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Ramos-Casals, M., A. L. Zignego, C. Ferri, P. Brito-Zeron, S. Retamozo, M. Casato, P. Lamprecht, A. Mangia, D. Saadoun, and A. G. Tzioufas, "Evidence-based recommendations on the management of extrahepatic manifestations of chronic hepatitis C virus infection", Journal of Hepatology, vol. 66, issue 6: Elsevier, pp. 1282-1299, 2017. Abstract
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M Fawzy, A Edrees, O. E. A. R. H. A. G., "Gastrointestinal manifestations in systemic lupus erythematosus", Lupus, 2016. Abstract
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Fawzy, M., A. Edrees, H. Okasha, A. El Ashmaui, and G. Ragab, "Gastrointestinal manifestations in systemic lupus erythematosus", Lupus, vol. 25, issue 13: SAGE Publications Ltd, pp. 1456 - 1462, 2016. Abstracthttps://scholar.google.com.eg/citations?hl=en&user=7L5p7RYAAAAJ
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Fawzy, M., A. Edrees, H. Okasha, A. El Ashmaui, and G. Ragab, "Gastrointestinal manifestations in systemic lupus erythematosus.", Lupus, 2016 Apr 6. Abstract

Systemic lupus erythematosus (SLE) is an autoimmune disorder characterized by multisystem involvement, including the gastrointestinal (GI) tract. There is a significant variation in the clinical presentation and severity of GI disorders. When GI symptoms present as the initial manifestation of SLE, there is likely to be a delay in the diagnosis. The cause of these GI manifestations in SLE may be the disease, or the side effects of medications, or infections. In this study we investigated the GI manifestations in a group of SLE patients. Our study was conducted on 40 SLE patients and 30 healthy controls to assess the prevalence of GI symptoms in SLE patients. The prevalence of gastrointestinal manifestations in our study was 42.5%. GI manifestations in our SLE patients were: acute abdominal pain (due to pleurisy and peritonitis), 6%; diffuse abdominal pain, 23.5%; epigastric pain, 29%; epigastric pain with vomiting, 23.5%; epigastric pain with chronic constipation, 6%; chronic constipation, 6%; and diffuse abdominal pain with bleeding per rectum, 6%. In our study, we found a higher incidence ofGiardiainfestation in SLE patients than in healthy controls, and 10% of these patients were asymptomatic. There was moreGiardiainfestation in patients with GI symptoms as compared with patients with no GI symptoms, with aPvalue of 0.009. In our study SLE patients with GI symptoms had a peak systolic velocity (cm/s) with a mean of 108.4 ± 32.1 standard deviation (SD) in the celiac Doppler study. Patients without GI symptoms had a peak systolic velocity with a mean of 111.9 ± 37.7 SD, meaning that our patients mostly had no evidence of celiac trunk stenosis, but there was significant difference between SLE patients without GI symptoms and controls, as the mean was higher in SLE patients than in the controls. Also, the celiac end diastolic velocity was higher in both groups of SLE patients with GI symptoms and those without GI symptoms, compared to controls.

Beshlawy, A. E., A. E. R. Zekri, M. S. Ramadan, Y. M. M. Selim, A. Abdel-Salam, M. T. Hegazy, L. Ragab, C. Gaggiano, L. Cantarini, and G. Ragab, "Genotype–phenotype associations in familial Mediterranean fever: a study of 500 Egyptian pediatric patients", Clinical Rheumatology, vol. 41, issue 5: Springer Science and Business Media Deutschland GmbH, pp. 1511 - 1521, 2022. Abstracthttps://scholar.google.com.eg/citations?hl=en&user=7L5p7RYAAAAJ
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Ragab, G., M. Elshahaly, and T. Bardin, "Gout: An old disease in new perspective – A review", Journal of Advanced Research, vol. 8, issue 5: Elsevier B.V., pp. 495 - 511, 2017. Abstracthttps://scholar.google.com.eg/citations?hl=en&user=7L5p7RYAAAAJ
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Ragab, G., M. Elshahaly, and T. Bardin, "Gout: An old disease in new perspective–A review", Journal of advanced research, vol. 8, issue 5: Elsevier, pp. 495-511, 2017. Abstract
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Ragab, G., M. A. El-Ghobary, R. M. Elgohary, and others, "The importance of using ultrasonography in knee osteoarthritis", The Egyptian Journal of Internal Medicine, vol. 24, no. 3: Medknow Publications, pp. 93, 2012. Abstract
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Ragab, G., M. A. El-Ghobary, and R. M. Elgohary, "The importance of using ultrasonography in knee osteoarthritis", The Egyptian Journal of Internal Medicine, vol. 24, issue 3: SpringerOpen, pp. 93-96, 2012. Abstract
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Hegazy, M. T., W. R. Allam, M. A. Hussein, N. Zoheir, L. Quartuccio, S. F. El-Khamisy, and G. Ragab, "Increased genomic instability following treatment with direct acting anti-hepatitis C virus drugs", EBioMedicine, vol. 35: Elsevier, pp. 106-113, 2018. Abstract
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Hegazy, M. T., W. R. Allam, M. A. Hussein, N. Zoheir, L. Quartuccio, S. F. El-Khamisy, G. Ragab, and M. C. C. the for the study of Vasculitis, "Increased genomic instability following treatment with direct acting anti-hepatitis C virus drugs", EBioMedicine, vol. 35: Elsevier B.V., pp. 106 - 113, 2018. Abstracthttps://scholar.google.com.eg/citations?hl=en&user=7L5p7RYAAAAJ
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Hegazy, M. T., W. R. Allam, M. A. Hussein, N. Zoheir, L. Quartuccio, S. F. El-Khamisy, and G. Ragab, "Increased genomic instability following treatment with direct acting anti-hepatitis C virus drugs.", EBioMedicine, vol. 35, pp. 106-113, 2018 Sep. Abstract

Mixed Cryoglobulinemic Vasculitis (MCV) is a prominent extra-hepatic manifestation of Hepatitis C virus (HCV) infection. HCV has been reported to cause B-cell disorders and genomic instability. Here, we investigated B-cell activation and genome stability in HCV-MCV patients receiving the direct antiviral agent, Sofosbuvir, at multiple centers in Egypt. Clinical manifestations in HCV-MCV patients were improved at the end of treatment (EOT), such as purpura (100%), articular manifestations (75%) and neuropathy (68%). Eighteen patients (56%) showed vasculitis relapse after EOT. BAFF and APRIL were higher at EOT and continued to increase one year following treatment onset. Chromosomal breaks were elevated at EOT compared to baseline levels and were sustained at 3 and 6 months post treatment. We report increased expression of DNA genome stability transcripts such as topoisomerase 1 and TDP1 in HCV-MCV patients after treatment, which continued to increase at 12 months from treatment onset. This data suggest that B-cell activation and DNA damage are important determinants of HCV-MCV treatment outcomes.

Ferri, C., M. Ramos-Casals, A. L. Zignego, L. Arcaini, D. Roccatello, A. Antonelli, D. Saadoun, A. C. Desbois, M. Sebastiani, and M. Casato, "International diagnostic guidelines for patients with HCV-related extrahepatic manifestations. A multidisciplinary expert statement", Autoimmunity Reviews, vol. 15, issue 12: Elsevier, pp. 1145-1160, 2016. Abstract
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Hamza, M. M. E., T. A. Macky, M. K. Sidky, G. Ragab, and M. M. Soliman, "Intravitreal infliximab in refractory uveitis in Behçet's disease: a safety and efficacy clinical study", Retina, vol. 36, issue 12: LWW, pp. 2399-2408, 2016. Abstract
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Hamza, M. M. E., T. A. Macky, M. K. Sidky, G. Ragab, and M. M. Soliman, "Intravitreal infliximab in refractory uveitis in Behcet's disease: A safety and efficacy clinical study", Retina, vol. 36, issue 12: Lippincott Williams and Wilkins, pp. 2399 - 2408, 2016. Abstracthttps://scholar.google.com.eg/citations?hl=en&user=7L5p7RYAAAAJ
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, "Latitude gradient influences the age of onset of rheumatoid arthritis: a worldwide survey", Clinical rheumatology, vol. 36: Springer London, pp. 485-497, 2017. Abstract
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Group, G. E. O. - R. A., C. Ramos-Remus, A. Ramirez-Gomez, V. Brambila-Barba, A. Barajas-Ochoa, J. D. Castillo-Ortiz, A. O. Adebajo, L. R. Espinoza, F. J. Aceves-Avila, J. M. Sánchez-González, et al., "Latitude gradient influences the age of onset of rheumatoid arthritis: a worldwide survey", Clinical Rheumatology, vol. 36, issue 3: Springer London, pp. 485 - 497, 2017. Abstracthttps://scholar.google.com.eg/citations?hl=en&user=7L5p7RYAAAAJ
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El-Gendy, H., R. M. El-Gohary, K. S. Shohdy, and G. Ragab, "Leprosy masquerading as systemic rheumatic diseases", JCR: Journal of Clinical Rheumatology, vol. 22, issue 5: LWW, pp. 264-271, 2016. Abstract
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El-Gendy, H., R. M. El-Gohary, K. S. Shohdy, and G. Ragab, "Leprosy Masquerading as Systemic Rheumatic Diseases", Journal of Clinical Rheumatology, vol. 22, issue 5: Lippincott Williams and Wilkins, pp. 264 - 271, 2016. Abstracthttps://scholar.google.com.eg/citations?hl=en&user=7L5p7RYAAAAJ
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El-Gendy, H., R. M. El-Gohary, K. S. Shohdy, and G. Ragab, "Leprosy Masquerading as Systemic Rheumatic Diseases.", Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases, vol. 22, issue 5, pp. 264-71, 2016 Aug. Abstract

Rheumatologic manifestations not only are encountered in leprosy but also can be the first and even the sole presenting manifestation. The hallmark of leprosy is skin and peripheral nerve affection; however, it can affect a wide range of other organs, with the joints being the commonest. We have searched PubMed with the key words leprosy, arthritis, vasculitis, rheumatic diseases, and autoantibodies in a proper combination. Relevant studies were retrieved from scanning of their abstracts. The relevant references provided in these articles were also selected and reviewed. We summarize the clinical and laboratory manifestations that make leprosy masquerade as a systemic rheumatic disease. Moreover, we report 4 Egyptian patients who presented with rheumatologic manifestations, namely, arthritis and vasculitis that turned out to be leprosy related.

Cacoub, P., S. Nafa Si Ahmed, Y. Ferfar, S. Pol, D. Thabut, C. Hezode, L. Alric, C. Comarmond, G. Ragab, and L. Quartuccio, "Long-term Efficacy of Interferon-Free Antiviral Treatment Regimens in Patients With Hepatitis C Virus–Associated Cryoglobulinemia Vasculitis", Clinical Gastroenterology and Hepatology, vol. 17, issue 3: WB Saunders, pp. 518-526, 2019. Abstract
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Cacoub, P., S. N. Si ahmed, Y. ferfar, S. Pol, D. Thabut, C. Hezode, L. Alric, C. Comarmond, G. Ragab, L. Quartuccio, et al., "Long-term Efficacy of Interferon-Free Antiviral Treatment Regimens in Patients With Hepatitis C Virus–Associated Cryoglobulinemia Vasculitis", Clinical Gastroenterology and Hepatology, vol. 17, issue 3: W.B. Saunders, pp. 518 - 526, 2019. Abstracthttps://scholar.google.com.eg/citations?hl=en&user=7L5p7RYAAAAJ
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Goubran, H., G. Ragab, and W. Sabry, "Metabolism-mediated thrombotic microangiopathy and B12", Vitamins and Hormones, vol. 119: Academic Press Inc., pp. 441 - 455, 2022. Abstracthttps://scholar.google.com.eg/citations?hl=en&user=7L5p7RYAAAAJ
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Goubran, H., J. Seghatchian, J. Radosevic, G. Ragab, and T. Burnouf, "The microbiome and transfusion in cancer patients", Transfusion and Apheresis ScienceTransfusion and Apheresis Science, vol. 56, issue 3: Elsevier, pp. 330 - 335, 2017. Abstracthttps://scholar.google.com.eg/citations?hl=en&user=7L5p7RYAAAAJ

Our microbiota is determined by many variables including ABO blood groups. The microbiota is not only confined to the gut and skin but is also recoverable from blood of healthy donors.The microbiota shape our immune system through cross reactivity with antigens, the expression of direct molecular patterns, the release of cytokines, the effects on nutrients and micronutrients and even through an interplay with epigenetics. It is likely, therefore, that a donor's microbiota could alter the antigenicity of blood and its components and potentially contribute to transfusion-related immune modulation [TRIM]. It could also potentially transmit infections. The recipient's microbiome contributes, on the other hand, to the tolerance to transfused blood, or to the development of transfusion reactions. Cancer patients are a particularly vulnerable population, often immunosuppressed with a significantly altered microbiota. They are more at risk for transmission of ?dormant? bacteria via blood transfusion. Furthermore, chemotherapy and radiation induce mucositis that likely results in significant translocation of gut microbiota and abnormal immune reactions to transfused blood. It is therefore relevant to revisit transfusion thresholds and consider transfusion-saving strategies in cancer patients.Our microbiota is determined by many variables including ABO blood groups. The microbiota is not only confined to the gut and skin but is also recoverable from blood of healthy donors.The microbiota shape our immune system through cross reactivity with antigens, the expression of direct molecular patterns, the release of cytokines, the effects on nutrients and micronutrients and even through an interplay with epigenetics. It is likely, therefore, that a donor's microbiota could alter the antigenicity of blood and its components and potentially contribute to transfusion-related immune modulation [TRIM]. It could also potentially transmit infections. The recipient's microbiome contributes, on the other hand, to the tolerance to transfused blood, or to the development of transfusion reactions. Cancer patients are a particularly vulnerable population, often immunosuppressed with a significantly altered microbiota. They are more at risk for transmission of ?dormant? bacteria via blood transfusion. Furthermore, chemotherapy and radiation induce mucositis that likely results in significant translocation of gut microbiota and abnormal immune reactions to transfused blood. It is therefore relevant to revisit transfusion thresholds and consider transfusion-saving strategies in cancer patients.

Goubran, H., J. Seghatchian, J. Radosevic, G. Ragab, and T. Burnouf, "The microbiome and transfusion in cancer patients", Transfusion and Apheresis Science, vol. 56, issue 3: Pergamon, pp. 330-335, 2017. Abstract
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Goubran, H., J. Seghatchian, J. Radosevic, G. Ragab, and T. Burnouf, "The microbiome and transfusion in cancer patients", Transfusion and Apheresis Science, vol. 56, issue 3: Elsevier Ltd, pp. 330 - 335, 2017. Abstracthttps://scholar.google.com.eg/citations?hl=en&user=7L5p7RYAAAAJ
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Ragab, G., P. T. Atkinson, and M. L. Stoll, The Microbiome in Rheumatic Diseases and Infection, : Springer, 2018. Abstract
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Ragab, G., T. P. Atkinson, and M. L. Stoll, "The microbiome in rheumatic diseases and infection", The Microbiome in Rheumatic Diseases and Infection: Springer International Publishing, pp. 1 - 490, 2018. Abstracthttps://scholar.google.com.eg/citations?hl=en&user=7L5p7RYAAAAJ
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REFAAT, M., A. M. Abdullatif, M. M. Hamza, T. A. Macky, M. - S. H. El-Agha, G. Ragab, and M. M. Soliman, "MONTHLY INTRAVITREAL INFLIXIMAB IN BEHÇET'S DISEASE ACTIVE POSTERIOR UVEITIS: A Long-Term Safety Study", Retina (Philadelphia, Pa.), vol. 41, issue 8: NLM (Medline), pp. 1739 - 1747, 2021. Abstracthttps://scholar.google.com.eg/citations?hl=en&user=7L5p7RYAAAAJ
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Refaat, M., A. M. Abdullatif, M. M. Hamza, T. A. Macky, M. H. El-Agha, G. Ragab, and M. M. Soliman, "Monthly Intravitreal Infliximab in Behçet's Disease Active Posterior Uveitis: A Long-Term Safety Study.", Retina (Philadelphia, Pa.), 2020. Abstract
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El-Gendy, H., R. M. El-Gohary, S. Mahfouz, H. M. A. Ahmed, D. M. El Demerdash, and G. Ragab, "Multifocal avascular necrosis in a patient with refractory immune thrombocytopenia and antiphospholipid antibodies; case report and review of literature", Platelets, vol. 30, issue 5: Taylor & Francis, pp. 664-671, 2019. Abstract
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El-Gendy, H., R. M. El-Gohary, S. Mahfouz, H. M. A. Ahmed, D. M. El Demerdash, and G. Ragab, "Multifocal avascular necrosis in a patient with refractory immune thrombocytopenia and antiphospholipid antibodies; case report and review of literature", Platelets, vol. 30, issue 5: Taylor and Francis Ltd, pp. 664 - 671, 2019. Abstracthttps://scholar.google.com.eg/citations?hl=en&user=7L5p7RYAAAAJ
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El-Gendy, H., R. M. El-Gohary, S. Mahfouz, H. M. A. Ahmed, D. M. El Demerdash, and G. Ragab, "Multifocal avascular necrosis in a patient with refractory immune thrombocytopenia and antiphospholipid antibodies; case report and review of literature.", Platelets, pp. 1-8, 2018 Oct 29. Abstract

Avascular necrosis (AVN) is a devastating condition that is rarely reported in patients with immune thrombocytopenia (ITP). Treatment with steroids remains a major risk factor for developing AVN. However, the incidence of AVN in patients with ITP requiring corticosteroid therapy is much less than that observed with other clinical conditions requiring corticosteroids. ITP is a bleeding disorder but can be also be a pro-thrombotic state via different mechanisms and thus could result in AVN. Among the possible causes of this pro-thrombotic state is the presence of antiphospholipid antibodies (aPLs). In this case, we report a patient with refractory ITP who developed multifocal AVN around the time she acquired new aPLs. We also discuss different mechanisms by which risk of thrombosis is increased in ITP and the relationship between ITP, aPLs and antiphospholipid syndrome.

Ragab, G., H. El-Gendy, and R. M. El-Gohary, Musculoskeletal Disorders and Treatment, , 2017. Abstract
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Cacoub, P., S. Pol, D. Thabut, C. Hezode, L. Alric, C. Comarmond, G. Ragab, L. Quatuccio, M. Hegazy, and T. Poynard, OP0235 Interferon-free antivirals for hepatitis c virus-associated cryoglobulinemia vasculitis: a long-term follow-up study, : BMJ Publishing Group Ltd, 2018. Abstract
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Quartuccio, L., L. Corazza, M. Ramos-Casals, S. Retamozo, G. M. Ragab, G. Ferraccioli, E. Gremese, A. Tzioufas, M. Voulgarelis, and D. Vassilopoulos, OP0274 Cryoglobulinemic Vasculitis and Primary sjögren's Syndrome are Independent Risk Factors for Lymphoma in a Large Worldwide Population of Patients with Positive Serum Cryoglobulins, : BMJ Publishing Group Ltd, 2015. Abstract
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Quartuccio, L., L. Corazza, M. Ramos-Casals, S. Retamozo, G. M. Ragab, G. Ferraccioli, E. Gremese, A. Tzioufas, M. Voulgarelis, D. Vassilopoulos, et al., "OP0274 Cryoglobulinemic Vasculitis and Primary sjögren's Syndrome are Independent Risk Factors for Lymphoma in a Large Worldwide Population of Patients with Positive Serum Cryoglobulins", Annals of the Rheumatic Diseases, vol. 74, issue Suppl 2, pp. 175-176, June 1, 2015. Abstracthttps://scholar.google.com.eg/citations?hl=en&user=7L5p7RYAAAAJ

Background Serum cryoglobulins (SC) may be found in many diseases (1), and the presence of serum cryoglobulins is a known risk factor for lymphoma evolution in some non malignant diseases.Objectives The aim of this study was to distiguish the role of cryoglobulinemic vasculitis (CV), classified according to the recent validated criteria (1,2), and primary Sjögren's syndrome (pSS) as risk factors of lymphoma in patients positive serum cryoglobulins. Importantly, SC, CV and pSS may occur together.Methods 950 charts from consecutive patients with positive SC were evaluated. Patients carrying both pSS and HCV infection, as well as incomplete charts, were excluded.Results 657 patients with SC were selected, 374 with CV and 283 without CV, according to the published criteria (2,3). PSS, classified according to the American-European Group Criteria was present in 96 patients (44 with CV, 52 without). Lymphoma was reported in 61/657 (9.8%) patients with SC. Among them, CV was present in 44/61 (72,1%; 14 also with pSS), and pSS in 17/61 (27,9%; and 14/17 had CV). Patients with SC with CV showed an higher prevalence of lymphoma than patients with SC without CV (44/374, 11.5% vs.17/283, 6.3%; p=0.025, OR=1.93 [95%IC: 1.08-3.39]. Patients with pSS, SC and CV also showed a higher prevalence of lymphoma than patients with pSS, SC but without CV (14/44, 31.8% vs. 3/52, 7.4%; p=0.001, OR=7.62 [95%CI 2.02-28.74]. CV and pSS were confirmed as independent risk factor for lymphoma by multivariate analysis (OR 2,18 95%CI 1,18-3,83, p=0,012; OR 2,65 95%CI 1,04-6,76, p=0,042, respectively). Infection by the hepatitis C virus (HCV) was detected in 467/561 (83,2%) patients with SC without pSS, and did not statistically predispose to lymphoma when associated with CV in this subset (p=1,0).Conclusions Cryoglobulinemic vasculitis and pSS are independent risk factors for lymphoma in patients with evidence of SC. Patients with both the conditions (CV and pSS) have the highest risk. In the follow-up of SC positive patients, a very high attention should be deserved to pSS, in particular when CV is present.ReferencesDe Vita S, et al. Ann Rheum Dis. 2011; 2) Quartuccio L, et al. Rheumatology (Oxford). 2014Disclosure of Interest None declared

Ragab, M., "Oral Direct Anticoagulants in Thrombosis Management in Anti-Phospholipid Syndrome: Unanswered Questions", J Hematol Thrombo Dis, vol. 3, issue 208: http://www.esciencecentral.org/journals/oral-direct-anticoagulants-in …, 2015. Abstract
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Hussein, M. A., M. I. Ellawindi, and G. Ragab, "Performance of classification criteria for Behcet's disease in an Egyptian cohort", Indian Journal of Rheumatology, vol. 12, issue 3: Medknow Publications, pp. 152, 2017. Abstract
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