Egyptian Rheumatologist最新文献_第3页

Gout with co-existing rosacea in a diabetic male: Expanding the clinical association 痛风与并存酒渣鼻在糖尿病男性：扩大临床关联

IF 1 Q4 RHEUMATOLOGY

Egyptian Rheumatologist

Pub Date : 2025-10-10 DOI: 10.1016/j.ejr.2025.10.008

Hamad Alfahaad , Fayeh Asiri , Hamza Alshehri , Bakhaitan Alumer , Soliman Alsaiari

Aim of the work

To shed light on the co-existence of rosacea with gout as a possible dermatologic association in the context of diabetes in an elderly male.

Case presentation

A 66-year-old Saudi male known diabetic on oral hypoglycemic agents for more than 10 years and a history of gouty arthritis receiving colchicine during attacks and is on regular allopurinol, presented with a facial lesion misdiagnosed initially as cutaneous leishmaniasis and did not respond to treatment for 2 years. The patient presented to the dermatology clinic at Khamis Mushayt Hospital and was further investigated. The skin lesions were well-defined pinkish nodules infiltrated with telangiectasia and pustules involving the malar area, dorsum of nose, nasolabial folds with positive apple jelly diascopy. Concurrently, the left foot showed an erythematous swelling over the 1st metatarsophalangeal (MTP) joint. Differential diagnosis included rosacea, systemic lupus erythematosus and sarcoidosis. Laboratory investigations were within normal ranges except for an increased hemoglobin A1C (9 %) and SUA (10.1 mg/dl). Skin biopsy histopathology revealed an image compatible with rosacea. Co-management with the rheumatologist provided colchicines (0.5 mg thrice daily until the gouty attack resolves, as well as avoidance of triggers including spicy food, using sunscreen, doxycycline 100 mg/day and metronidazole gel for the rosacea.

Conclusion

The present case confirms a relationship between gout and rosacea occurring in an elderly male with diabetes. Awareness of such cases by dermatologists is crucial due to the challenges of similar clinical presentations to other rheumatic diseases such as SLE.

目的：阐明酒渣鼻与痛风的共存，作为一种可能的皮肤病学关联，在糖尿病的背景下，在一个老年男性。病例介绍：一名66岁沙特男性，已知患有糖尿病，口服降糖药10年以上，有痛风性关节炎病史，发作时服用秋水仙碱，并定期服用别嘌呤醇，面部病变最初误诊为皮肤利什曼病，治疗2年无反应。患者被送到Khamis Mushayt医院皮肤科诊所，并接受了进一步调查。皮肤病变为界限分明的粉红色结节，伴毛细血管扩张和脓疱浸润，累及颧区、鼻背、鼻唇襞，伴有阳性的苹果果冻软硬膜。同时，左脚第一跖趾（MTP）关节处出现红斑性肿胀。鉴别诊断包括酒渣鼻、系统性红斑狼疮和结节病。实验室检查在正常范围内，除了血红蛋白A1C升高（9%）和SUA （10.1 mg/dl）。皮肤活检组织病理学显示图像与酒渣鼻相容。与风湿病学家共同管理提供秋水仙碱(0.5毫克，每日三次，直到痛风发作消退，以及避免触发因素，包括辛辣食物，使用防晒霜，强力霉素100毫克/天，甲硝唑凝胶用于酒sacea。结论本病例证实了老年男性糖尿病患者痛风与酒渣鼻之间的关系。皮肤科医生对此类病例的认识至关重要，因为类似的临床表现与其他风湿病（如SLE）具有挑战性。

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引用次数: 0

Assessment of vascular involvement in polymyalgia rheumatica (PMR) patients by duplex ultrasound 多肌痛风湿病（PMR）患者血管受累的双超声评估

IF 1 Q4 RHEUMATOLOGY

Egyptian Rheumatologist

Pub Date : 2025-10-10 DOI: 10.1016/j.ejr.2025.09.002

Passant N. El-Husseiny , Marwa H. Niazy , Sama A. Anwar , Amira A. Shahin

Aim of the work

To assess the vascular involvement consistent with giant cell arteritis (GCA) in polymyalgia rheumatica (PMR) patients by duplex ultrasound (US).

Patients and methods

Twenty PMR patients and 20 matched healthy controls were recruited. Vascular duplex was performed for: common carotid artery (CCA), extracranial part of internal carotid artery (ICA), external carotid artery (ECA), superficial temporal artery (STA), frontal and occipital arteries. Vessels were considered abnormal if Outcome Measures in Rheumatology (OMERACT) definitions for GCA were found; or if intima media thickness (IMT) exceeded respective cut-off values: ≥0.4 mm for STA, frontal and occipital arteries, ≥1mm for CCA, ECA and ICA.

Results

Included PMR patients were females, with mean ages of 56.5 ± 4.5 years. Vascular findings suggestive of GCA by duplex US were found in 14/20 PMR patients (70 %)(sonography pathological group), and subclinical vasculitis was reported in 10/14 PMR patients (71.4 %). The STA was affected in 85.7 %, occipital in 71.4 %, frontal in 64.3 %, ECA 35.7 %, CCA 28.6 % and ICA 28.6 %. Overlap pattern (cranial and extra-cranial) was observed in 8/14 PMR patients (57.1 %); while cranial pattern in 42.9 % and none had isolated extra-cranial affection. Halo sign, stenosis and occlusion were detected in none of PMR patients. Significantly longer duration of the current steroid therapy was found in sonography pathological group (16 ± 9.95 months) versus pure PMR patients (2 ± 1.4 months)(p = 0.03).

Conclusion

Subclinical vascular involvement suggestive of GCA has been depicted in the studied PMR patients, implying that sonographic assessment of group set of vessels by vascular duplex is warranted in PMR.

目的应用双工超声（US）评价风湿性多肌痛（PMR）患者巨细胞动脉炎（GCA）的血管受累情况。患者和方法招募20例PMR患者和20例匹配的健康对照。血管双工：颈总动脉（CCA）、颈内动脉颅外段（ICA）、颈外动脉（ECA）、颞浅动脉（STA）、额、枕动脉。如果发现风湿病预后指标（OMERACT）定义的GCA，则认为血管异常；或者如果内膜中膜厚度（IMT）超过各自的临界值：STA、额动脉和枕动脉≥0.4 mm， CCA、ECA和ICA≥1mm。结果PMR患者均为女性，平均年龄56.5±4.5岁。超声病理组有70%（14/20）的PMR患者出现双超声血管征象提示GCA， 71.4%（10/14）的PMR患者出现亚临床血管炎。侧枕部占85.7%，枕部占71.4%，额部占64.3%，ECA占35.7%，CCA占28.6%，ICA占28.6%。在8/14的PMR患者（57.1%）中观察到重叠模式（颅骨和颅外）；而颅型占42.9%，无孤立性颅外病变。所有PMR患者均未发现晕征、狭窄和闭塞。超声病理组当前类固醇治疗持续时间（16±9.95个月）明显高于纯PMR患者（2±1.4个月）（p = 0.03）。结论经研究的PMR患者中存在提示GCA的亚临床血管累及，提示PMR中有必要通过血管双相超声评估组组血管。

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引用次数: 0

Disease- and mental health-related predictors of quality of life among radiographic axial spondyloarthritis patients 影像学中轴性脊柱炎患者生活质量的疾病和精神健康相关预测因素

IF 1 Q4 RHEUMATOLOGY

Egyptian Rheumatologist

Pub Date : 2025-09-24 DOI: 10.1016/j.ejr.2025.09.003

Suzan S. Al-Adle , Radwa S. ELbahnasy , Shirin M. El-Makawi , Hania S. Zayed

Background

Radiographic axial spondyloarthritis (r-axSpA) significantly impacts health-related quality of life (HRQoL).

Aim of the work

To evaluate the disease-and mental health-related predictors of HRQoL in r-axSpA patients.

Patients and methods

Fifty-five r-axSpA patients and 55 age-, sex- and education-matched healthy controls were studied. Patients were evaluated by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI) and patient global (PG) assessment of disease activity. Patients and controls were evaluated by the Short Form-36 (SF-36), its physical and mental component summaries (PCS and MCS, respectively), the Depression, Anxiety and Stress scale (DASS) and the Montreal Cognitive Assessment (MoCA)-Basic test.

Results

Patients’ mean age was 36.4 ± 7.48 years, median disease duration 10 years with interquartile range (IQR) (6–14) and 47 (85.5 %) were males. DASS scores were significantly higher while MoCA, PCS and MCS scores were lower in patients than controls, p < 0.001. BASDAI (r = −0.701), BASFI (r = −0.73), BASMI (r = −0.52), PG (r = −0.51), depression (r = −0.73), anxiety (r = −0.627) and stress (r = −0.691) scores showed significant negative correlations with PCS, p < 0.001. BASDAI (r = −0.602), BASFI (r = −0.668), BASMI (r = −0.37), PG (r = −0.45), depression (r = −0.74), anxiety (r = −0.63) and stress (r = −0.68) showed significant negative correlations with MCS; p < 0.001. MoCA significantly correlated with PCS (r = 0.36, p = 0.007) and MCS (r = 0.36, p = 0.008). On multivariable logistic regression analyses, PG and stress were independent predictors for PCS (β = −0.22, p = 0.041 and β = −0.35, p = 0.038, respectively), and stress was an independent predictor for MCS (β = −0.39, p = 0.035).

Conclusion

The PG assessment and stress scale are predictors of HRQoL in r-axSpA patients.

x线摄影中轴性脊柱炎（r-axSpA）显著影响健康相关生活质量（HRQoL）。研究目的：评价r-axSpA患者HRQoL的疾病及心理相关预测因素。患者和方法研究了55名r-axSpA患者和55名年龄、性别和教育程度相匹配的健康对照者。采用巴斯强直性脊柱炎疾病活动指数（BASDAI）、巴斯强直性脊柱炎功能指数（BASFI）、巴斯强直性脊柱炎计量指数（BASMI）和患者整体疾病活动评估（PG）对患者进行评估。采用短表36 （SF-36）、其生理和心理成分摘要（PCS和MCS）、抑郁、焦虑和压力量表（DASS）和蒙特利尔认知评估(MoCA)-基本测试对患者和对照组进行评估。结果患者平均年龄36.4±7.48岁，中位病程10年，四分位间距（IQR）为6 ~ 14，男性47例（85.5%）。DASS评分显著高于对照组，MoCA、PCS、MCS评分显著低于对照组，p < 0.001。BASDAI （r = - 0.701）、BASFI （r = - 0.73）、BASMI （r = - 0.52）、PG （r = - 0.51）、抑郁（r = - 0.73）、焦虑（r = - 0.627）、压力（r = - 0.691）得分与PCS呈显著负相关，p < 0.001。BASDAI （r =−0.602）、BASFI （r =−0.668）、BASMI （r =−0.37）、PG （r =−0.45）、抑郁（r =−0.74）、焦虑（r =−0.63）、应激（r =−0.68）与MCS呈显著负相关；p < 0.001。MoCA与PCS （r = 0.36, p = 0.007）、MCS （r = 0.36, p = 0.008）显著相关。在多变量logistic回归分析中，PG和应激是PCS的独立预测因子（β = - 0.22, p = 0.041和β = - 0.35, p = 0.038），应激是MCS的独立预测因子（β = - 0.39, p = 0.035）。结论PG评分和应激量表是r-axSpA患者HRQoL的预测指标。

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引用次数: 0

Subclinical cognitive dysfunction in systemic lupus erythematosus patients: Insights from clinical and electrophysiological measures 系统性红斑狼疮患者的亚临床认知功能障碍：来自临床和电生理测量的见解

IF 1 Q4 RHEUMATOLOGY

Egyptian Rheumatologist

Pub Date : 2025-09-06 DOI: 10.1016/j.ejr.2025.09.001

Esraa M. Seif El-Din , Ahmed K. Mohamed , Dina F. Osman

Background

Cognitive dysfunction is common in systemic lupus erythematosus (SLE) with considerable impact on patients’ quality of life.

Aim of the work

To evaluate cognitive function in SLE patients with (NPSLE) and without (non-NPSLE) neuropsychiatric involvement and their association with disease parameters.

Patients and methods

The study included 30 SLE patients (15 NPSLE and 15 non-NPSLE) and 30 matched controls. Cognitive evaluation included the mini-mental state examination (MMSE), symbol digit modalities test (SDMT) and electrophysiological event-related potentials (P300). Audiological assessment was performed. The SLE disease activity index (SLEDAI) was assessed.

Results

Patients were 26 females and 4 males with a mean of age of 36.4 ± 6.3 years. All patients had a prolonged P300 latency, reduced P300 amplitude, lower MMSE and SDMT scores compared to the control (408.9 ± 40.08 vs 313.8 ± 10.72, 3.63 ± 0.8 vs 4.85 ± 0.9, 26.6 ± 1.1vs 29.17 ± 0.8 and 35.1 ± 3.06 vs 50.47 ± 2.54, all p < 0.001). The SDMT was significantly lower in NPSLE (33.80 ± 3.61) compared to non-NPSLE (36.4 ± 1.68,p = 0.03) patients. There was a significant correlation between MMSE and P300 latency in NPSLE and non-NPSLE groups (r = -0.54, p = 0.03 and r = -0.84, p < 0.001 respectively). Cognitive performance via MMSE negatively correlated with disease duration in both NPSLE and non-NPSLE (r = -0.553,p = 0.032 and r = -0.784,p = 0.001 respectively) as well as P300 latency negatively correlated significantly with disease duration in the non-NPSLE (r = 0.764,p = 0.001). The SDMT had significant predictive ability in differentiating NPSLE from non-NPSLE (sensitivity 73.3 % and specificity 60 %,p = 0.023).

Conclusion

Cognitive impairment is frequent in SLE patients, regardless of neuropsychiatric involvement. Early cognitive screening is warranted, and chronic disease progression rather than activity may underlie cognitive deficits.

认知功能障碍在系统性红斑狼疮（SLE）中很常见，对患者的生活质量有相当大的影响。研究目的评估合并（NPSLE）和未合并（非NPSLE）神经精神疾病累及的SLE患者的认知功能及其与疾病参数的关系。患者和方法该研究包括30例SLE患者（15例NPSLE和15例非NPSLE）和30例匹配的对照。认知评价包括最小精神状态检查（MMSE）、符号数字模态测试（SDMT）和电生理事件相关电位（P300）。进行听力学评估。评估SLE疾病活动指数（SLEDAI）。结果女性26例，男性4例，平均年龄36.4±6.3岁。与对照组相比，所有患者P300潜伏期延长，P300振幅降低，MMSE和SDMT评分降低（408.9±40.08 vs 313.8±10.72,3.63±0.8 vs 4.85±0.9,26.6±1.1vs 29.17±0.8和35.1±3.06 vs 50.47±2.54，均p <； 0.001）。NPSLE患者的SDMT（33.80±3.61）明显低于非NPSLE患者（36.4±1.68,p = 0.03）。NPSLE组和非NPSLE组的MMSE与P300潜伏期有显著相关性（r = -0.54, p = 0.03和r = -0.84, p < 0.001）。NPSLE和非NPSLE患者的MMSE认知表现与病程呈负相关（r = -0.553,p = 0.032和r = -0.784,p = 0.001），非NPSLE患者的P300潜伏期与病程呈显著负相关（r = 0.764,p = 0.001）。SDMT在区分NPSLE和非NPSLE方面具有显著的预测能力（敏感性73.3%，特异性60%，p = 0.023）。结论认知障碍在SLE患者中很常见，与神经精神疾病无关。早期认知筛查是必要的，慢性疾病进展而不是活动可能是认知缺陷的基础。

{"title":"Subclinical cognitive dysfunction in systemic lupus erythematosus patients: Insights from clinical and electrophysiological measures","authors":"Esraa M. Seif El-Din , Ahmed K. Mohamed , Dina F. Osman","doi":"10.1016/j.ejr.2025.09.001","DOIUrl":"10.1016/j.ejr.2025.09.001","url":null,"abstract":"<div><h3>Background</h3><div>Cognitive dysfunction is common in systemic lupus erythematosus (SLE) with considerable impact on patients’ quality of life.</div></div><div><h3>Aim of the work</h3><div>To evaluate cognitive function in SLE patients with (NPSLE) and without (non-NPSLE) neuropsychiatric involvement and their association with disease parameters.</div></div><div><h3>Patients and methods</h3><div>The study included 30 SLE patients (15 NPSLE and 15 non-NPSLE) and 30 matched controls. Cognitive evaluation included the mini-mental state examination (MMSE), symbol digit modalities test (SDMT) and electrophysiological event-related potentials (P300). Audiological assessment was performed. The SLE disease activity index (SLEDAI) was assessed.</div></div><div><h3>Results</h3><div>Patients were 26 females and 4 males with a mean of age of 36.4 ± 6.3 years. All patients had a prolonged P300 latency, reduced P300 amplitude, lower MMSE and SDMT scores compared to the control (408.9 ± 40.08 <em>vs</em> 313.8 ± 10.72, 3.63 ± 0.8 <em>vs</em> 4.85 ± 0.9, 26.6 ± 1.1<em>vs</em> 29.17 ± 0.8 and 35.1 ± 3.06 <em>vs</em> 50.47 ± 2.54, all p < 0.001). The SDMT was significantly lower in NPSLE (33.80 ± 3.61) compared to non-NPSLE (36.4 ± 1.68,p = 0.03) patients. There was a significant correlation between MMSE and P300 latency in NPSLE and non-NPSLE groups (r = -0.54, p = 0.03 and r = -0.84, p < 0.001 respectively). Cognitive performance via MMSE negatively correlated with disease duration in both NPSLE and non-NPSLE (r = -0.553,p = 0.032 and r = -0.784,p = 0.001 respectively) as well as P300 latency negatively correlated significantly with disease duration in the non-NPSLE (r = 0.764,p = 0.001). The SDMT had significant predictive ability in differentiating NPSLE from non-NPSLE (sensitivity 73.3 % and specificity 60 %,p = 0.023).</div></div><div><h3>Conclusion</h3><div>Cognitive impairment is frequent in SLE patients, regardless of neuropsychiatric involvement. Early cognitive screening is warranted, and chronic disease progression rather than activity may underlie cognitive deficits.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"47 4","pages":"Pages 227-231"},"PeriodicalIF":1.0,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003958","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

Lupus profundus in a three years old boy with a favorable response to hydroxychloroquine and steroids: Case report & a comprehensive case-based review 对羟氯喹和类固醇有良好反应的3岁男孩深狼疮：病例报告&一个全面的基于病例的回顾

IF 1 Q4 RHEUMATOLOGY

Egyptian Rheumatologist

Pub Date : 2025-09-04 DOI: 10.1016/j.ejr.2025.08.002

Hamad A. Alfahaad , Anwar A. Farhan , Ola A. Farhan , Ammar A. Farhan , Hussain H. Alhatailah , Rashad A. Feddah , Soliman A. Alsaiari

Background

To ensure patients receive timely dermatologic care, dermatologists and rheumatologists must be fully aware of the full range of cutaneous diseases in systemic lupus erythematosus (SLE).

Aim of the work

This report aims to highlight a rare presentation of lupus profundus in a pre-school aged boy to highlight diagnostic challenges, management, and outcome. Similar juvenile cases worldwide are also presented for a comparison via a comprehensive review of existing literature.

Case presentation

A three-year-old Saudi boy of non-consanguineous parents and with six healthy siblings, presented at two years of age with multiple 1–2 cm firm, erythematous, indurated and mildly tender subcutaneous nodules and plaques on the right upper-arm and lower-extremities. Some lesions were ulcerative with suppurative discharge. There were no systemic symptoms of fever, arthritis, or photosensitivity, making the diagnosis of SLE unlikely. Anti-nuclear antibody (ANA) was negative and complements normal. Skin biopsy revealed perivascular lymphohistiocytic infiltrate mixed with plasma cells, follicular plugging, superficial telangiectasia, dermal fibrosis, lobular and septal panniculitis and hyaline fat necrosis. The patient received potent topical steroid twice daily, and hydroxychloroquine (HCQ) 5 mg/kg, and prednisolone 5 mg oral daily. At 8-weeks, there was complete clinical resolution, with residual mild lipoatrophy. A 1-year follow-up found no recurrence or progression to SLE.

Conclusion

The diagnosis of lupus profundus in children is confirmed by biopsy and early intervention using HCQ, local and systemic steroid therapy can noticeably lead to rapid complete remission and to minimize cosmetic and psychosocial sequelae. Long-term follow-up is recommended to monitor for recurrence or SLE progression in the pediatric population.

背景：为了确保患者得到及时的皮肤科护理，皮肤科医生和风湿病学家必须充分了解系统性红斑狼疮（SLE）的所有皮肤病。本报告旨在强调一个罕见的学龄前男孩深狼疮的表现，以强调诊断挑战，管理和结果。通过对现有文献的全面审查，也提出了世界范围内类似的少年案件进行比较。病例表现：一名三岁的沙特男孩，父母无血缘关系，有6个健康的兄弟姐妹，两岁时表现为右上臂和下肢多发1-2厘米坚硬、红斑、硬化和轻度压痛的皮下结节和斑块。部分病变为溃疡性伴化脓性分泌物。没有发热、关节炎或光敏性的全身性症状，因此不太可能诊断为SLE。抗核抗体（ANA）阴性，补体正常。皮肤活检显示血管周围淋巴组织细胞浸润混合浆细胞，滤泡堵塞，浅表毛细血管扩张，真皮纤维化，小叶和间隔泛膜炎，透明脂肪坏死。患者接受有效的局部类固醇治疗，每日2次，羟氯喹（HCQ） 5mg /kg，强的松龙5mg /kg口服。8周时，临床完全消退，残余轻度脂肪萎缩。1年随访未发现SLE复发或进展。结论儿童深狼疮的诊断可以通过活检和HCQ的早期干预来证实，局部和全身类固醇治疗可以显著地导致快速完全缓解，并减少美容和社会心理后遗症。建议长期随访以监测小儿人群的复发或SLE进展。

{"title":"Lupus profundus in a three years old boy with a favorable response to hydroxychloroquine and steroids: Case report & a comprehensive case-based review","authors":"Hamad A. Alfahaad , Anwar A. Farhan , Ola A. Farhan , Ammar A. Farhan , Hussain H. Alhatailah , Rashad A. Feddah , Soliman A. Alsaiari","doi":"10.1016/j.ejr.2025.08.002","DOIUrl":"10.1016/j.ejr.2025.08.002","url":null,"abstract":"<div><h3>Background</h3><div>To ensure patients receive timely dermatologic care, dermatologists and rheumatologists must be fully aware of the full range of cutaneous diseases in systemic lupus erythematosus (SLE).</div></div><div><h3>Aim of the work</h3><div>This report aims to highlight a rare presentation of lupus profundus in a pre-school aged boy to highlight diagnostic challenges, management, and outcome. Similar juvenile cases worldwide are also presented for a comparison via a comprehensive review of existing literature.</div></div><div><h3>Case presentation</h3><div>A three-year-old Saudi boy of non-consanguineous parents and with six healthy siblings, presented at two years of age with multiple 1–2 cm firm, erythematous, indurated and mildly tender subcutaneous nodules and plaques on the right upper-arm and lower-extremities. Some lesions were ulcerative with suppurative discharge. There were no systemic symptoms of fever, arthritis, or photosensitivity, making the diagnosis of SLE unlikely. Anti-nuclear antibody (ANA) was negative and complements normal. Skin biopsy revealed perivascular lymphohistiocytic infiltrate mixed with plasma cells, follicular plugging, superficial telangiectasia, dermal fibrosis, lobular and septal panniculitis and hyaline fat necrosis. The patient received potent topical steroid twice daily, and hydroxychloroquine (HCQ) 5 mg/kg, and prednisolone 5 mg oral daily. At 8-weeks, there was complete clinical resolution, with residual mild lipoatrophy. A 1-year follow-up found no recurrence or progression to SLE.</div></div><div><h3>Conclusion</h3><div>The diagnosis of lupus profundus in children is confirmed by biopsy and early intervention using HCQ, local and systemic steroid therapy can noticeably lead to rapid complete remission and to minimize cosmetic and psychosocial sequelae. Long-term follow-up is recommended to monitor for recurrence or SLE progression in the pediatric population.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"47 4","pages":"Pages 221-226"},"PeriodicalIF":1.0,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988229","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

Clinical expression of axial spondyloarthritis among a cohort of Egyptian patients 一组埃及患者中轴性脊柱炎的临床表现

IF 1 Q4 RHEUMATOLOGY

Egyptian Rheumatologist

Pub Date : 2025-09-03 DOI: 10.1016/j.ejr.2025.08.003

Basma R Sakr , Kamal El-Garf , Maha Mousa

Aim of the work

To study characteristics of axial spondyloarthritis (axSpA) among Egyptian patients in relation to disease and gender related features.

Patients and methods

This study recruited 88 axSpA patients. Evaluation of demographics, clinical characteristics, laboratory tests, Bath ankylosing spondylitis disease activity index (BASDAI), Axial Spondyloarthritis Disease Activity Score (ASDAS), Bath Ankylosing Spondylitis Functional Index (BASFI), and health index (HI) was performed.

Results

Patients with axSpA showed male predominance (M: F 2.3:1), human leucocytic antigen-B27 (HLA-B27) positivity in 59.4 %, high ASDAS in 60.2 %, poor HI in 13.3 %, peripheral manifestations were mainly arthritis, and enthesitis, extra musculoskeletal manifestations were mainly anterior uveitis. Early axSpA was reported in 8 % of patients. Females displayed initial axial and peripheral symptoms (p = 0.019), more arthritis (p = 0.003), dactylitis (p < 0.001), enthesitis (p = 0.042), and family history of SpA (p = 0.022) than males, with comparable BASDAI, ASDAS, BASFI and HI. Patients with radiographic axSpA (r-axSpA) exhibited initial axial symptoms (p < 0.001), male predominance (p = 0.002), higher C-reactive protein (CRP) (p = 0.016), HI (p = 0.007) and HLA-B27 positivity (p = 0.04), while non-radiographic axSpA (nr-axSpA) patients displayed initial axial and peripheral symptoms (p < 0.001), more arthritis (p < 0.001), dactylitis (p < 0.001), enthesitis (p = 0.001), early axSpA (p = 0.001), family history of SpA (p = 0.021), with comparable BASDAI, ASDAS and BASFI.

Conclusion

Patients with r-axSpA were predominantly males, with higher CRP, HLA-B27 positivity, initial axial presentation, worse HI, less frequent arthritis, dactylitis and enthesitis, early axSpA, and family history of SpA compared to nr-axSpA. Females displayed more arthritis, dactylitis and enthesitis, initial axial and peripheral symptoms, and family history of SpA compared to males.

研究埃及中轴性脊柱炎（axSpA）患者与疾病和性别相关特征的关系。患者和方法本研究招募了88例axSpA患者。对人口统计学、临床特征、实验室检查、巴斯强直性脊柱炎疾病活动性指数（BASDAI）、轴向性脊柱炎疾病活动性评分（ASDAS）、巴斯强直性脊柱炎功能指数（BASFI）和健康指数（HI）进行评估。结果axSpA患者以男性为主（M: F 2.3:1），人白细胞抗原b27 （HLA-B27）阳性占59.4%，ASDAS高占60.2%，HI差占13.3%，外周表现以关节炎为主，鼻炎、外肌骨骼表现以葡萄膜前炎为主。8%的患者报告了早期axSpA。女性表现出最初的轴和外周症状（p = 0.019），关节炎（p = 0.003）、指炎（p < 0.001）、鼻炎（p = 0.042）和SpA家族史（p = 0.022）多于男性，BASDAI、ASDAS、BASFI和HI与男性相当。x线axSpA （r-axSpA）患者表现为初始轴向症状（p < 0.001）、男性优势（p = 0.002）、较高的c反应蛋白（CRP）（p = 0.016）、HI （p = 0.007）和HLA-B27阳性（p = 0.04），而非x线axSpA （r-axSpA）患者表现为初始轴向和外周症状（p < 0.001）、较多的关节炎（p < 0.001）、趾炎（p < 0.001）、鼻炎（p = 0.001）、早期axSpA （p = 0.001）、SpA家族史（p = 0.021），与BASDAI相当。ASDAS和BASFI。结论与nr-axSpA相比，r-axSpA患者以男性为主，CRP、HLA-B27阳性、初始轴向表现较高、HI较差、关节炎、指炎、鼻炎、早期axSpA发生率较低、家族史较轻。与男性相比，女性表现出更多的关节炎、指趾炎和鼻炎、初始轴向和外周症状以及SpA家族史。

{"title":"Clinical expression of axial spondyloarthritis among a cohort of Egyptian patients","authors":"Basma R Sakr , Kamal El-Garf , Maha Mousa","doi":"10.1016/j.ejr.2025.08.003","DOIUrl":"10.1016/j.ejr.2025.08.003","url":null,"abstract":"<div><h3>Aim of the work</h3><div>To study characteristics of axial spondyloarthritis (axSpA) among Egyptian patients in relation to disease and gender related features.</div></div><div><h3>Patients and methods</h3><div>This study recruited 88 axSpA patients. Evaluation of demographics, clinical characteristics, laboratory tests, Bath ankylosing spondylitis disease activity index (BASDAI), Axial Spondyloarthritis Disease Activity Score (ASDAS), Bath Ankylosing Spondylitis Functional Index (BASFI), and health index (HI) was performed.</div></div><div><h3>Results</h3><div>Patients with axSpA showed male predominance (M: F 2.3:1), human leucocytic antigen-B27 (HLA-B27) positivity in 59.4 %, high ASDAS in 60.2 %, poor HI in 13.3 %, peripheral manifestations were mainly arthritis, and enthesitis, extra musculoskeletal manifestations were mainly anterior uveitis. Early axSpA was reported in 8 % of patients. Females displayed initial axial and peripheral symptoms (p = 0.019), more arthritis (p = 0.003), dactylitis (p < 0.001), enthesitis (p = 0.042), and family history of SpA (p = 0.022) than males, with comparable BASDAI, ASDAS, BASFI and HI. Patients with radiographic axSpA (r-axSpA) exhibited initial axial symptoms (p < 0.001), male predominance (p = 0.002), higher C-reactive protein (CRP) (p = 0.016), HI (p = 0.007) and HLA-B27 positivity (p = 0.04), while non-radiographic axSpA (nr-axSpA) patients displayed initial axial and peripheral symptoms (p < 0.001), more arthritis (p < 0.001), dactylitis (p < 0.001), enthesitis (p = 0.001), early axSpA (p = 0.001), family history of SpA (p = 0.021), with comparable BASDAI, ASDAS and BASFI.</div></div><div><h3>Conclusion</h3><div>Patients with r-axSpA were predominantly males, with higher CRP, HLA-B27 positivity, initial axial presentation, worse HI, less frequent arthritis, dactylitis and enthesitis, early axSpA, and family history of SpA compared to nr-axSpA. Females displayed more arthritis, dactylitis and enthesitis, initial axial and peripheral symptoms, and family history of SpA compared to males.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"47 4","pages":"Pages 216-220"},"PeriodicalIF":1.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144932023","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

Frequency and clinical impact of fibromyalgia among patients with multiple sclerosis in Saudi Arabia: A cross-sectional study 沙特阿拉伯多发性硬化症患者纤维肌痛的频率和临床影响：一项横断面研究

IF 1 Q4 RHEUMATOLOGY

Egyptian Rheumatologist

Pub Date : 2025-08-18 DOI: 10.1016/j.ejr.2025.08.001

Hind Abdullah Alnajashi

Background

Pain is a prevalent and disabling symptom in multiple sclerosis (MS). Fibromyalgia (FM), a chronic widespread pain syndrome, may coexist with MS and exacerbate fatigue, anxiety, depression, and poor quality of life (QoL). While this association has been studied in Western populations, data from Saudi-Arabia and the Middle-East are limited.

Aim of the work

To determine the frequency of FM in Saudi MS patients and assess its impact on fatigue, disability, depression, anxiety, and quality of life as well as its association with disease characteristics and treatment.

Patients and methods

This retrospective study included 73 Saudi adults with MS. FM was screened using the Arabic Fibromyalgia Rapid Screening Tool (FiRST). Fatigue was assessed using the modified fatigue impact scale (MFIS), disability via expanded disability status scale (EDSS), depression with the patient health questionnaire (PHQ-9), anxiety with the generalized anxiety disorder (GAD-7) and QoL with the MS international QoL (MusiQoL) questionnaire.

Results

The mean patient age was 37.3 ± 10.2 years; 52 females and 21 males. FM was detected in 11 (15.1 %) patients. Disease-modifying therapies were significantly less frequently received by patients with FM (p = 0.015). FIRST score significantly correlated with MFIS (r = 0.45,p < 0.0001), PHQ-9 (r = 0.3,p = 0.009) and GAD-7 (r = 0.29,p = 0.013) and inversely with MusiQoL (r = -0.3,p = 0.011). In regression analysis, fatigue remained the only significant predictor of FM.

Conclusion

FM is not uncommon in Saudi MS patients and is associated with fatigue, depression, anxiety, and reduced QoL. Fatigue emerged as a significant predictor of FM. Early identification and integrated management of FM may improve outcomes in MS.

背景：疼痛是多发性硬化症（MS）中一种普遍的致残症状。纤维肌痛（FM）是一种慢性广泛性疼痛综合征，可与MS共存，并加重疲劳、焦虑、抑郁和生活质量差（QoL）。虽然这种关联已经在西方人群中进行了研究，但来自沙特阿拉伯和中东的数据有限。确定沙特多发性硬化症患者的FM频率，评估其对疲劳、残疾、抑郁、焦虑和生活质量的影响，以及与疾病特征和治疗的关系。患者和方法本回顾性研究包括73名沙特成年ms - FM患者，使用阿拉伯纤维肌痛快速筛查工具（FiRST）进行筛查。疲劳评估采用改良疲劳影响量表（MFIS），残疾评估采用扩展残疾状态量表（EDSS），抑郁评估采用患者健康问卷（PHQ-9），焦虑评估采用广泛性焦虑障碍（GAD-7），生活质量评估采用MS国际生活质量（musiol）问卷。结果患者平均年龄37.3±10.2岁；52名女性和21名男性。11例（15.1%）患者检出FM。FM患者接受疾病改善治疗的频率显著降低（p = 0.015）。FIRST评分与MFIS显著相关(r = 0.45,p <；0.0001), phq - 9 (r = 0.3, p = 0.009)和GAD-7 (r = 0.29, p = 0.013)和反向MusiQoL (r = -0.3, p = 0.011)。在回归分析中，疲劳仍然是FM的唯一显著预测因子。结论fm在沙特MS患者中并不少见，并与疲劳、抑郁、焦虑和生活质量降低有关。疲劳是FM的显著预测因子。FM的早期识别和综合管理可以改善MS的预后。

{"title":"Frequency and clinical impact of fibromyalgia among patients with multiple sclerosis in Saudi Arabia: A cross-sectional study","authors":"Hind Abdullah Alnajashi","doi":"10.1016/j.ejr.2025.08.001","DOIUrl":"10.1016/j.ejr.2025.08.001","url":null,"abstract":"<div><h3>Background</h3><div>Pain is a prevalent and disabling symptom in multiple sclerosis (MS). Fibromyalgia (FM), a chronic widespread pain syndrome, may coexist with MS and exacerbate fatigue, anxiety, depression, and poor quality of life (QoL). While this association has been studied in Western populations, data from Saudi-Arabia and the Middle-East are limited.</div></div><div><h3>Aim of the work</h3><div>To determine the frequency of FM in Saudi MS patients and assess its impact on fatigue, disability, depression, anxiety, and quality of life as well as its association with disease characteristics and treatment.</div></div><div><h3>Patients and methods</h3><div>This retrospective study included 73 Saudi adults with MS. FM was screened using the Arabic Fibromyalgia Rapid Screening Tool (FiRST). Fatigue was assessed using the modified fatigue impact scale (MFIS), disability via expanded disability status scale (EDSS), depression with the patient health questionnaire (PHQ-9), anxiety with the generalized anxiety disorder (GAD-7) and QoL with the MS international QoL (MusiQoL) questionnaire.</div></div><div><h3>Results</h3><div>The mean patient age was 37.3 ± 10.2 years; 52 females and 21 males. FM was detected in 11 (15.1 %) patients. Disease-modifying therapies were significantly less frequently received by patients with FM (p = 0.015). FIRST score significantly correlated with MFIS (r = 0.45,p < 0.0001), PHQ-9 (r = 0.3,p = 0.009) and GAD-7 (r = 0.29,p = 0.013) and inversely with MusiQoL (r = -0.3,p = 0.011). In regression analysis, fatigue remained the only significant predictor of FM.</div></div><div><h3>Conclusion</h3><div>FM is not uncommon in Saudi MS patients and is associated with fatigue, depression, anxiety, and reduced QoL. Fatigue emerged as a significant predictor of FM. Early identification and integrated management of FM may improve outcomes in MS.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"47 4","pages":"Pages 212-215"},"PeriodicalIF":1.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144860287","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

Cardiovascular involvement in Behçet’s disease patients: Carotid atherosclerosis, neutrophil–lymphocyte ratio, platelet-lymphocyte ratio, and serum asymmetric dimethylarginine behet病患者的心血管介入：颈动脉粥样硬化、中性粒细胞-淋巴细胞比率、血小板-淋巴细胞比率和血清不对称二甲基精氨酸

IF 1 Q4 RHEUMATOLOGY

Egyptian Rheumatologist

Pub Date : 2025-07-24 DOI: 10.1016/j.ejr.2025.07.004

Omima A. Sayed , Rasha A. Abdel-Magied , Hazem M.A. Farrag , Mostafa A. Abu Elela , Abdallah M.M. Safwat , Ahmed M. Abdel-Nasser

Aim of the work

To assess the frequency of subclinical atherosclerosis in Behçet’s disease (BD) and the influence of neutrophil–lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and serum asymmetric dimethylarginine (ADMA) compared to traditional cardiovascular risk factors and their relation to the disease characteristics.

Patients and methods

This study included 60 BD patients and 30 age and sex matched healthy controls. The BD current activity form (BDCAF) was scored. Traditional cardiovascular risk factors were evaluated. Complete blood count was assessed and both NLR and PLR were calculated. Serum ADMA level was measured. Radiological evaluation of carotid intima media thickness (CIMT) was performed.

Results

The mean age of patients was 36.5 ± 10 years and were 48 males and 12 females (M:F 4:1). BD patients had significantly higher CIMT and carotid atherosclerotic plaques compared to the control (0.53 ± 0.14 versus 0.41 ± 0.09, p < 0.001 and 21.7 % versus 0 % respectively) despite similar rate of traditional cardiovascular risk factors. CIMT of BD patients correlated with age (r = 0.38,p = 0.003), disease duration (r = 0.3,p = 0.02), presence of ocular manifestation (r = 0.31,p = 0.02), waist/hip ratio (WHR)(r = 0.29,p = 0.03), NLR (r = 0.42, p = 0.001), PLR (r = 0.27, p = 0.04) and ADMA (r = 0.5,p < 0.001). Only serum ADMA level was found to be a significant determinant of CIMT in BD (p < 0.001), contributing in 37.9 % of the variance of CIMT. NLR, PLR and ADMA can differentiate BD with subclinical atherosclerosis at cut-off values 2.36, 125.51 and 1.27 umol/L respectively.

Conclusion

BD is associated with an increased rate of subclinical atherosclerosis, which is best determined by increased hematological indices and serum ADMA level rather than traditional cardiovascular risk factors.

目的评价behet病（BD）亚临床动脉粥样硬化的发生频率、中性粒细胞-淋巴细胞比率（NLR）、血小板-淋巴细胞比率（PLR）和血清不对称二甲基精氨酸（ADMA）与传统心血管危险因素的比较及其与疾病特征的关系。患者和方法本研究包括60例BD患者和30例年龄和性别匹配的健康对照。对BD当前活动表（BDCAF）进行评分。评估传统的心血管危险因素。评估全血细胞计数，计算NLR和PLR。测定血清ADMA水平。影像学评估颈动脉内膜中膜厚度（CIMT）。结果患者平均年龄36.5±10岁，男48例，女12例（男∶女4:1）。与对照组相比，BD患者的CIMT和颈动脉粥样硬化斑块明显增加(0.53±0.14比0.41±0.09,p <；0.001和21.7%（分别为0%），尽管传统心血管危险因素的发生率相似。测量出的双相障碍患者与年龄相关(r = 0.38, p = 0.003),疾病持续时间(r = 0.3, p = 0.02),出现眼部表现(r = 0.31, p = 0.02),腰围/臀围(WHR) (r = 0.29, p = 0.03), NLR (r = 0.42, p = 0.001), PLR (r = 0.27, p = 0.04)和ADMA (r = 0.5, p & lt;0.001)。只有血清ADMA水平是BD患者CIMT的重要决定因素(p <；0.001)，贡献了37.9%的CIMT方差。NLR、PLR和ADMA可以区分BD与亚临床动脉粥样硬化，临界值分别为2.36、125.51和1.27 umol/L。结论bd与亚临床动脉粥样硬化发生率升高相关，与血液学指标和血清ADMA水平升高有关，而不是传统的心血管危险因素。

{"title":"Cardiovascular involvement in Behçet’s disease patients: Carotid atherosclerosis, neutrophil–lymphocyte ratio, platelet-lymphocyte ratio, and serum asymmetric dimethylarginine","authors":"Omima A. Sayed , Rasha A. Abdel-Magied , Hazem M.A. Farrag , Mostafa A. Abu Elela , Abdallah M.M. Safwat , Ahmed M. Abdel-Nasser","doi":"10.1016/j.ejr.2025.07.004","DOIUrl":"10.1016/j.ejr.2025.07.004","url":null,"abstract":"<div><h3>Aim of the work</h3><div>To assess the frequency of subclinical atherosclerosis in Behçet’s disease (BD) and the influence of neutrophil–lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and serum asymmetric dimethylarginine (ADMA) compared to traditional cardiovascular risk factors and their relation to the disease characteristics.</div></div><div><h3>Patients and methods</h3><div>This study included 60 BD patients and 30 age and sex matched healthy controls. The BD current activity form (BDCAF) was scored. Traditional cardiovascular risk factors were evaluated. Complete blood count was assessed and both NLR and PLR were calculated. Serum ADMA level was measured. Radiological evaluation of carotid intima media thickness (CIMT) was performed.</div></div><div><h3>Results</h3><div>The mean age of patients was 36.5 ± 10 years and were 48 males and 12 females (M:F 4:1). BD patients had significantly higher CIMT and carotid atherosclerotic plaques compared to the control (0.53 ± 0.14 versus 0.41 ± 0.09, p < 0.001 and 21.7 % versus 0 % respectively) despite similar rate of traditional cardiovascular risk factors. CIMT of BD patients correlated with age (r = 0.38,p = 0.003), disease duration (r = 0.3,p = 0.02), presence of ocular manifestation (r = 0.31,p = 0.02), waist/hip ratio (WHR)(r = 0.29,p = 0.03), NLR (r = 0.42, p = 0.001), PLR (r = 0.27, p = 0.04) and ADMA (r = 0.5,p < 0.001). Only serum ADMA level was found to be a significant determinant of CIMT in BD (p < 0.001), contributing in 37.9 % of the variance of CIMT. NLR, PLR and ADMA can differentiate BD with subclinical atherosclerosis at cut-off values 2.36, 125.51 and 1.27 umol/L respectively.</div></div><div><h3>Conclusion</h3><div>BD is associated with an increased rate of subclinical atherosclerosis, which is best determined by increased hematological indices and serum ADMA level rather than traditional cardiovascular risk factors.</div></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"47 4","pages":"Pages 201-206"},"PeriodicalIF":1.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144704362","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

Class V membranous nephropathy in patients with systemic lupus erythematosus: Clinical characteristics, outcome and prognosis 系统性红斑狼疮患者的V类膜性肾病：临床特征、结局和预后

IF 1 Q4 RHEUMATOLOGY

Egyptian Rheumatologist

Pub Date : 2025-07-24 DOI: 10.1016/j.ejr.2025.07.003

Nermeen Samy, Sherin H. Hamza, Fatma I. Mabrouk, Duaa F. Atyaallah, Mohammed M. Mohammed

Aim of the work

To study the clinical presentation, course, outcome and prognostic factors of membranous lupus nephritis (MLN) in systemic lupus erythematosus (SLE) patients.

Patients and methods

Ninty-six SLE patients with MLN were studied. The SLE disease activity index (SLEDAI) and SLE International Collaborating Clinics damage index (SLICC-DI) were assessed. 48 patients had pure MLN (Class V) and another 48 mixed (membranous plus proliferative classes III/IV) were recruited. The median follow-up was 24 months after the initial renal biopsy.

Results

Out of 96 patients, 86 were females and 10 were males with a mean age of 34.9 ± 10.6 years and disease duration of 8.85 ± 1.7 years. 43 (44.8 %) had nephrotic and 25 (26 %) nephritic syndrome.The mean SLICC-DI was 2.46 ± 1.2 while SLEDAI was 12.6 ± 4.3.76 (79.2 %) achieved complete remission, and 20 (20.8 %) partial remission. 4.2 % developed renal or extra-renal flare, 13.5 % had chronic kidney disease. Patients with mixed-type had a significantly higher SLEDAI (p < 0.0001), anti-double-stranded deoxyribonucleic acid (anti-dsDNA) titre (p = 0.028), serum creatinine (p = 0.016), chronicity index of renal biopsy (p = 0.001) and longer duration to achieve nephritis remission (p = 0.001) together with lower creatinine clearance (p = 0.009) in comparison with pure type. SLICC-DI > 3 (p = 0.002), SLEDAI > 14 (p < 0.001), Albumin/ Creatinine > 4.5 g/day (p = 0.013), serum creatinine > 1.36 mg/dl (p < 0.001), creatinine clearance < 84.3 mL/min (p = 0.002), urinary casts (p < 0.0001) and chronicity index > 6 (p = 0.003) were the main predictors of poor outcome among patients with MLN.

Conclusion

Mixed MLN had more severe clinical and histological presentations and a longer time to achieve complete and partial remission than the pure MLN.

目的探讨系统性红斑狼疮（SLE）患者膜性狼疮肾炎（MLN）的临床表现、病程、预后及影响预后的因素。患者与方法对96例合并MLN的SLE患者进行研究。评估SLE疾病活动性指数（SLEDAI）和SLE国际合作诊所损害指数（SLICC-DI）。48例单纯MLN （V类），另外48例混合性（膜性加增生性III/IV类）。中位随访时间为首次肾活检后24个月。结果96例患者中，女性86例，男性10例，平均年龄34.9±10.6岁，病程8.85±1.7年。43例（44.8%）有肾病，25例（26%）有肾病综合征。SLICC-DI平均为2.46±1.2，SLEDAI平均为12.6±4.3.76(79.2%)，部分缓解20（20.8%）。4.2%有肾脏或肾外耀斑，13.5%有慢性肾脏疾病。混合型患者SLEDAI显著高于对照组(p <；0.0001)、抗双链脱氧核酸（抗dsdna）滴度（p = 0.028）、血清肌酐（p = 0.016）、肾活检慢性指数（p = 0.001）、实现肾炎缓解所需时间更长（p = 0.001）、肌酐清除率较低（p = 0.009）。SLICC-DI祝辞3 (p = 0.002), SLEDAI >；14 (p <；0.001)，白蛋白/肌酐>；4.5 g/d (p = 0.013)，血清肌酐>；1.36 mg/dl；0.001)，肌酐清除率<；84.3 mL/min (p = 0.002)，尿模(p <；0.0001)和慢性指数>；6个（p = 0.003）是MLN患者预后不良的主要预测因子。结论与单纯MLN相比，混合型MLN具有更严重的临床和组织学表现，达到完全和部分缓解的时间更长。

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引用次数: 0

Asymptomatic hyperuricemia and the risk of colistin-induced acute kidney injury in critically-ill patients with ventilator-associated pneumonia 无症状高尿酸血症和粘菌素诱导的呼吸机相关性肺炎危重患者急性肾损伤的风险

IF 1 Q4 RHEUMATOLOGY

Egyptian Rheumatologist

Pub Date : 2025-07-22 DOI: 10.1016/j.ejr.2025.07.001

Alia H. Abd El Fatah, Mohamed M.Y. Khaled, Mohammed S. Sayed, Mohamed A. Fakher, Sherif R.A. Mohamed

Background

Hyperuricemia has been associated with many chronic metabolic diseases, such as cardiovascular disease, chronic kidney disease, and metabolic syndrome.

Aim of the work

To reveal the risk of hyperuricemia and its association with development of acute kidney injury (AKI) during treatment with colistin incritically-illpatients with multidrug and extensive drug resistant ventilator-associated pneumonia not known to be hyperuricemic.

Patients and methods

This study included 60 patients with ventilator-associated pneumonia admitted to the intensive care unit (ICU): 23 with hyperuricemia and 37with normal serum uric acid (SUA) levels. The APACHE II (Acute Physiology And Chronic Health Evaluation) and Sequential Organ Failure Assessment (SOFA) were scored. All patients were receiving intravenous colistin 2.5–5 mg/kg/d in 2–4 divided doses.

Results

The mean age of the patients was 61.3 ± 14.4 years, 17 females (F:M 1:2.19), the APACHE II and SOFA were lower in those with hyperuricemia (20.5 ± 6.3 and 16.0 ± 4.9) compared to those with normal SUA (24.8 ± 9.3 and 8.7 ± 5.6; p = 0.0.04 and p = 0.001). 12 (52.1 %) patients with hyperuricemia developed AKI and 11 (47.8 %) died while 5 (13.5 %) developed AKI and 17 (45.9 %) died in those with normal SUA (p = 0.001 and p = 0.89 respectively). The area under the curve (AUC) for SUA levels predicting AKI was 0.77 (95 %CI:0.62–0.9) at > 7 mg/dL (sensitivity 71 %, specificity 77 %) (p = 0.001).

Conclusion

Asymptomatic hyperuricemia is a potential risk factor for AKI in critically-ill patients with multidrug resistant ventilator-associated pneumonia. It may play a role in the development of sepsis-related AKI, and managing hyperuricemia could potentially serve as an effective strategy to prevent its development.

背景：高尿酸血症与许多慢性代谢性疾病有关，如心血管疾病、慢性肾病和代谢综合征。研究目的：揭示未发现高尿酸血症的多药和广泛耐药呼吸机相关性肺炎危重患者在使用粘菌素治疗期间发生高尿酸血症的风险及其与急性肾损伤（AKI）发展的关系。患者和方法本研究纳入重症监护病房（ICU）收治的60例呼吸机相关性肺炎患者：23例高尿酸血症，37例血清尿酸（SUA）水平正常。对APACHE II（急性生理和慢性健康评估）和顺序器官衰竭评估（SOFA）进行评分。所有患者均静脉注射粘菌素2.5 ~ 5mg /kg/d，分2 ~ 4次给药。结果患者平均年龄为61.3±14.4岁，女性17例（F∶M∶2.19），高尿酸血症患者的APACHEⅱ和SOFA（20.5±6.3和16.0±4.9）低于SUA正常患者（24.8±9.3和8.7±5.6）；P = 0.0.04和P = 0.001)。高尿酸血症组有12例（52.1%）发生AKI， 11例（47.8%）死亡，SUA正常组有5例（13.5%）发生AKI， 17例（45.9%）死亡（p = 0.001和p = 0.89）。SUA水平预测AKI的曲线下面积（AUC）为0.77 (95% CI: 0.62-0.9)；7 mg/dL（敏感性71%，特异性77%）（p = 0.001）。结论无症状高尿酸血症是多药耐药呼吸机相关性肺炎危重患者AKI的潜在危险因素。它可能在脓毒症相关AKI的发展中发挥作用，管理高尿酸血症可能是预防其发展的有效策略。

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引用次数: 0