal DNA damage, particularly in Group II, confirming safety. MRI revealed improved cartilage thickness and morphology without significant joint effusion changes. The two dosing schedules were comparable.

Conclusion

LDRT, particularly 0.5 Gy twice weekly for three weeks, is an effective and safer treatment for knee OA in breast cancer survivors, providing symptoms relief and cartilage improvement with low toxicity. Further large-scale trials are needed to refine protocols and confirm optimal dosing.

膝关节骨关节炎（OA）引起疼痛、僵硬和活动能力降低，显著影响生活质量。由于其抗炎和免疫调节作用，低剂量放疗（LDRT）已成为一种潜在的治疗方法，但其对特定人群（如乳腺癌幸存者）的疗效仍在研究中。研究目的：评估LDRT治疗女性乳腺癌膝关节OA患者（II级和III级）的有效性和安全性，重点关注疼痛缓解、炎症、关节功能和遗传毒性。患者和方法在最初的36例患者中，20例（45-65岁）分为两组：组I接受0.5 Gy的LDRT治疗，每周3次，持续2周；组II接受0.5 Gy的LDRT治疗，每周2次，持续3周。结果评估使用西安大略省和麦克马斯特大学关节炎（WOMAC）指数，红细胞沉降率（ESR），遗传毒性试验（微核和彗星试验），以及软骨厚度和关节间隙的磁共振成像（MRI）。结果两种LDRT方案均可显著改善WOMAC，减轻疼痛、僵硬，增强关节功能。炎症指标无明显下降，提示抗炎作用轻微。遗传毒性测试表明，DNA损伤最小，特别是在第二组中，证实了安全性。MRI显示软骨厚度和形态改善，无明显关节积液改变。两种给药方案具有可比性。结论ldrt，特别是0.5 Gy，每周2次，持续3周，是治疗乳腺癌幸存者膝关节OA的有效且安全的治疗方法，可缓解症状和改善软骨，且毒性低。需要进一步的大规模试验来完善方案并确认最佳剂量。

{"title":"Assessment of the efficacy of beam irradiation in breast cancer patients with knee osteoarthritis","authors":"Dina F. El-Essawi , Ibrahim Elzawahry , Manal R. Mohammed , Asmaa Zohry , Hany William","doi":"10.1016/j.ejr.2025.10.003","DOIUrl":"10.1016/j.ejr.2025.10.003","url":null,"abstract":"<div><h3>Background</h3><div>Knee osteoarthritis (OA) causes pain, stiffness, and reduced mobility, significantly impairing quality of life. Low-dose radiotherapy (LDRT) has emerged as a potential treatment due to its anti-inflammatory and immunomodulatory effects, but its efficacy in specific populations, such as breast cancer survivors, remains under studied.</div></div><div><h3>Aim of the work</h3><div>To evaluate the effectiveness and safety of LDRT in female breast cancer survivors with knee OA (grades II and III), focusing on pain relief, inflammation, joint function, and genotoxicity.</div></div><div><h3>Patients and methods</h3><div>Out of an initial 36 patients, 20 (aged 45–65) were divided into two groups: Group I received 0.5 Gy LDRT three times weekly for two weeks, while Group II received 0.5 Gy twice weekly for three weeks. Outcomes were assessed using the Western Ontario and McMaster Universities Arthritis (WOMAC) index, erythrocyte sedimentation rate (ESR), genotoxicity tests (Micronucleus and Comet assays), and magnetic resonance imaging (MRI) for cartilage thickness and joint space.</div></div><div><h3>Results</h3><div>Both the LDRT regimens significantly improved WOMAC, reduced pain, stiffness, and enhanced joint function. Inflammatory markers showed a non-significant decline, suggesting mild anti-inflammatory effects. Genotoxicity tests indicated minimal DNA damage, particularly in Group II, confirming safety. MRI revealed improved cartilage thickness and morphology without significant joint effusion changes. The two dosing schedules were comparable.</div></div><div><h3>Conclusion</h3><div>LDRT, particularly 0.5 Gy twice weekly for three weeks, is an effective and safer treatment for knee OA in breast cancer survivors, providing symptoms relief and cartilage improvement with low toxicity. Further large-scale trials are needed to refine protocols and confirm optimal dosing.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"48 1","pages":"Pages 16-21"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271303","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}

引用次数: 0

Impact of systemic lupus erythematosus on cardiovascular health in young adults 系统性红斑狼疮对青壮年心血管健康的影响

IF 1 Q4 RHEUMATOLOGY

Egyptian Rheumatologist

Pub Date : 2026-01-01 Epub Date: 2025-10-11 DOI: 10.1016/j.ejr.2025.10.007

Noha H. Shedid , Hanan M. Farouk , Reem A. Habib , Amr E. Mahdy

Aim of the work

To evaluate cardiovascular (CV) characteristics of young adult patients with systemic lupus erythematosus (SLE) and their potential association with disease-related features.

Patients and methods

This study included 60 adult SLE patients <45 years old and 30 healthy controls matched for age and gender. The demographic and clinical characteristics were recorded and laboratory data including lipid profile, high sensitivity C-reactive protein (hs-CRP) and anticardiolipin antibodies were measured. The SLE Disease Activity Index 2000 (SLEDAI-2K) and Systemic Lupus International Collaborating Clinics damage index (SDI) score were assessed. Echocardiography and carotid ultrasound (US) were performed.

Results

The 60 patients were 42 females and 12 males (F:M 4:1). Their mean age was 32.3±7.6 years and disease duration 9.1±4.7 years. Carotid US abnormalities were present in 8 (13.3%). Echocardiographic abnormalities (n=39, 65%) particularly valve and left ventricular dysfunction as well as mean carotid intima-media thickness (CIMT) were significantly higher in patients compared to control (p<0.001). SLE patients with abnormal carotid ultrasound had higher age, disease duration (both p<0.001), triglycerides (p=0.03), fasting blood glucose (p=0.005), SDI (p=0.02), steroid dose (p=0.004) and duration (p<0.001). CIMT significantly correlated with disease duration (r=0.46, p<0.001), steroids cumulative dose (r=0.38, p=0.003) and steroids duration (r=0.41, p<0.001). Disease duration was an independent risk factor affecting CIMT (r=0.12, p<0.001).

Conclusion

Young patients with SLE have an increased risk of premature CV disease that is linked to traditional and lupus-related risk factors. Implementation of early CV screening and preventive strategies is essential to decrease the incidence of CV morbidity and mortality.

研究目的评估年轻成年系统性红斑狼疮（SLE）患者的心血管（CV）特征及其与疾病相关特征的潜在关联。患者和方法本研究包括60例45岁的SLE成人患者和30例年龄和性别匹配的健康对照。记录患者的人口学和临床特征，并检测血脂、高敏c反应蛋白（hs-CRP）和抗心磷脂抗体等实验室数据。评估SLE疾病活动指数2000 （SLEDAI-2K）和系统性狼疮国际合作诊所损害指数（SDI）评分。超声心动图和颈动脉超声（US）。结果60例患者中女性42例，男性12例（男女比例为4:1）。平均年龄32.3±7.6岁，病程9.1±4.7年。颈动脉US异常8例（13.3%）。超声心动图异常（n=39, 65%），尤其是瓣膜和左心室功能障碍以及颈动脉内膜-中膜平均厚度（CIMT）在患者中显著高于对照组（p<0.001）。颈动脉超声异常的SLE患者年龄、病程（p= 0.001）、甘油三酯（p=0.03）、空腹血糖（p=0.005）、SDI （p=0.02）、类固醇剂量（p=0.004）、病程（p= 0.001）较高。CIMT与疾病持续时间（r=0.46, p= 0.001）、类固醇累积剂量（r=0.38, p=0.003）和类固醇持续时间（r=0.41, p= 0.001）显著相关。病程是影响CIMT的独立危险因素（r=0.12, p<0.001）。结论年轻SLE患者发生早期心血管疾病的风险增加，这与传统的和狼疮相关的危险因素有关。实施早期CV筛查和预防策略对于降低CV发病率和死亡率至关重要。

{"title":"Impact of systemic lupus erythematosus on cardiovascular health in young adults","authors":"Noha H. Shedid , Hanan M. Farouk , Reem A. Habib , Amr E. Mahdy","doi":"10.1016/j.ejr.2025.10.007","DOIUrl":"10.1016/j.ejr.2025.10.007","url":null,"abstract":"<div><h3>Aim of the work</h3><div>To evaluate cardiovascular (CV) characteristics of young adult patients with systemic lupus erythematosus (SLE) and their potential association with disease-related features.</div></div><div><h3>Patients and methods</h3><div>This study included 60 adult SLE patients <45 years old and 30 healthy controls matched for age and gender. The demographic and clinical characteristics were recorded and laboratory data including lipid profile, high sensitivity C-reactive protein (hs-CRP) and anticardiolipin antibodies were measured. The SLE Disease Activity Index 2000 (SLEDAI-2K) and Systemic Lupus International Collaborating Clinics damage index (SDI) score were assessed. Echocardiography and carotid ultrasound (US) were performed.</div></div><div><h3>Results</h3><div>The 60 patients were 42 females and 12 males (F:M 4:1). Their mean age was 32.3±7.6 years and disease duration 9.1±4.7 years. Carotid US abnormalities were present in 8 (13.3%). Echocardiographic abnormalities (n=39, 65%) particularly valve and left ventricular dysfunction as well as mean carotid intima-media thickness (CIMT) were significantly higher in patients compared to control (p<0.001). SLE patients with abnormal carotid ultrasound had higher age, disease duration (both p<0.001), triglycerides (p=0.03), fasting blood glucose (p=0.005), SDI (p=0.02), steroid dose (p=0.004) and duration (p<0.001). CIMT significantly correlated with disease duration (r=0.46, p<0.001), steroids cumulative dose (r=0.38, p=0.003) and steroids duration (r=0.41, p<0.001). Disease duration was an independent risk factor affecting CIMT (r=0.12, p<0.001).</div></div><div><h3>Conclusion</h3><div>Young patients with SLE have an increased risk of premature CV disease that is linked to traditional and lupus-related risk factors. Implementation of early CV screening and preventive strategies is essential to decrease the incidence of CV morbidity and mortality.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"48 1","pages":"Pages 22-27"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271302","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}

引用次数: 0

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Egyptian Rheumatologist

全部 ACTA GEOL POL Conserv. Genet. Resour. ARCH ACOUST Annu. Rev. Earth Planet. Sci. ECOTOXICOLOGY 2011 International Conference on Electric Technology and Civil Engineering (ICETCE) Chin. Phys. C 2011 Annual Report Conference on Electrical Insulation and Dielectric Phenomena GROUNDWATER ACTA MEDICA PORT ATMOSPHERE-BASEL Environ. Prog. Sustainable Energy CAN J UROL "Radiation and Risk" Bulletin of the National Radiation and Epidemiological Registry 2013 IEEE 39th Photovoltaic Specialists Conference (PVSC) Commun. Theor. Phys. J. Math. Phys. Aquat. Geochem. Arquivos de Gastroenterologia Toxicology and Environmental Health Sciences Isl. Arc ARCT ANTARCT ALP RES Environmental Epigenetics ACTA RADIOL Energy Ecol Environ ENVIRON HEALTH-GLOB Stanovnistvo 2008 IEEE 35th International Conference on Plasma Science J PHYS-CONDENS MAT Classical Quantum Gravity Condens. Matter Phys. 2005 Asian Conference on Sensors and the International Conference on New Techniques in Pharmaceutical and Biomedical Research AGING DIS J. Earth Syst. Sci. Nursing New Zealand (Wellington, N.Z. : 1995) Trans Narratives 非金属矿 2008 Annual Report Conference on Electrical Insulation and Dielectric Phenomena Appl. Geochem. Basin Res. ERN: Stock Market Risk (Topic) Prog. Oceanogr. ACTA CHIR BELG Ecol. Monogr. ACTA REUMATOL PORT Contrib. Mineral. Petrol. Ocean and Polar Research 2011 IEEE/ACM International Conference on Computer-Aided Design (ICCAD) Chin. Phys. B Am. Mineral. 2013 IEEE MTT-S International Microwave Workshop Series on RF and Wireless Technologies for Biomedical and Healthcare Applications (IMWS-BIO) AAPG Bull. ACTA GEOL SIN-ENGL Geochim. Cosmochim. Acta Int. J. Biometeorol. Am. J. Phys. Anthropol. IZV-PHYS SOLID EART+ Acta Oceanolog. Sin. 2011 IEEE 2nd International Conference on Computing, Control and Industrial Engineering Adv. Atmos. Sci. Acta Geophys. Appl. Clay Sci. 2012 9th International Conference on Electrical Engineering/Electronics, Computer, Telecommunications and Information Technology Adv. Meteorol. J. Hydrol. Geobiology [1993] Proceedings Eighth Annual IEEE Symposium on Logic in Computer Science 2012 38th IEEE Photovoltaic Specialists Conference Ann. Glaciol. "Laboratorio;" analisis clinicos, bacteriologia, inmunologia, parasitologia, hematologia, anatomia patologica, quimica clinica Acta Geochimica 2013 Abstracts IEEE International Conference on Plasma Science (ICOPS) Carbon Balance Manage. Org. Geochem. 2009 International Workshop on Intelligent Systems and Applications Am. J. Sci. J. Atmos. Chem. Clim. Change ACTA PETROL SIN Archaeol. Anthropol. Sci. ARCHAEOMETRY Chem. Ecol. 2009 12th International Symposium on Design and Diagnostics of Electronic Circuits & Systems Atmos. Chem. Phys. 2009 16th International Conference on Industrial Engineering and Engineering Management 2013 International Conference on Optical MEMS and Nanophotonics (OMN) 2013 IEEE International Conference on Computer Vision 2011 VII Southern Conference on Programmable Logic (SPL) Journal de Medecine Legale Droit Medical Geochem. J. J. Clim. NUCL INSTRUM METH A ECOSYSTEMS Atmos. Res. Clean-Soil Air Water ECOL RESTOR Environ. Educ. Res, Asia-Pac. J. Atmos. Sci. Environ. Eng. Manage. J. Ius et Praxis

﹀