Egyptian Rheumatologist最新文献_第9页

Comparative assessment of hepatitis C virus-related arthritis and rheumatoid arthritis: Relation to clinical, serologic and ultrasonographic characteristics 丙型肝炎病毒相关性关节炎和类风湿性关节炎的比较评估：与临床、血清学和超声特征的关系

IF 0.9 Q4 RHEUMATOLOGY

Egyptian Rheumatologist

Pub Date : 2023-06-01 DOI: 10.1016/j.ejr.2023.03.006

Hala L. Fayed , Amira A. Shahin , Abo El-Magd M. El-Bohy , Sahar S. Younis

Background

Extrahepatic manifestations of hepatitis C virus (HCV) infection includes HCV-related arthritis (HCV-A) that may mimic rheumatoid arthritis (RA). Musculoskeletal ultrasound (MSUS) can aid in discriminating both conditions.

Aim of the work

To study the clinical, serological and imaging (Xray, MSUS) characteristics of HCV-A and compare them to RA.

Patients and methods

The study included 30 patients with HCV-A and 30 age- and sex-matched RA patients negative for HCV. Ritchie articular index (RAI), tender joint count (TJC) and swollen joint count (SJC) assessed arthritis. Patient global health assessment (PGHA) and modified health assessment questionnaire (MHAQ) were evaluated. The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP) and serum cryoglobulins were measured. Radiologic assessment included short Larsen score (SLS) and MSUS using 7-joint ultrasound score (US7).

Results

The mean age of the HCV-A patients was 45.8 ± 4.7 years; RA was 43.3 ± 5.6 years; F:M was 27:3 in HCV-A patients; 29:1 in RA; HCV-A patients had no subcutaneous nodules, joint deformities or bone erosions. US7 showed that Gray-Scale (GS)/Power Doppler (PD) synovitis and tenosynovitis had higher mean values in RA versus HCV-A patients (p < 0.001; p < 0.001; p = 0.011; p = 0.008 respectively). A significant correlation was found between SJC with GS and PD synovitis in both groups.

Conclusion

HCV-A differ from RA features as being non nodular, non-deforming, non-erosive and aid in the predilection of HCV-A diagnosis. MSUS can offer a useful imaging modality elucidating inflammatory components of HCV-A and highlighting the spectrum of the condition.

背景丙型肝炎病毒（HCV）感染的肝外表现包括可能与类风湿性关节炎（RA）相似的HCV相关关节炎（HCV-A）。肌肉骨骼超声（MSUS）可以帮助区分这两种情况。研究HCV-A的临床、血清学和影像学（Xray，MSUS）特征，并与RA进行比较。患者和方法本研究包括30例HCV-A患者和30例年龄和性别匹配的HCV阴性RA患者。Ritchie关节指数（RAI）、软关节计数（TJC）和肿胀关节计数（SJC）评估关节炎。对患者整体健康评估（PGHA）和改良健康评估问卷（MHAQ）进行评估。测定红细胞沉降率（ESR）、C反应蛋白（CRP）、类风湿因子（RF）、抗环瓜氨酸肽（anti-CCP）和血清冷球蛋白。放射学评估包括短拉森评分（SLS）和使用7关节超声评分（US7）的MSUS。结果HCV-A患者的平均年龄为45.8±4.7岁；RA为43.3±5.6岁；F： HCV-A患者的M为27:3；RA为29:1；HCV-A患者没有皮下结节、关节畸形或骨侵蚀。US7显示，与HCV-A患者相比，RA患者的灰度（GS）/功率多普勒（PD）滑膜炎和肌腱滑膜炎具有更高的平均值（分别为p＜0.001；p＜0.001，p＝0.011；p＝0.008）。在两组中，SJC与GS和PD滑膜炎之间存在显著相关性。结论HCV-A与RA的特点不同，无结节、无变形、无侵蚀，有助于诊断HCV-A。MSUS可以提供一种有用的成像模式，阐明HCV-a的炎症成分并突出病情的光谱。

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引用次数: 2

Pulmonary artery pseudoaneurysms (PAPs) in Hughes-Stovin syndrome (HSS) as an emerging concept for a potentially fatal course Hughes-Stovin综合征（HSS）中的肺动脉假性动脉瘤（PAPs）是一种潜在致命过程的新兴概念

IF 0.9 Q4 RHEUMATOLOGY

Egyptian Rheumatologist

Pub Date : 2023-06-01 DOI: 10.1016/j.ejr.2023.03.004

Tubig C. Joy , Juljani Sherwina , Ayuyao Fernando , Ma E Limpin , Ma Paz Mateo , Khalid Alhusseiny

Introduction

Hughes-Stovin syndrome (HSS) is a systemic vasculitis characterized by pulmonary artery aneurysms (PAA) and widespread venous and arterial thrombosis. Fatalities in HSS resulted from unforeseeable fatal suffocating hemoptysis. It is critical to early detect pulmonary involvement to take timely measures against inevitable serious life-threatening complications.

Case presentation

A 27 year old Filipino male patient presented to the emergency department with an acute attack of massive hemoptysis. The markers of inflammation were elevated with anemia and a normal coagulation profile. The patient had bilateral lower limb edema with tender calf muscles. Color Doppler ultrasound revealed bilateral deep vein thrombosis. Importantly, an urgent computerized tomography pulmonary angiography (CTPA) revealed bilateral large PAAs which matched the pattern of pseudoaneurysms described by the HSS international study group (HSSISG). There was no history of iridocyclitis, recurrent oral or genital ulcers. Accordingly, the patient was diagnosed with HSS. The patient received intravenous pulse methylprednisolone (1 g/3 days), then oral prednisone (1 mg/kg/d/3 months), and monthly pulse cyclophosphamide (1 g) for three months. The patient remained symptom-free, yet on the third pulse of cyclophosphamide; he patient contracted corona virus disease-2019 (COVID-19) infection and died three weeks later from a fatal episode of massive hemoptysis. The case was discussed and the recent literature was reviewed relative to fatal hemoptysis associated with pulmonary artery pseudoaneurysms (PAPs) pattern in HSS

Conclusion

HSS presenting with massive hemoptysis could be lifethreatening and the PAPs are considered a double edged sword. Detailed description of such rare cases is warranted for optimum future management.

休斯-斯托文综合征（HSS）是一种以肺动脉瘤（PAA）和广泛的静脉和动脉血栓形成为特征的系统性血管炎。HSS的死亡是由不可预见的致命窒息性咳血引起的。早期发现肺部受累，及时采取措施预防不可避免的严重危及生命的并发症，这一点至关重要。病例介绍：一名27岁的菲律宾男性患者因大咯血急性发作而被送往急诊科。炎症标志物随着贫血和正常凝血而升高。患者双侧下肢水肿，小腿肌肉酸痛。彩色多普勒超声显示双侧深静脉血栓形成。重要的是，紧急计算机断层扫描肺血管造影术（CTPA）显示双侧大PAA与HSS国际研究小组（HSSISG）描述的假性动脉瘤模式相匹配。没有虹膜睫状体炎、复发性口腔或生殖器溃疡的病史。因此，患者被诊断为HSS。患者接受静脉注射甲基强的松龙（1g/3天），然后口服泼尼松（1mg/kg/d/3个月），每月注射环磷酰胺（1g），持续3个月。患者仍然没有症状，但接受了环磷酰胺的第三次注射；该患者感染了2019冠状病毒病（新冠肺炎），三周后死于致命的大咳血。对该病例进行了讨论，并回顾了与HSSC中肺动脉假性动脉瘤（PAPs）模式相关的致命性咳血的最新文献。结论HSS表现为大量咳血可能会危及生命，PAPs被认为是一把双刃剑。对这种罕见情况的详细描述是有必要的，以优化未来的管理。

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引用次数: 0

Juvenile clinically amyopathic dermatomyositis (CADM): Case-based review 青少年临床肌萎缩性皮肌炎（CADM）：基于病例的综述

IF 0.9 Q4 RHEUMATOLOGY

Egyptian Rheumatologist

Pub Date : 2023-06-01 DOI: 10.1016/j.ejr.2023.03.005

Wahinuddin Sulaiman , Farisya Mohd Lepatoni , Jyi Jong Tang , Nurul Bahiyah Baharudin

Background

Clinically amyopathic dermatomyositis (CADM) is rare as the classical cutaneous features are present with absence of myopathy and the serum creatinine kinase, electromyographic examination and muscle biopsy are usually normal.

Aim of the work

To report a young girl with juvenile CADM who responded to corticosteroid and mycophenolate mofetil, without progressing to myopathy and other systemic complications over a 3-year period.

Case presentation

An 11-year-old Malay girl was afebrile and presented with debilitating polyarthritis and classical cutaneous manifestations of dermatomyositis which was confirmed by histological findings, but without myopathy and systemic involvement. The anti-nuclear antibody (ANA) was positive 1:160, with speckled pattern and anti-p155/140 antibodies (anti-transcriptional intermediary factor 1, anti-TIF1γ antibody) were positive. Skin biopsy revealed typical histological findings consistent with dermatomyositis including vacuolar changes of the basal layer, increased lymphocytic infiltrate and increased mucin deposition in the dermis. She received pulse methylprednisolone (250 mg/day/3 days) followed by oral prednisolone 1 mg/kg/day tapered until her cutaneous lesions showed marked improvement. Hydroxychloroquine (HCQ) (200 mg/day) and oral methotrexate (10 mg/week) were added. Six months after initial treatment, mycophenolate mofetil (MMF) 1 g/day was added in view of the slow improvement of her cutaneous lesions and was discontinued a year later as she demonstrated favourable outcome. Besides the skin lesions, her arthritis also responded well to treatment.

Conclusion

Juvenile CADM is rare but with early recognition and treatment, the prognosis is good especially in children as this may reduce the risk of systemic complications and progression to myopathy.

背景临床上肌病理性皮肌炎（CADM）是罕见的，因为典型的皮肤特征是没有肌病，血清肌酸酐激酶、肌电图检查和肌肉活检通常是正常的。工作目的报告一名患有青少年CADM的年轻女孩，她对皮质类固醇和霉酚酸酯有反应，在3年内没有发展为肌病和其他系统性并发症。病例介绍：一名11岁的马来女孩发烧，表现为衰弱性多关节炎和皮肌炎的典型皮肤表现，经组织学检查证实，但没有肌病和全身受累。抗核抗体（ANA）阳性率为1:160，呈斑点状，抗p155/140抗体（抗转录中间因子1，抗TIF1γ抗体）阳性。皮肤活检显示了与皮肌炎一致的典型组织学表现，包括基底层的空泡变化、真皮中淋巴细胞浸润增加和粘蛋白沉积增加。她接受了甲基强的松龙脉冲治疗（250 mg/天/3天），然后口服泼尼松1 mg/kg/天，直到她的皮肤损伤出现明显改善。加入羟氯喹（HCQ）（200mg/天）和口服甲氨蝶呤（10mg/周）。首次治疗6个月后，考虑到她的皮肤病变改善缓慢，添加了1 g/天的霉酚酸酯（MMF），一年后，由于她表现出良好的结果，停止了治疗。除了皮肤损伤，她的关节炎对治疗也有很好的反应。结论青少年CADM是罕见的，但通过早期识别和治疗，预后良好，尤其是在儿童中，因为这可以降低系统并发症和进展为肌病的风险。

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引用次数: 1

High frequency ultrasound assessment of skin in systemic sclerosis patients 系统性硬化患者皮肤的高频超声评估

IF 0.9 Q4 RHEUMATOLOGY

Egyptian Rheumatologist

Pub Date : 2023-06-01 DOI: 10.1016/j.ejr.2023.04.005

Mervat Abo Gabal, Mohamed R. Mohamed, Mohamed A. Moawed, Caroline S. Morad

Aim of the work

To evaluate the role of high frequency ultrasound (HFU) in assessing skin changes in terms of thickness and echogenicity in systemic sclerosis (SSc) patients with early and late changes.

Patients and methods

Twenty-three SSc patients were enrolled along with 21 matched controls. Skin thickness was assessed using modified Rodnan skin score (mRSS) and HFU.

Results

Patients had mean age of 41.8 ± 9.1 years, 91.3% were females, mean disease duration 6.0 ± 4.6 years, 11 patients had early (<5 years) and 12 late (≥5 years) disease, 8 patients had limited (lcSSc) and 15 diffuse (dcSSc) cutaneous SSc. Antinuclear antibody was positive in 17 (73.9%) and antiscleroderma-17 in 18 (78.3%). Patients had significantly thicker skin between second and third metacarpophalangeal joint (L = 1.52 ± 0.35 mm vs 1.25 ± 0.35 mm; p = 0.017 and T = 1.48 ± 0.34 mm vs 1.26 ± 0.33 mm; p = 0.038 respectively). Patients with early disease had thicker skin than those with late disease. HFU dermal thickness showed no significant difference according to gender, subtypes, presence and absence of clinical manifestations or autoantibody positivity. There was significant higher dermal thickness in patients with reflux (p = 0.009) and was lower in patients with interstitial pulmonary fibrosis (p < 0.05). There was negative correlation between US dermal thickness and disease duration (p < 0.05). mRSS showed no correlation with HFU dermal thickness in all areas.

Conclusion

HFU is useful in assessing skin pathologic changes (even subclinical changes) in terms of thickness and echogenicity in SSc patients. Moreover, it could be a potential screening tool in differentiating normal from pathologic skin thickness.

工作目的评估高频超声（HFU）在评估早期和晚期变化的系统性硬化症（SSc）患者皮肤厚度和回声变化中的作用。患者和方法纳入23名SSc患者和21名匹配的对照组。结果患者平均年龄41.8±9.1岁，女性91.3%，平均病程6.0±4.6年，11例早期（＜5岁）和12例晚期（≥5岁），8例局限性（lcSSc）和15例弥漫性（dcSSc）皮肤SSc。抗核抗体阳性17例（73.9%），抗巩膜17例（78.3%）。患者第二和第三掌指关节之间的皮肤明显较厚（分别为L=1.52±0.35 mm和1.25±0.35 mm；p=0.017和T=1.48±0.34 mm和1.26±0.33 mm；p=0.038）。早期疾病患者的皮肤比晚期疾病患者厚。HFU真皮厚度根据性别、亚型、临床表现或自身抗体阳性的存在与否没有显著差异。反流患者的真皮厚度显著较高（p=0.009），间质性肺纤维化患者的真皮厚较低（p<；0.05）。US真皮厚度与疾病持续时间呈负相关（p<）。mRSS在所有区域均与HFU真皮厚度无关。结论HFU可用于评估SSc患者皮肤厚度和回声的病理变化（甚至亚临床变化）。此外，它可能是区分正常和病理皮肤厚度的潜在筛查工具。

{"title":"High frequency ultrasound assessment of skin in systemic sclerosis patients","authors":"Mervat Abo Gabal, Mohamed R. Mohamed, Mohamed A. Moawed, Caroline S. Morad","doi":"10.1016/j.ejr.2023.04.005","DOIUrl":"https://doi.org/10.1016/j.ejr.2023.04.005","url":null,"abstract":"<div><h3>Aim of the work</h3><p>To evaluate the role of high frequency ultrasound (HFU) in assessing skin changes in terms of thickness and echogenicity in systemic sclerosis (SSc) patients with early and late changes.</p></div><div><h3>Patients and methods</h3><p>Twenty-three SSc patients were enrolled along with 21 matched controls. Skin thickness was assessed using modified Rodnan skin score (mRSS) and HFU.</p></div><div><h3>Results</h3><p>Patients had mean age of 41.8 ± 9.1 years, 91.3% were females, mean disease duration 6.0 ± 4.6 years, 11 patients had early (<5 years) and 12 late (≥5 years) disease, 8 patients had limited (lcSSc) and 15 diffuse (dcSSc) cutaneous SSc. Antinuclear antibody was positive in 17 (73.9%) and antiscleroderma-17 in 18 (78.3%). Patients had significantly thicker skin between second and third metacarpophalangeal joint (L = 1.52 ± 0.35 mm vs 1.25 ± 0.35 mm; p = 0.017 and T = 1.48 ± 0.34 mm vs 1.26 ± 0.33 mm; p = 0.038 respectively). Patients with early disease had thicker skin than those with late disease. HFU dermal thickness showed no significant difference according to gender, subtypes, presence and absence of clinical manifestations or autoantibody positivity. There was significant higher dermal thickness in patients with reflux (p = 0.009) and was lower in patients with interstitial pulmonary fibrosis (p < 0.05). There was negative correlation between US dermal thickness and disease duration (p < 0.05). mRSS showed no correlation with HFU dermal thickness in all areas.</p></div><div><h3>Conclusion</h3><p>HFU is useful in assessing skin pathologic changes (even subclinical changes) in terms of thickness and echogenicity in SSc patients. Moreover, it could be a potential screening tool in differentiating normal from pathologic skin thickness.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"45 3","pages":"Pages 241-246"},"PeriodicalIF":0.9,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49819193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Avascular necrosis in systemic lupus erythematosus patients: Analysis of the demographics, clinical manifestations, management and outcomes 系统性红斑狼疮患者的缺血性坏死：人口统计学、临床表现、治疗和预后分析

IF 0.9 Q4 RHEUMATOLOGY

Egyptian Rheumatologist

Pub Date : 2023-06-01 DOI: 10.1016/j.ejr.2023.05.002

Asadullah Khan , Roshila Shamim , Abrar A Wagan , Sheikh M Khan , Syed Nazeer Ahmed , Muhammad Haroon

Background

Avascular necrosis (AVN) is a rare complication of systemic lupus erythematosus (SLE) that may develop from the disease or its treatment.

Aim of the work

To present the clinical characteristics, management and outcomes of SLE patients with AVN.

Patients and methods

The SLE patients with AVN on X-ray or magnetic resonance imaging (MRI) following up at Fatima Memorial Hospital College of Medicine and Dentistry Shadman, Lahore, Pakistan were studied. Detailed medical history, clinical examination, laboratory investigations, treatment details and outcomes were recorded.

Results

Out of 230 SLE patients, 20 (8.6%) had AVN; 80% females, F:M 4:1 with a mean age at onset of SLE 19.8 ± 6.5 years, and mean duration till occurrence of AVN 3.9 ± 2.3 years. AVN developed within 4 years of onset in 80% of patients. Mucocutaneous symptoms were the most common presentation (95%) and 65% had positive antiphospholipid antibodies. Until AVN development, all patients received a mean of 3.5 ± 0.7 g pulse steroid and a mean cumulative oral steroid dose of 18.6 ± 6.2 g. AVN was in the hip joint in 95% of cases, 80% were bilateral. AVN was grade II in 45% patients, grade III in 25% (n = 5), I in 20% (n = 4) and grade IV in 10% (n = 2). Grade I and II had preserved joint function and didn't need any surgery compared to stage III and IV.

Conclusions

In SLE patients, AVN is a relatively early complication occurring within 4 years of illness in patients with a young age at onset, and have a better outcome when detected at earlier stages.

背景缺血性坏死（AVN）是系统性红斑狼疮（SLE）的一种罕见并发症，可能由疾病或其治疗发展而来。本工作的目的是介绍系统性红斑狼疮合并AVN患者的临床特点、治疗和预后。患者和方法对巴基斯坦拉合尔Fatima Memorial Hospital College of Medicine and Dentry Shadman的SLE AVN患者进行了X射线或磁共振成像（MRI）随访研究。记录详细的病史、临床检查、实验室调查、治疗细节和结果。结果230例SLE患者中，AVN 20例（8.6%）；80%女性，F:M4:1，SLE发病时平均年龄19.8 ± 6.5 年，AVN发生前的平均持续时间3.9 ± 2.3 年。AVN在4年内发展 80%的患者发病年份。粘膜皮肤症状是最常见的表现（95%），65%的患者抗磷脂抗体呈阳性。在AVN发展之前，所有患者平均接受3.5 ± 0.7 g脉冲类固醇和18.6的平均累积口服类固醇剂量 ± 6.2 g.95%的AVN发生在髋关节，80%发生在双侧。AVN在45%的患者中为II级，25%的患者为III级（n = 5），I在20%（n = 4） IV级占10%（n = 2）。与III期和IV期相比，I级和II级患者的关节功能得到了保护，不需要任何手术。结论在SLE患者中，AVN是一种相对早期的并发症，发生在4 发病时年龄较小的患者患病多年，在早期发现时有更好的结果。

{"title":"Avascular necrosis in systemic lupus erythematosus patients: Analysis of the demographics, clinical manifestations, management and outcomes","authors":"Asadullah Khan , Roshila Shamim , Abrar A Wagan , Sheikh M Khan , Syed Nazeer Ahmed , Muhammad Haroon","doi":"10.1016/j.ejr.2023.05.002","DOIUrl":"https://doi.org/10.1016/j.ejr.2023.05.002","url":null,"abstract":"<div><h3>Background</h3><p>Avascular necrosis (AVN) is a rare complication of systemic lupus erythematosus (SLE) that may develop from the disease or its treatment.</p></div><div><h3>Aim of the work</h3><p>To present the clinical characteristics, management and outcomes of SLE patients with AVN.</p></div><div><h3>Patients and methods</h3><p>The SLE patients with AVN on X-ray or magnetic resonance imaging (MRI) following up at Fatima Memorial Hospital College of Medicine and Dentistry Shadman, Lahore, Pakistan were studied. Detailed medical history, clinical examination, laboratory investigations, treatment details and outcomes were recorded.</p></div><div><h3>Results</h3><p>Out of 230 SLE patients, 20 (8.6%) had AVN; 80% females, F:M 4:1 with a mean age at onset of SLE 19.8 ± 6.5 years, and mean duration till occurrence of AVN 3.9 ± 2.3 years. AVN developed within 4 years of onset in 80% of patients. Mucocutaneous symptoms were the most common presentation (95%) and 65% had positive antiphospholipid antibodies. Until AVN development, all patients received a mean of 3.5 ± 0.7 g pulse steroid and a mean cumulative oral steroid dose of 18.6 ± 6.2 g. AVN was in the hip joint in 95% of cases, 80% were bilateral. AVN was grade II in 45% patients, grade III in 25% (n = 5), I in 20% (n = 4) and grade IV in 10% (n = 2). Grade I and II had preserved joint function and didn't need any surgery compared to stage III and IV.</p></div><div><h3>Conclusions</h3><p>In SLE patients, AVN is a relatively early complication occurring within 4 years of illness in patients with a young age at onset, and have a better outcome when detected at earlier stages.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"45 3","pages":"Pages 261-265"},"PeriodicalIF":0.9,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49792899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Molecular typing of HLA-class II alleles reveals an association with autoantibodies and disease subsets of systemic sclerosis in a North Indian (Kashmir) population HLA II类等位基因的分子分型揭示了北印度（克什米尔）人群中自身抗体和系统性硬化症疾病亚群的相关性

IF 0.9 Q4 RHEUMATOLOGY

Egyptian Rheumatologist

Pub Date : 2023-06-01 DOI: 10.1016/j.ejr.2023.04.007

Sakeena Ayub , Zafar Shah , Tabasum Shafi , Fayaz Sofi , Imtiyaz Bhat , Roohi Rasool , Mushtaq Dangroo , Shahid Baba , Nasia Ismail , Nahidah Majid

Aim of the work

To identify specific human leukocyte antigen (HLA)-Class II (DRB/DQB1/DPB1) alleles associated with systemic sclerosis (SSc) and to explore their relation with SSc autoantibodies, clinical manifestations, and disease subsets.

Patients and methods

HLA-class II alleles (DRB1/DRB3/DRB4/DRB5/DQB1) were determined by DNA typing in 80 SSc cases and 60 matched controls and HLA-DPB1 in 40 SSc patients and 30 controls by allele-specific-polymerase chain reaction with sequence-specific primers (PCR-SSP).

Results

The mean age of SSc patients was 36.9 ± 9.4 years; 76 females and 4 males (F:M 19:1) and a disease duration of 5.3 ± 3.3 years, they were 43(53.7%) limited and 37(46.2%) diffuse subtypes. SSc was significantly associated with DRB1*11, DRB1*01, DQB1*04, and DQB1*03*03 in a >4-fold manner, whereas DPB1*04 had a >7-fold increased risk compared to controls. There was a strong association between DRB1*11 (p = 0.04), DQB1*03*03 (p = 0.005), and DPB1*13 (p = 0.009) with anti-topoisomerase I (anti-topoI) whereas the frequency of DRB1*01 (p < 0.0001) was increased in patients with anti-centromere (ACA) positive SSc compared those negative (56% vs 25%; p < 0.0001). DRB1*03, DRB1*15, and DQB1*03*01 were SSc protective alleles in patients with positive ACA. Anti-topo I was associated with interstitial lung disease (ILD) (p < 0.01), whereas ACA with pulmonary arterial hypertension (PAH) (p = 0.01) and protection against ILD (p < 0.001). In addition, HLA-DRB1*03, DQB1*03*01and DPB1*03 were more frequent in patients with ILD than in patients without.

Conclusion

Associations between specific HLA-class II alleles with certain SSc-specific autoantibodies (anti-topo I and ACA) were identified. Specific HLA associations with clinical and serological subtypes could serve as biomarkers of disease severity and progression in SSc.

本工作的目的是鉴定与系统性硬化症（SSc）相关的特异性人类白细胞抗原（HLA）-Ⅱ类（DRB/DQB1/DPB1）等位基因，并探讨它们与SSc自身抗体、临床表现和疾病亚群的关系。患者和方法80例SSc患者和60例对照组采用DNA分型法检测HLAⅡ类等位基因（DRB1/DRB3/DRB4/DRB5/DQB1），40例SSc病人和30例对照组用等位基因特异性聚合酶链反应-序列特异性引物（PCR-SSP）检测HLA-DPB1。结果SSc患者的平均年龄为36.9±9.4岁；女性76例，男性4例（F:M 19:1），病程5.3±3.3年，局限性亚型43例（53.7%），弥漫性亚型37例（46.2%）。SSc与DRB1*11、DRB1*01、DQB1*04和DQB1*03*03显著相关；4倍方式，而DPB1*04具有>；与对照组相比，风险增加了7倍。DRB1*11（p=0.04）、DQB1*03*03（p=0.005）和DPB1*13（p=0.009）与抗拓扑异构酶I（抗拓扑酶I）有很强的相关性，而与阴性患者相比，抗着丝粒（ACA）阳性SSc患者DRB1*01（p<；0.0001）的频率增加（56%vs 25%，DQB1*03*01是ACA阳性患者的SSc保护性等位基因。抗topo I与间质性肺病（ILD）相关（p＜0.01），而ACA与肺动脉高压（PAH）相关（p＝0.01），并对ILD具有保护作用（p＜0.001）。此外，HLA-DRB1*03、DQB1*03*01和DPB1*03在ILD患者中比无ILD患者更常见。结论特异性HLAⅡ类等位基因与某些SSc特异性自身抗体（抗topoⅠ和ACA）之间存在相关性。与临床和血清学亚型的特异性HLA关联可以作为SSc疾病严重程度和进展的生物标志物。

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引用次数: 0

Leukocytoclastic vasculitis induced by adalimumab biosimilar in an elderly female with rheumatoid arthritis: A case-based review 阿达木单抗生物类似物在一名患有类风湿性关节炎的老年女性中诱导的白细胞碎屑性血管炎：基于病例的综述

IF 0.9 Q4 RHEUMATOLOGY

Egyptian Rheumatologist

Pub Date : 2023-06-01 DOI: 10.1016/j.ejr.2023.04.001

Dena Mohamadzadeh , Shirin Assar , Faraneh Farsad

Background

Adalimumab is one of the most frequently used tumor necrosis factor (TNF) inhibitors considered in the treatment of several autoimmune diseases including rheumatoid arthritis (RA). There have been reports of being adversely associated with the development of lupus and vasculitis. Leukocytoclastic vasculitis (LCV) is the most common form of cutaneous vasculitis that could be associated with different medications including TNF inhibitors.

Case presentation

A 64-year-old Iranian female with RA for 11 years presented to the rheumatology clinic, Imam Reza Hospital, Kermanshah University, complaining of erythematous patches, plaques, and erosions on her lower extremities for 20-days. She had been receiving methotrexate (MTX) for 11 years (on 5 mg/week) and adalimumab biosimilar 40 mg every other week for nine months prior to developing the skin lesions. There were no signs of RA activity. The routine laboratory tests and immunological workup including anti-nuclear antibodies (ANA), anti-neutrophil cytoplasmic antibody (ANCA) and serum complements were within normal limits. Abdominopelvic sonography showed no pathological finding. A skin biopsy confirmed the diagnosis of LCV. Adalimumab and MTX were discontinued and she was started on prednisolone (5 mg/day) and mycophenolate mofetil (2 g/day). Gradual improvement was observed. Similar reported cases of adalimumab-related LCV are presented.

Conclusion

Leukocytoclastic vasculitis could be a possible adverse event of TNF inhibitors. Complete improvement occurs after withdrawal of the culprit drug in most cases while corticosteroids and immunosuppressive medications are required in some cases. LCV associated with adalimumab biosimilar should raise the awareness of rheumatologists about this possible complication for appropriate management.

阿达木单抗是治疗类风湿性关节炎（RA）等多种自身免疫性疾病最常用的肿瘤坏死因子（TNF）抑制剂之一。有报道称其与狼疮和血管炎的发展有关。白细胞碎屑性血管炎（LCV）是最常见的皮肤血管炎，可能与包括TNF抑制剂在内的不同药物有关。病例介绍：一名64岁的伊朗女性，患有类风湿性关节炎11年，在克尔曼沙大学伊玛目礼萨医院风湿病诊所就诊，主诉下肢出现红斑斑块、斑块和侵蚀，持续20天。在出现皮肤病变之前，她已经接受了11年的甲氨蝶呤（MTX）治疗（每周5毫克），并每隔一周接受阿达木单抗生物类似物40毫克治疗，持续了9个月。没有RA活动的迹象。常规实验室测试和免疫学检查，包括抗核抗体（ANA）、抗中性粒细胞细胞质抗体（ANCA）和血清补体，均在正常范围内。腹部左心室超声检查无病理学发现。皮肤活检证实了LCV的诊断。阿达木单抗和MTX停用，她开始服用泼尼松（5 mg/天）和霉酚酸酯（2 g/天）。观察到病情逐渐好转。报告了阿达木单抗相关LCV的类似病例。结论白细胞破裂性血管炎可能是TNF抑制剂的不良反应。在大多数情况下，完全改善发生在停药后，而在某些情况下需要皮质类固醇和免疫抑制药物。与阿达木单抗生物类似物相关的LCV应提高风湿病学家对这种可能并发症的认识，以便进行适当的管理。

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引用次数: 1

Pain neuroscience education versus transcutaneous vagal nerve stimulation in the management of patients with fibromyalgia 疼痛神经科学教育与经皮迷走神经刺激治疗纤维肌痛患者

IF 0.9 Q4 RHEUMATOLOGY

Egyptian Rheumatologist

Pub Date : 2023-06-01 DOI: 10.1016/j.ejr.2023.03.001

Asmaa M. Abdel-Baset , Maii A. Abdellatif , Haydy H.S. Ahmed , Nashwa K. El Shaarawy

Aim of the work

To evaluate the effectiveness of pain neuroscience education (PNE) and transcutaneous vagal nerve stimulation (tVNS) for fibromyalgia (FM) patients, as one of the chronic pain treatment modalities.

Patients and methods

The study was conducted on 99 patients that were divided into 3 groups (n = 33 each): Patients in group A received 6 sessions of tVNS twice weekly (25 Hz for 30 min), group B received 6 sessions of tVNS twice weekly (25 Hz for 30 min) and 3 sessions of PNE once weekly (for 30 min) and group C received 3 sessions of PNE once weekly (for 30 min). The follow up done immediately after the end of the sessions by Visual Analogue Scale score, Fibromyalgia Impact Questionnaire (FIQ), Pain catastrophizing scale questionnaire (PCS-Q, Pain DETECT questionnaire (PD-Q) and state trait anxiety inventory (STAI Q) self-reported questionnaire.

Results

The mean age of patients was 33.3 ± 8.2 years and they were 86 females and 13 males (F:M 6.6: 1) and the 3 groups were matched for age (p = 0.15) and gender (p = 0.13). During the procedures no side effects were encountered. The 3 groups showed significant improvement of FM symptoms assessed by VAS, FIQ, PCS-Q, PD-Q and STAI-Q (state and trait), but group B showed the best results percentage of improvement (60%, 34.4%, 54.2%, 40%, 51.1% and 52,2% respectively).

Conclusion

Combined tVNS and PNE are more effective than PNE alone or VNS alone in management of FM. Further studies with long term follow up to assess the long-term effect of tVNS or PNE.

本工作的目的是评估疼痛神经科学教育（PNE）和经皮迷走神经刺激（tVNS）作为慢性疼痛治疗模式之一对纤维肌痛（FM）患者的有效性。患者和方法本研究对99名患者进行了研究，共分为3组（每组33人）：A组患者接受6次tVNS治疗，每周两次（25 Hz，持续30分钟），B组患者每周接受6次t VNS治疗（25 Hz），每周接受3次PNE治疗（30分钟）。疗程结束后立即通过视觉模拟量表评分、纤维肌痛影响问卷（FIQ）、疼痛灾难量表（PCS-Q）、痛苦检测问卷（PD-Q）和状态-特质焦虑量表（STAI-Q）自我报告问卷进行随访。结果患者平均年龄为33.3±8.2岁，女性86例，男性13例（F:M 6.6:1），三组患者年龄和性别匹配（p=0.015），手术过程中未出现副作用。通过VAS、FIQ、PCS-Q、PD-Q和STAI-Q（状态和特质）评估，3组FM症状均有显著改善，但B组的改善率最高（分别为60%、34.4%、54.2%、40%、51.1%和52.2%）。对tVNS或PNE的长期疗效进行长期随访的进一步研究。

{"title":"Pain neuroscience education versus transcutaneous vagal nerve stimulation in the management of patients with fibromyalgia","authors":"Asmaa M. Abdel-Baset , Maii A. Abdellatif , Haydy H.S. Ahmed , Nashwa K. El Shaarawy","doi":"10.1016/j.ejr.2023.03.001","DOIUrl":"https://doi.org/10.1016/j.ejr.2023.03.001","url":null,"abstract":"<div><h3>Aim of the work</h3><p>To evaluate the effectiveness of pain neuroscience education (PNE) and transcutaneous vagal nerve stimulation (tVNS) for fibromyalgia (FM) patients, as one of the chronic pain treatment modalities.</p></div><div><h3>Patients and methods</h3><p>The study was conducted on 99 patients that were divided into 3 groups (n = 33 each): Patients in group A received 6 sessions of tVNS twice weekly (25 Hz for 30 min), group B received 6 sessions of tVNS twice weekly (25 Hz for 30 min) and 3 sessions of PNE once weekly (for 30 min) and group C received 3 sessions of PNE once weekly (for 30 min). The follow up done immediately after the end of the sessions by Visual Analogue Scale score, Fibromyalgia Impact Questionnaire (FIQ), Pain catastrophizing scale questionnaire (PCS-Q, Pain DETECT questionnaire (PD-Q) and state trait anxiety inventory (STAI Q) self-reported questionnaire.</p></div><div><h3>Results</h3><p>The mean age of patients was 33.3 ± 8.2 years and they were 86 females and 13 males (F:M 6.6: 1) and the 3 groups were matched for age (p = 0.15) and gender (p = 0.13). During the procedures no side effects were encountered. The 3 groups showed significant improvement of FM symptoms assessed by VAS, FIQ, PCS-Q, PD-Q and STAI-Q (state and trait), but group B showed the best results percentage of improvement (60%, 34.4%, 54.2%, 40%, 51.1% and 52,2% respectively).</p></div><div><h3>Conclusion</h3><p>Combined tVNS and PNE are more effective than PNE alone or VNS alone in management of FM. Further studies with long term follow up to assess the long-term effect of tVNS or PNE.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"45 3","pages":"Pages 191-195"},"PeriodicalIF":0.9,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49835222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Potential value of collagen triple helix repeat containing-1 (CTHRC1) in systemic lupus erythematosus (SLE) patients with arthritis detected clinically or by musculoskeletal ultrasound 胶原三螺旋重复序列-1（CTHRC1）在系统性红斑狼疮（SLE）合并关节炎患者临床或肌肉骨骼超声检测中的潜在价值

IF 0.9 Q4 RHEUMATOLOGY

Egyptian Rheumatologist

Pub Date : 2023-06-01 DOI: 10.1016/j.ejr.2023.03.002

Reem El-Mallah , Dina A. Farrag , Nesma Ahmed Safwat

Aim of the work

Is to measure collagen triple helix repeat containing 1 (CTHRC1) in systemic lupus erythematosus (SLE) patients and assessing its value as a marker of arthritis.

Patients and methods

This study included 44 female SLE patients and 44 matched healthy controls. All patients underwent hand and wrist Ultrasound (US) examination. Patients were divided into those with arthritis either clinically or sub-clinically by Ultrasound (A) and second one without arthritis. Serum level of CTHRC1 was measured using Enzyme linked immunosorbent assay. Disease activity was assessed using SLEDAI-2 K and joint activity using swollen to tender ratio (STR).

Results

Serum CTHRC1 level was significantly higher in patients compared to controls (52.3 ± 25.7 ng/ml and 14.5 ± 3.9 ng/ml respectively, p < 0.001). It was significantly higher in renal patients with nephritis and active arthritis by STR compared to those without (p = 0.04 and p = 0.003 respectively). Arthritis was detected in 68% of patients and they showed significantly higher CTHRC1 levels compared to those without (p = 0.037). Serum CTHRC1 showed positive significant correlation with STR (P = 0.007), CRP (p < 0.001), SLEDAI-2 K (p = 0.01) but not US findings. The STR showed significant association with CTHRC1 on regression analysis (p = 0.034). There was a fair ability for CTHRC1 to predict clinical and sub-clinical arthritis among SLE patients with sensitivity 56.7, specificity 85.7 at cut off value >55 ng/ml and area under curve 0.67.

Conclusion

Serum CTHRC1 level was significantly higher in SLE patients with nephritis and arthritis. It was significantly related to arthritis activity, inflammatory markers and disease activity. However, it showed fair performance for detecting arthritis.

本工作的目的是测量系统性红斑狼疮（SLE）患者的胶原三螺旋重复序列1（CTHRC1），并评估其作为关节炎标志物的价值。患者和方法本研究包括44名女性SLE患者和44名匹配的健康对照。所有患者均接受了手腕超声检查。通过超声（A）将患者分为临床或亚临床关节炎患者和非关节炎患者。采用酶联免疫吸附法测定血清CTHRC1水平。结果患者血清CTHRC1水平明显高于对照组（分别为52.3±25.7ng/ml和14.5±3.9ng/ml，p＜0.001），而肾炎和活动性关节炎患者血清CTHRC1水平则明显高于非肾炎患者（p分别为0.04和0.003）。68%的患者检测到关节炎，与未检测到的患者相比，他们的CTHRC1水平显著升高（p=0.037）。血清CTHRC1与STR（p=0.007）、CRP（p<；0.001）、SLEDAI-2K（p=0.01）呈正相关，但与US结果无关。回归分析显示STR与CTHRC1显著相关（p=0.034）。CTHRC1对SLE患者临床和亚临床关节炎的预测能力尚可，其敏感性为56.7，在临界值>；55 ng/ml，曲线下面积0.67。结论SLE合并肾炎和关节炎患者血清CTHRC1水平明显升高。它与关节炎活性、炎症标志物和疾病活性显著相关。然而，它在检测关节炎方面表现尚可。

{"title":"Potential value of collagen triple helix repeat containing-1 (CTHRC1) in systemic lupus erythematosus (SLE) patients with arthritis detected clinically or by musculoskeletal ultrasound","authors":"Reem El-Mallah , Dina A. Farrag , Nesma Ahmed Safwat","doi":"10.1016/j.ejr.2023.03.002","DOIUrl":"https://doi.org/10.1016/j.ejr.2023.03.002","url":null,"abstract":"<div><h3>Aim of the work</h3><p>Is to measure collagen triple helix repeat containing 1 (CTHRC1) in systemic lupus erythematosus (SLE) patients and assessing its value as a marker of arthritis.</p></div><div><h3>Patients and methods</h3><p>This study included 44 female SLE patients and 44 matched healthy controls. All patients underwent hand and wrist Ultrasound (US) examination. Patients were divided into those with arthritis either clinically or sub-clinically by Ultrasound (A) and second one without arthritis. Serum level of CTHRC1 was measured using Enzyme linked immunosorbent assay. Disease activity was assessed using SLEDAI-2 K and joint activity using swollen to tender ratio (STR).</p></div><div><h3>Results</h3><p>Serum CTHRC1 level was significantly higher in patients compared to controls (52.3 ± 25.7 ng/ml and 14.5 ± 3.9 ng/ml respectively, p < 0.001). It was significantly higher in renal patients with nephritis and active arthritis by STR compared to those without (p = 0.04 and p = 0.003 respectively). Arthritis was detected in 68% of patients and they showed significantly higher CTHRC1 levels compared to those without (p = 0.037). Serum CTHRC1 showed positive significant correlation with STR (P = 0.007), CRP (p < 0.001), SLEDAI-2 K (p = 0.01) but not US findings. The STR showed significant association with CTHRC1 on regression analysis (p = 0.034). There was a fair ability for CTHRC1 to predict clinical and sub-clinical arthritis among SLE patients with sensitivity 56.7, specificity 85.7 at cut off value >55 ng/ml and area under curve 0.67.</p></div><div><h3>Conclusion</h3><p>Serum CTHRC1 level was significantly higher in SLE patients with nephritis and arthritis. It was significantly related to arthritis activity, inflammatory markers and disease activity. However, it showed fair performance for detecting arthritis.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"45 3","pages":"Pages 197-202"},"PeriodicalIF":0.9,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49835224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association between periodontitis and cardiovascular health in rheumatoid arthritis patients: Prospective effect of periodontal treatment on cardiovascular risk 类风湿性关节炎患者牙周炎与心血管健康的关系：牙周治疗对心血管风险的前瞻性影响

IF 0.9 Q4 RHEUMATOLOGY

Egyptian Rheumatologist

Pub Date : 2023-06-01 DOI: 10.1016/j.ejr.2023.05.001

Shaimaa Salah , Nevin Hammam , Mohamed Raouf Abdel Razek , Nadia M. Ismail , Ahmed Mortada Fikry , Wageeh A. Ali , Essam A. Abda

Background

Rheumatoid arthritis (RA) patients are more likely to develop cardiovascular disease (CVD), which increases the risk of morbidity and mortality. Periodontitis is known to be associated with CVD, yet its relationship with CVD in RA is limited.

Aim of the work

To examine the relationship between periodontitis with subclinical atherosclerosis and with long term CVD risk. Examining if periodontitis treatment can be associated with CVD improvement was well thought out.

Patients and methods

This prospective interventional study included 49 adults with RA. Demographic, clinical and therapeutic data and laboratory markers were assessed. Dental examination for periodontitis was performed. The carotid intima media thickness (CIMT) and Framingham risk score (FRS) were evaluated. Medical treatment was provided to RA patients with periodontitis, and assessments were repeated after 6 months.

Results

The mean age of the patients was 46.4 ± 12.4 years, disease duration 10.9 ± 5.4 years and 79.6% were females. 25 (51%) patients had subclinical atherosclerosis, 30 (61.2%) had periodontitis and 25 (51%) had both. RA patients with subclinical atherosclerosis had higher clinical attachment loss (CAL) (3.12 ± 1.45) and higher probing depth (PD) (4.96 ± 1.37) compared to those without (p < 0.001). CAL (β = 0.01, 95 %CI: 0–0.01, p < 0.001), and PD (β = 0.01, 95% CI: 0–0.01; p < 0.001) were independently associated with CIMT. The 30 patients after treatment of periodontitis showed an average improvement in the mean CIMT (0.14 mm, p < 0.001).

Conclusion

Periodontitis is associated with subclinical atherosclerosis in RA. Treatment of periodontitis could improve the cardiovascular health in RA patients and prompts physicians to early diagnose and treat periodontitis.

背景类风湿性关节炎（RA）患者更容易发展为心血管疾病（CVD），这增加了发病率和死亡率。众所周知，牙周炎与心血管疾病有关，但其与RA心血管疾病的关系有限。研究牙周炎与亚临床动脉粥样硬化和长期心血管疾病风险之间的关系。检查牙周炎治疗是否与CVD改善有关是经过深思熟虑的。患者和方法本前瞻性介入研究包括49例RA患者。对人口统计学、临床和治疗数据以及实验室标志物进行了评估。对牙周炎进行了牙齿检查。评估颈动脉内膜-中膜厚度（CIMT）和Framingham风险评分（FRS）。对患有牙周炎的RA患者进行药物治疗，并在6个月后重复评估。结果患者平均年龄46.4±12.4岁，病程10.9±5.4岁，女性79.6%。25名（51%）患者患有亚临床动脉粥样硬化，30名（61.2%）患者患有牙周炎，25名（52%）患者同时患有这两种疾病。患有亚临床动脉粥样硬化的RA患者的临床附着丧失（CAL）（3.12±1.45）和探测深度（PD）（4.96±1.37）高于无临床动脉粥样硬化的患者（p<；0.001）。CAL（β=0.01，95%CI:0–0.01，p<；001）和PD（β=0.1，95%CI:0.–0.01；p<；.001）与CIMT独立相关。30例牙周炎患者治疗后平均CIMT平均改善（0.14mm，p＜0.001）。结论牙周炎与RA亚临床动脉粥样硬化有关。牙周炎的治疗可以改善RA患者的心血管健康，促使医生对牙周炎进行早期诊断和治疗。

{"title":"Association between periodontitis and cardiovascular health in rheumatoid arthritis patients: Prospective effect of periodontal treatment on cardiovascular risk","authors":"Shaimaa Salah , Nevin Hammam , Mohamed Raouf Abdel Razek , Nadia M. Ismail , Ahmed Mortada Fikry , Wageeh A. Ali , Essam A. Abda","doi":"10.1016/j.ejr.2023.05.001","DOIUrl":"https://doi.org/10.1016/j.ejr.2023.05.001","url":null,"abstract":"<div><h3>Background</h3><p>Rheumatoid arthritis (RA) patients are more likely to develop cardiovascular disease (CVD), which increases the risk of morbidity and mortality.Periodontitis is known to be associated with CVD, yet its relationship with CVD in RA is limited.</p></div><div><h3>Aim of the work</h3><p>To examine the relationship betweenperiodontitis with subclinical atherosclerosis and with long term CVD risk. Examining if periodontitis treatment can be associated with CVD improvement was well thought out.</p></div><div><h3>Patients and methods</h3><p>This prospective interventional study included 49 adults with RA. Demographic, clinical and therapeutic data and laboratory markers were assessed. Dental examination for periodontitis was performed. The carotid intima media thickness (CIMT) and Framingham risk score (FRS) were evaluated. Medical treatment was provided to RA patients with periodontitis, and assessments were repeated after 6 months.</p></div><div><h3>Results</h3><p>The mean age of the patients was 46.4 ± 12.4 years, disease duration 10.9 ± 5.4 years and 79.6% were females. 25 (51%) patients had subclinical atherosclerosis, 30 (61.2%) had periodontitis and 25 (51%) had both. RA patients with subclinical atherosclerosis had higher clinical attachment loss (CAL) (3.12 ± 1.45) and higher probing depth (PD) (4.96 ± 1.37) compared to those without (p < 0.001). CAL (β = 0.01, 95 %CI: 0–0.01, p < 0.001), and PD (β = 0.01, 95% CI: 0–0.01; p < 0.001) were independently associated with CIMT. The 30 patients after treatment of periodontitis showed an average improvement in the mean CIMT (0.14 mm, p < 0.001).</p></div><div><h3>Conclusion</h3><p>Periodontitis is associated with subclinical atherosclerosis in RA. Treatment of periodontitis could improve the cardiovascular health in RA patients and prompts physicians to early diagnose and treat periodontitis.</p></div>","PeriodicalId":46152,"journal":{"name":"Egyptian Rheumatologist","volume":"45 3","pages":"Pages 255-260"},"PeriodicalIF":0.9,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49819195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1