Gheita, T. A., N. Hammam, and S. M. Fawzy, "Development and validation of a Behcet's Disease Damage Index for adults with BD: An Explicit, Composite and Rated ( ECR ) tool ", International Journal of Rheumatic Diseases / Early View , vol. 24, issue 8, pp. 1071-1079, 2021.
HAMDY, M. O. N. A., F. Ali, S. Fawzy, and A. A. Fotouh, "The mounting importance of knee sonographic signs in 425 gouty arthritis patients: A multi-centre study ", The Egyptian Rheumatologist , vol. 44, issue 4, pp. 287-293, 2022.
Gamal, S. M., S. M. Fawzy, and I. Siam, "Does anti-DNA positivity increase the incidence of secondary antiphospholipid syndrome in lupus patients ?", The Egyptian Rheumatologist , vol. 35, issue 1110-1164, pp. 141-144, 2013.
Fawzy, S. M., T. A. Gheita, E. El-Nabarawy, H. H. El-Demellawy, and O. G. Shaker, "Serum \{BAFF\} level and its correlations with various disease parameters in patients with systemic sclerosis and systemic lupus erythematosus", The Egyptian Rheumatologist, vol. 33, no. 1, pp. 45 - 51, 2011. AbstractWebsite

Introduction Interest in B-cells has been revived due to the description of new functions. Supporting a role for B-cells in the genesis of autoimmune diseases is the fact that the B-cell-activating factor of the \{TNF\} ligand family (BAFF) is essential in their physiology. The role of BAFF, a new cytokine, in autoimmune diseases has been highlighted. Aim of the work To assess serum \{BAFF\} level in systemic sclerosis (SSc) and systemic lupus erythematosus (SLE) to verify its role in these diseases and find any relation with the clinical manifestations, laboratory investigations, disease activity and damage. Patients and methods The study included 12 \{SSc\} and 40 \{SLE\} patients. The patients were subjected to full history taking and thorough clinical rheumatological and dermatological examinations and relevant investigations including autoantibodies and \{CT\} chest in SSc. In SSc, the total skin thickness score was scored according to the modified Rodnan skin score (MRSS) method. In SLE, the disease activity was assessed using the Systemic Lupus Activity Measure (SLAM) and organ damage using the Systemic Lupus International Collaborating Clinics/ACR (SLICC/ACR) index. The serum \{BAFF\} levels were measured using a specific ELISA. Results The \{BAFF\} level was remarkably elevated in \{SSc\} and \{SLE\} in a comparable percentage of patients, yet the level was highest in \{SLE\} and lower in the limited \{SSc\} subtype. The \{BAFF\} significantly correlated with the level with the \{MRSS\} in \{SSc\} and with both the \{SLAM\} and \{SLICC\} in \{SLE\} patients. Conclusion The elevated level of \{BAFF\} in \{SSc\} further confirms the importance for new therapeutic targets for its inhibition to slow the disease progression, particularly skin fibrosis. The role of \{BAFF\} in the pathogenesis and disease activity in \{SLE\} is well-known and the novel noticeable correlation with the damage index high lightens on the utility of \{BAFF\} as an indicator of disease damage and predictor of poor outcome.

Fawzy, S. M., H. E. H. Sherbeni, A. Rashad, and H. E. H. demellawy, "Serum COMP and their correlations with various disease parameters in patients with systemic lupus erythematosus and osteoarthritis", The Egyptian Rheumatologist, vol. 33, issue 1110-1164, pp. 13-19, 2010. Abstract

Introduction: The cartilage oligomeric matrix protein (COMP) is a glycoprotein, which
occurs mainly in an articular cartilage. The amount of this protein increases under the influence of
cytokines and growth factors. As a result of various diseases that cause damage to cartilage, fragments
of matrix protein are released into synovial fluid and then into blood. The assessment of
matrix protein level in serum, for example COMP, permits the establishment of the degree of cartilage
damage in inflammatory joint diseases, and permits observation of the effectiveness of the
treatment.
Aim of the work: To assess serum COMP level, as a marker for cartilage degradation, in SLE and
OA patients and to find a correlation between serum COMP level and other markers as well as
activity of disease, disease duration and the age of the patients.
Patients and methods: Blood was collected from 40 systemic lupus erythematosus (SLE) patients
group I, [the patients were further subdivided into two subgroups, group (Ia) comprised 20 SLE
patients received 1 g IV methylprednisolone (MP) daily for three successive days, group (Ib) comprised
20 SLE patients did not receive IV methylprednisolone (MP)], and from 20 patients with
* Corresponding author.
E-mail addresses: samarfawzy1@yahoo.com (S.M. Fawzy),
hhalsherbeni@gmail.com (H.H. El Sherbeni).
1110-1164  2011 Egyptian Society for Joint Diseases and Arthritis.
Production and hosting by Elsevier B.V. All rights reserved.
Peer review under responsibility of Egyptian Society for Joint Diseases
and Arthritis.
doi:10.1016/j.ejr.2010.09.001
Production and hosting by Elsevier
The Egyptian Rheumatologist (2011) 33, 13–19
Egyptian Society for Joint Diseases and Arthritis
The Egyptian Rheumatologist
www.rheumatology.eg.net
www.sciencedirect.com
Author's personal copy
knee osteoarthritis (OA) group II who constituted the control group. Serum COMP level was determined
using an inhibition enzyme-linked immunosorbent assay (ELISA).
Results: The measured values of the serum COMP level in SLE patients ranged from 1.32 to 1.71 lg/
ml with a mean of 1.51 ±0.13 lg/ml in group (Ia), and ranged from 2.43 to 3.56 lg/ml with a mean of
2.86 ±0.31 lg/ml in group (Ib). While inOAgroup (II) the value of serumCOMPranged from 0.97 to
2.65 lg/ml with a mean of 1.25 ± 0.37 lg/ml.Wefound significantly elevatedCOMPlevels in theSLE
group (Ib) compared to the SLE group (Ia) patients and OA group (II) (p< 0.001). We found a statistically
significant positive correlations with the number of tender joints (correlation coefficient Pearson’s:
r = 0.45, p< 0.01), the number of swollen joints (r = 0.55, p< 0.001),SLAMvalue (r = 0.56,
p< 0.001). A significant positive correlation was found between serum COMP level and the ESR
value in the first hour (r =0.35, p< 0.001). While the serum COMP level was independent of the
patients’ age (r= 0.04, p= NS), disease duration (r =0.03, p=NS) and morning stiffness duration
(r = 0.05, p =NS). Also a Negative correlation was found between the serumCOMPlevel and
haemoglobin value (r = 0.11, p=NS). As regards theOAgroup, no correlation was found between
the serum COMP level and patients’ age (r = 0.05, p=NS) and disease duration (r = 0.24,
p= NS). There were positive correlations between serum COMP and WOMAC index score for the
lower limbs (r = 0.64, p< 0.05).
Conclusion: The serum COMP level can be an important marker of disease activity and cartilage
destruction in SLE and OA Patients, and that serum levels of COMP can be used as a parameter
for monitoring the therapy response in SLE patients undergoing an intravenous bolus steroid therapy.
 2011 Egyptian Society for Joint Diseases and Arthritis. Production and hosting by Elsevier B.V.
All rights reserved.

Sedky, M. M., S. M. Fawzy, N. A. E. Baki, N. H. E. Eishi, and A. E. M. M. E. Bohy, "Systemic sclerosis: an ultrasonographic study of skin and subcutaneous tissue in relation to clinical findings", Skin Research and Technology, vol. 9, pp. 78–84 , 2013. Abstract

Background: Skin thickening and tightness are characteristic manifestations of systemic sclerosis (SSc) and the only major diagnostic criterion. The aim of this study is to compare the results of high frequency ultrasound of skin and subcutaneous tissue (SC) in SSc patients and healthy control subjects and also to correlate our patientsa ˆ€TM US findings with the severity score and with different clinical parameters. Methods: Skin thickness and subcutaneous thickness were measured by high frequency (12-5 MHz) ultrasound at five dif- ferent anatomical sites in 40 patients with SSc and 40 healthy control subjects. Results were compared with modified Rodnan skin score (mRss), with the severity score and with different clinical parameters. Results: Patients with SSc had thicker skin than control sub- jects. Ultrasound measurements correlated with the mRss as
well as the severity score of the disease. The degree of skin thickening tended to diminish with longer disease duration. Also, SSc patients had thinner SC fat thickness than control subjects. Conclusion: Ultrasound technique is a reliable noninvasive tool that gives reproducible results for the evaluation of skin and SC tissue involvement in SSc patients, adding a separate dimension to the assessment of disease severity and may be used to identify different phases of skin involvement.

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