Aim of the work: Interstitial lung disease (ILD) is an uncommon yet clinically significant complication of systemic lupus erythematosus (SLE), contributing to increased morbidity. This study aimed to evaluate clinical predictors and radiological patterns of ILD in SLE and to investigate the association of serum interleukin-23 (IL-23) with ILD, disease activity and pulmonary involvement. Patients and methods: This study included thirty SLE patients with ILD and 30 without as well as 30 matched controls. Pulmonary function tests and high-resolution computed tomography (HRCT) were performed. SLE disease activity index was assessed. Serum IL-23 was measured. Results: IL-23 levels were significantly elevated in SLE patients compared to controls (p < 0.001) but did not differ between patients with and without ILD (p = 0.96). IL-23 demonstrated good diagnostic performance for SLE (cutoff >= 89.5 pg/mL, sensitivity 96.7%, AUC = 0.76) and significantly correlated with SLEDAI (r = 0.53,p < 0.001) and negatively with complement levels (C3: r = -0.33, p = 0.001; C4: r = -0.41,p = 0.001). ILD was associated with older age (p = 0.008), longer disease duration (p = 0.045), and prominent respiratory symptoms. Cough (OR = 9.7,p < 0.001) and Raynaud's phenomenon (OR = 5.2,p = 0.047) were independent predictors of ILD. HRCT revealed a predominance of inflammatory patterns. IL-23 significantlycorrelated with inflammatory radiological features (r = 0.62,p < 0.001) and negatively with fibrotic changes (p <= 0.001). Conclusions: IL-23 is elevated in SLE and reflects overall disease activity but is not a predictor of ILD occurrence. ILD risk is identified by cough and Raynaud's phenomenon. IL-23 appears to be associated with inflammatory lung features rather than fibrotic changes. Early clinical assessment combined with HRCT remains essential for timely diagnosis and management of SLE-associated ILD.
Background: Identifying psoriasis patients at risk of developing psoriatic arthritis (PsA) is challenging but crucial as it enables early diagnosis and reduces disability. Aim of the work: To evaluate the value of musculoskeletal ultrasound (MSUS) and Mac-2 binding protein (Mac-2BP) in early detection psoriasis patients who are likely to develop PsA. Patients and methods: The study included 137 psoriasis patients, 44 patients diagnosed clinically as PsA, in addition to 45 healthy controls. All patients underwent MSUS assessment. Serum Mac-2BP level was measured by Enzyme linked immunosorbent assay (ELISA). Results: The patients were 74 males and 63 females (M:F 1.2:1) and mean age of 38.8 +/- 12.4 years. Family history of psoriasis was represented in 15.3%. Subclinical PsA with minimal or no musculoskeletal symptoms was successfully detected in 46 patients showing ultrasound abnormalities, clearly distinguishing them from 47 patients with only skin psoriasis (PsO). Serum Mac-2BP level was significantly elevated in subclinical PsA patients 165.9 +/- 14.8 ng/ml compared to PsO 102.4 +/- 34.4 ng/ml and controls 82.8 +/- 39.5 ng/ml (p < 0.001) while non-significant difference was found between PsO and controls (p=0.19). The optimum cut-off for Mac-2BP was >143 ng/ml to discriminate PsA and subclinical PsA from PsO with sensitivity 100%, specificity 100%, p < 0.001. MSUS dactylitis (beta=603.2, p=0.001) and MSUS arthritis (beta=163.4, p=0.043) were found as predictors of increase serum Mac-2BP level. Conclusion: Early and silent musculoskeletal changes in psoriasis patients are detected by MSUS, while serum Mac-2BP helps identify subclinical PsA; together, they enable earlier diagnosis and better patient outcomes.
Aim of the work: Diagnosis of axial spondyloarthritis (ax-SpA) presents a significant challenge and may be delayed by as many as ten years. The lack of clearly defined referral pathways and the scarcity of rheumatologists prompt patients to seek treatment from non-rheumatologists. This study aimed to assess the knowledge and practices of non-rheumatologist practitioners in Pakistan regarding inflammatory back pain and ax-SpA.
Aim of the work: To ascertain whether serum levels of interleukin (IL)-6 and IL-2 in systemic lupus erythematosus (SLE) patients are associated with disease characteristics and activity. Patients and methods: The study included 60 SLE patients, 30 active and 30 inactive, alongside 30 matched healthy controls. SLE Disease Activity Index-2000 (SLEDAI-2 K) and SLE Damage Index (SDI) were assessed. Results: The age and gender of the patients were 38.5 +/- 14.6 years, female: male = 52:8. Active SLE patients had significantly higher IL-6 level 235.6 (16.6-2067.0) (p < 0.001), lower IL-2 level 279.4 (46.5-466.7) (p < 0.001), and higher IL-6/IL-2 ratio 0.66 (0.01-4.14) (p < 0.001) compared to inactive SLE patients 39.7 (2.5-372.4), 426.5 (222.0-1696.9), 0.06 (0-1.01), respectively, and healthy controls 4 (2.2-9.2), 576.4 (204.6-882.5), and 0.01 (0-0.02), respectively. The IL-6 level correlated significantly with SDI (r = 0.46, p < 0.001) and SLEDAI-2 K (r = 0.71, p < 0.001), whereas the IL-2 level showed significant inverse correlations with these indices (r = - 0.35, r = - 0.45, p < 0.001). The IL-6/IL-2 ratio correlated significantly with SDI (r = 0.27, p = 0.04) and SLEDAI-2 K (r = 0.50, p < 0.001). In active SLE patients, IL-6 correlated significantly with SLEDAI-2 K (r = 0.73, p < 0.001), urine albumin/creatinine ratio (r = 0.39, p = 0.03), and complement C4 (r = - 0.51, p < 0.04). In active SLE patients, the IL-6/IL-2 ratio correlated significantly with serum creatinine (r = - 0.45, p = 0.01), leucocyte count (r = - 0.37, p = 0.04), and complement C3 (r = 0.45, p = 0.01). IL-2 showed no significant associations with these parameters in active SLE (p >= 0.05). Conclusion: In SLE patients, particularly those with active disease, IL-6 and IL-6/IL-2 are valid biochemical indicators for the presence of illness. Therapeutic interventions targeting IL-6 may serve as a promising strategy for managing patients.
Background: Rheumatoid arthritis (RA) is associated with metabolic and nutritional disturbances. Vitamin D3 and vitamin K2 are essential factors for bone health. Aim of the work: To assess the relationship between vitamin D3 and K2 with dual energy X-ray absorptiometry (DEXA) in patients with active RA. Patients and methods: The study included 30 active RA patients. Key biochemical markers related to bone metabolism, vitamin D3 and K2, DEXA and disease activity score (DAS28) were studied. Total Sharp score (erosions) was assessed. Results: The cases were 24 females and 6 males (F:M 4:1), with a mean age of 45.2 +/- 10.9 years (23-64 years) and age at onset 38 +/- 9.5 years. The mean DAS28 was 4.8 +/- 1.2 (2.71-7). The mean vitamin D3 was 23.7 +/- 10.6 ng/ml (9.2-43.7), vitamin K2 3.04 +/- 1.1 ng/ml (1.5-4.2), ionized calcium 3.6 +/- 0.48 (2.8-4.4), DEXA (t score) -1.12 +/- 0.67 (-2.4-0) and Total Sharp score (erosions) 11.8 +/- 13.9 (1-47). In patients there was a significant decrease in vitamin D3 compared to the control (23.7 +/- 10.6 vs. 46.9 +/- 7.1 ng/mL respectively, p < 0.0001) and vitamin K2 (3.04 +/- 1.08 vs. 5.1 +/- 0.7 ng/mL respectively, p < 0.0001). There was osteopenia in cases vs. controls (-1.12 +/- 0.67 vs. -0.81 +/- 0.11 respectively, p < 0.01). Ionized calcium levels were significantly elevated in cases (3.6 +/- 0.48 vs. 3.02 +/- 0.58 mg/dL respectively, p < 0.0001). Radiographic assessments showed progressive joint damage. Conclusion: Reduced vitamin D3 and K2 as well as bone mineral density is established in RA patients. Vitamin D3 and K2 supplementation, lifestyle modifications and metabolic monitoring may alleviate bone loss and improve disease outcomes.
Background Interstitial lung disease (ILD) is a common extra-articular feature in rheumatoid arthritis (RA) necessitating an accurate assessment method. Krebs vonden Lungen-6 (KL-6) is a key biomarker for ILD and is related to disease severity. Lung ultrasound (LUS) is recommended for the detection and quantification of B-lines to assess the degree and severity of ILD. Aim of the work: to investigate the potential role of serumKL-6 and LUS B-lines for screening and monitoring of RA-ILD. Patients and methods This study included 44 patients with RA; 22 asymptomatic (group I) and another 22 had both radiological and clinical ILD (group II). ILD was diagnosed and assessed via chest high-resolution CT (HRCT) andLUS.Serum KL-6 level was estimated by Enzyme-Linked Immunosorbent Assay. The disease activity score (DAS28) was assessed. Results Serum KL-6 level was significantly higher in RA patients with ILD (818.3; 731.3-918.6 U/mL) than in those without (304.5; 141.3-450.8 U/mL) and controls (34.6; 24-49.9)(p < 0.001). Between group I and group II, the optimal cut-off point was > 450.8 U/mL, while between controls and groups I/II, it was > 67.17 U/mL. In ILD patients, there were noticeably more B-lines, and the best cut-off point was > 6 lines. A significant correlation was found between serum KL-6 and the number of B-lines in ILD patients. Conclusion RA patients with ILD had higher levels of KL-6 and a larger number of B lines, with a strong link between them. Being non-ionizing, inexpensive, and readily available makes LUS a potential tool in the assessment of ILD.
Background: Autoimmune rheumatic diseases (ARDs) are chronic systemic disorders associated with high morbidity and mortality. Although infections, cardiovascular, and respiratory complications remain leading causes of death, regional data on mortality in ARDs are still limited Aim of the work: To determine the frequency and main causes of mortality in hospitalized patients with ARDs and to assess their relation to clinical and laboratory features as well as medications received. Patients and methods The medical records were retrospectively reviewed for 214 hospitalized rheumatology patients deceased in the Rheumatology inpatient and intensive care unit of Kasr Al-Ainy University Hospitals between 2011 and 2025. Of these, 77 complete records were included in the final analysis. Results: Most deaths occurred in females (84.4%) with a mean age of 33.9 +/- 13 years. Family history of ARD was present in 11 (14.3). Systemic lupus erythematosus (SLE) was the most frequent diagnosis (70.1%). The leading cause of mortality was infection (40.3%), followed by cardiovascular (15.6%), respiratory (15.6%), and central nervous system causes (14.3%). Hematologic (87%), mucocutaneous (72.7%), musculoskeletal (68.8%), and renal (67.5%) involvements were the predominant major organs involved. Comorbidities included hypertension (51.9%) and diabetes (20.8%). Sepsis-related mortality was strongly associated with corticosteroid and immunosuppressant use. Conclusion: This study provides information on the characteristics of mortality in patients with ARDs. Infections remain the major cause of mortality among patients with ARDs, especially in SLE, often linked to corticosteroid and immunosuppressive use. Early infection control, rational immunosuppressant use, and management of comorbidities are essential to improving survival outcomes in ARDs.
Background: Genetic testing is one of the critical tools in understanding and treating lupus nephritis (LN) which is known to cause severe kidney damage and inflammation. The current work studied the expression of three different immune genes, Interferon Regulatory Factor 7 (IRF7), Fc Gamma Receptor IIA (FCGR2A), and Integrin Subunit Alpha V (ITGAV) mRNA levels, in relation to LN onset, flare, and histopathological severity. Patients and methods: This study included 47 LN patients (20 newly diagnosed, 27 with flare) and 33 controls. The expression of three genes in the renal biopsies of patients and controls, was quantitatively assessed using qRTPCR. The correlation of gene expressions with laboratory and histopathological parameters was studied. Results: The median age of the patients was 27 (16-58) years. 36 females and 11 males (F:M 3.3:1). A significant elevation in FCGR2A gene expression was observed in LN patients compared to the control (p < 0.001). Within the newly diagnosed group, IRF7 gene expression was significantly related with urine red blood cell count (p = 0.039) and the percentage of cellular crescents (p = 0.019). Within the flare group, FCGR2A significantly correlated with urine red blood cell count (p = 0.046) and fibrous crescents (p = 0.034). Furthermore, ITGA5 correlated considerably with fibrinoid necrosis (p = 0.003) and the renal activity index (p = 0.048). Conclusion: The differences in gene expression within LN renal biopsies, either newly diagnosed or in a flare in relation to various histopathological parameters, can pave the way for a better understanding of LN. However, more continued research is still needed to explore this sophisticated area.
Aim of the work: To describe various musculoskeletal manifestations in patients with Familial Mediterranean Fever (FMF) and their relation to different genotypes. Patients and methods: Fifty-four FMF patients were included. All patients underwent detailed history taking, physical examination, and Mediterranean Fever (MEFV) gene mutation analysis using real-time polymerized chain reaction (PCR). Results: The median age was 25 years (6-53 years). 35 were females and 19 males (F:M 1.84:1). 61.1% of patients developed symptoms before the age of 20 years. MEFV gene mutations were detected in 83.3% of cases with M694I mutation the most frequent. Musculoskeletal manifestations were the most frequent feature (92.6%). Arthralgia, myalgia and mechanical back pain were significantly more frequent during attacks. Arthritis was found in 22.2% of patients during attacks and 16.7% between attacks. No significant association was found between mutation positivity and the presence of arthralgia, myalgia, or arthritis during attacks. During attacks, knee joint pain was significantly more frequent in homozygous patients. Between attacks, shoulder joint pain was significantly more prevalent among homozygous patients. Patients with M694V mutation showed higher frequency of arthritis during attacks (50%) and higher prevalence myalgia (83.3%). Between attacks myalgia was significantly more frequent among M694V-positive patients compared with M694V-negative patients. Conclusions: Musculoskeletal manifestations are frequent clinical features in FMF patients. While MEFV mutations are common, type of gene mutation alone do not predict clinical manifestations, except for an association between homozygosity and specific joint involvement and a higher frequency of myalgia among M694V mutation positive patients.
Background Predicting therapy effectiveness before starting anti-tumor necrosis factor (anti-TNF) agents can help the rheumatologists select the best regimen for rheumatoid arthritis (RA) patients, reduce the cost and side effects. Aim of the work To measure interferon-alpha (IFN-alpha), interferon-beta (IFN-beta), and IFN-beta/alpha ratio in RA biologic-naive patients prior to initiating anti-TNF-alpha therapy, to investigate their potential role as predictors of the response to TNF inhibitors (TNFi). Patients and methods Eighty-eight (n = 88) biologic-naive RA patients were subjected to disease activity assessment, measurement of routine laboratory investigations, assessment of inflammatory markers and pretreatment levels of serum IFN-alpha and IFN-beta and the IFN-beta/alpha ratio and after 6 months. Results The age of the patients was 44.9 +/- 7.7 years, disease duration 8.01 +/- 6.3 years and the F:M 3.9:1. The levels of IFN-beta, IFN-alpha, and the IFN-beta/alpha ratio were significantly greater (286.7 ng/l, 158.7 pg/ml and 1.86) in non-responders (n = 59) than in responders (94.4 ng/l, 70.8 pg/ml and 1.26)(n = 29)(p < 0.001, p < 0.023, and p < 0.001, respectively). In non-responders, significant correlation was found between disease duration and IFN-beta (r = 0.39, p = 0.04) and IFN-alpha (r = 0.38, p = 0.049). At optimal cut-off values of IFN-beta (>159.1 ng/l), IFN-alpha (>79.2 pg/ml), and IFN-beta/alpha ratio (>1.47) non-responders could be differentiated from responders; IFN-beta/alpha ratio had the highest sensitivity (85.2%) and specificity (84.6%). Conclusion The pretreatment serum IFN-beta/alpha ratio in RA patients might be a predictor of early response to anti-TNF therapy. The present data can aid in the development of a personalized approach for treating RA in a cost-effective way if supported by further studies with different ethnicities.
Aim of the work: To evaluates the neutrophil/lymphocyte ratio (NLR), eosinophil/ lymphocyte ratio (ELR) and platelet/lymphocyte ratio (PLR) as potential biomarkers of disease activity in systemic lupus erythematosus (SLE). Patients and methods: This study included 82 SLE patients and 82 matched controls. The SLE disease activity index (SLEDAI) was assessed. The NLR, ELR and PLR were estimated. Results: The mean age of patients was 31 f 11 years and were 72 females and 10) males (F:M 7.2:1).The mean SLEDAI was 8.1 f 9.2.NLR (4.14 f 11.93) and ELR (0.62 f 4.74) were significantly higher in SLE patients compared to control (2.14 f 4.36 and 0.06 f 0.17)(p = 0.044 and p = 0.01 respectively) and both significantly correlated with the SLEDAI (r = 0.4, p < 0.0001 and r = 0.26,p = 0.02 respectively). The PLR was comparable between cases and control (p = 0.17) and showed no significant correlation with SLEDAI (p = 0.2). NLR was significantly higher in cases with positive C-reactive protein (CRP)(n = 18)(p = 0.001) and anti-double stranded deoxyribonucleic acid (antids-DNA)(n = 19)(p = 0.024). NLR significantly correlated with ESR (r = 0.3,p = 0.006) but not with complement (C3 and C4) consumption. NLR was not related to lupus nephritis. ELR significantly correlated with the erythrocyte sedimentation rate (ESR) (r = 0.27,p = 0.02) whereas PLR significantly higher in cases with positive CRP (n = 18,p = 0.008). Conclusion: The NLR, ELR, and PLR may all serve as useful parameters in determining systemic inflammation in SLE. The strong association of NLR and ELR with SLEDAI points to their remarkable and practical role in assessment of the current disease activity in SLE. These non-invasive tools and accessible ratios should be further routinely explored for monitoring of disease status and therapeutic response in clinical practice.
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(st)hr) levels than those without IBD (1.66 +/- 2.70 mg/dl and 7.55 +/- 4.99 mm/1(st)hr; p < 0.001for both). r-axSpA patients with IBD had significantly higher mean fecal calprotectin levels (522 +/- 178.52 g/g) compared to those without (232.57 +/- 70.13 mu g/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 g/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.
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.
Aim of the work: To assess the role of urinary biomarkers, macrophage inflammatory protein (MIP)-1 beta 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-1 beta 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-1 beta was significantly high in patients with severe renal disease activity, albuminuria and pyuria. Both MIP-1 beta and CXCL10 were significantly high in patients with microscopic hematuria. MIP-1 beta significantly correlated with protein/creatinine ratio, and CXCL10 had positive correlation with erythrocyte sedimentation rate (ESR). MIP-1 beta 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-1 beta and CXCL10 may have a potential role in the evaluation of SLE disease activity, particularly lupus nephritis.
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 f 10.2 years, 58 females and 5 males (F:M 11.6:1); SLE patients' age was 34.5 f 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 f 8.07 and 5.2 f 3.1) compared to RA (15.6 f 9.1 and 4 f 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.
Background: Beh & ccedil;et'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 Beh & ccedil;et's Disease Current Activity Form (Ar-BDCAF). The damage events in BD patients were determined by Beh & ccedil;et'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.
