Lotfy, H. M., S. M. Sabry, E. E. Ghobrial, S. A. Abed, and others, "The effect of regular hemodialysis on the nutritional status of children with end-stage renal disease", Saudi Journal of Kidney Diseases and Transplantation, vol. 26, no. 2: Medknow Publications, pp. 263, 2015. Abstract
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Abu-Zaid, M. H., Y. El Miedany, M. A. Mortada, W. Hassan, M. Eissa, Y. Atef, S. I. Nasef, hala lotfy, yomna farag, G. El Deriny, et al., FRI0074 UPDATE FOR THE CLINICAL PRACTICE: INTEGRATED, EVIDENCE-BASED APPROACH FOR THE MANAGEMENT OF RHEUMATOID ARTHRITIS, : BMJ Publishing Group Ltd, 2019. Abstract
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Salah, S., H. M. Lotfy, S. M. Sabry, A. E. Hamshary, and H. Taher, "Systemic lupus erythematosus in Egyptian children", Rheumatology international, vol. 29, no. 12: Springer-Verlag, pp. 1463–1468, 2009. Abstract
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Eissa, M., Y. El Miedany, W. Hassan, D. Mekkawy, M. A. Mortada, S. I. Nasef, M. El Gaafary, hala lotfy, yomna farag, G. El Deriny, et al., AB0962 UPDATE FOR THE CLINICAL PRACTICE: INTEGRATED, EVIDENCE-BASED APPROACH FOR THE MANAGEMENT OF JUVENILE SPONDYLOARTHRITIS, : BMJ Publishing Group Ltd, 2019. Abstract
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Lotfy, H. M., H. S. M. El Dien, N. M. El Minawi, and H. A. W. A. Aziz, "The role of Doppler Ultrasonography in evaluating disease activity in a group of juvenile idiopathic arthritis patients", The Egyptian Journal of Radiology and Nuclear Medicine, vol. 49, no. 4: Elsevier, pp. 1036–1042, 2018. Abstract
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huda marzouk, H. M. Lotfy, yomna farag, L. A. Rashed, and K. El-Garf, "Mean platelet volume and splenomegaly as useful markers of subclinical activity in Egyptian children with familial Mediterranean fever: a cross-sectional study", International Journal of Chronic Diseases, vol. 2015: Hindawi, 2015. Abstract
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Lotfy, H. M., E. F. Halawa, and M. E. Baz, "Pulmonary involvement in juvenile-onset systemic lupus erythematosus patients asymptomatic for respiratory disease", Egyptian Journal of Bronchology, vol. 9, no. 1: Springer, pp. 59–63, 2015. Abstract
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Al-Mayouf, S. M., M. Almutairi, K. Bouayed, S. Habjoka, D. Hadef, H. M. Lotfy, C. Scott, E. M. Sharif, and N. Tahoun, "Epidemiology and demographics of juvenile idiopathic arthritis in Africa and Middle East.", Pediatric rheumatology online journal, vol. 19, issue 1, pp. 166, 2021. Abstract

Juvenile Idiopathic Arthritis (JIA) is a group of chronic heterogenous disorders that manifests as joint inflammation in patients aged <16 years. Globally, approximately 3 million children and young adults are suffering from JIA with prevalence rates consistently higher in girls. The region of Africa and Middle East constitute a diverse group of ethnicities, socioeconomic conditions, and climates which influence the prevalence of JIA. There are only a few studies published on epidemiology of JIA in the region. There is an evident paucity of adequate and latest data from the region. This review summarizes the available data on the prevalence of JIA and its subtypes in Africa and Middle East and discusses unmet needs for patients in this region. A total of 8 journal publications were identified concerning epidemiology and 42 articles describing JIA subtypes from Africa and Middle East were included. The prevalence of JIA in Africa and Middle East was observed to be towards the lower range of the global estimate. We observed that the most prevalent subtype in the region was oligoarticular arthritis. The incidence of uveitis and anti-nuclear antibody (ANA) positivity were found to be lower as compared to the incidence from other regions. There is a huge unmet medical need in the region for reliable epidemiological data, disease awareness, having regional and local treatment guidelines and timely diagnosis. Paucity of the pediatric rheumatologists and economic disparities also contribute to the challenges regarding the management of JIA.

Alkwai, H. M., A. Mirza, R. Abdwani, A. Asiri, R. Bakry, A. Alenazi, K. Khawaja, hala lotfy, M. Almutairi, M. Muzaffer, et al., "Consensus clinical approach for a newly diagnosed systemic juvenile idiopathic arthritis among members of the pediatric rheumatology Arab group.", International journal of pediatrics & adolescent medicine, vol. 8, issue 3, pp. 129-133, 2021. Abstract

BACKGROUND: Systemic juvenile idiopathic arthritis (sJIA) is a diagnosis of exclusion. The complex nature and clinical variety of the disease, as well as the vast clinical variation of disease presentation, may lead to difficulties in disease detection and subsequent delays in treatment.

AIM: To provide a consensus guidance on the management of newly diagnosed sJIA patients among pediatric rheumatologists in Arab countries.

METHODS: This work was conducted in two phases. The first phase utilized an electronic survey sent through an email invitation to all pediatric rheumatologists in Arab countries. In the second phase, a Task Force of ten expert pediatric rheumatologists from Arab countries met through a series of virtual meetings. Results obtained in phase one were prioritized using a nominal group and Delphi-like techniques in phase two.

RESULTS: Seven overarching principles and a set of recommendations were approved by the Task Force to form the final consensus.

CONCLUSION: This is the first consensus on a clinical approach for pediatric rheumatic diseases among Arab pediatric rheumatologists. It is presented as a guidance on the clinical approach to sJIA that requires further evidence, and future updates are anticipated.

Al-Mayouf, S. M., A. Alrasheedi, I. Almsellati, S. Hashad, K. Khawaja, R. Abdwani, S. AlHashim, M. Muzaffer, hala lotfy, and N. Almutairi, "Familial aggregation of juvenile idiopathic arthritis with other autoimmune diseases: Impact on clinical characteristics, disease activity status and disease damage.", International journal of rheumatic diseases, vol. 24, issue 8, pp. 1080-1085, 2021. Abstract

OBJECTIVES: To evaluate the impact of family history of autoimmune diseases (FHADs) on the clinical characteristics and outcome of juvenile idiopathic arthritis (JIA).

METHODS: We retrospectively reviewed children with JIA seen in 7 pediatric rheumatology clinics from 6 Arab countries. All included patients met the International League of Associations for Rheumatology classification criteria for JIA and had a disease duration greater than 1 year. Data were collected at the last follow-up visit and comprised clinical findings, including FHADs. Disease activity and disease damage were assessed by Juvenile Arthritis Multidimensional Assessment Report, and juvenile arthritis damage index (JADI) respectively. Disease activity was categorized as remission off treatment, remission on treatment, or active disease.

RESULTS: A total of 349 (224 females) JIA patients with a disease duration of 5 (interquartile range 2.9-7.5) years were included. The most frequent JIA categories were polyarticular JIA and oligoarticular JIA, followed by systemic JIA. There were 189 patients with FHADs and 160 patients without FHADs. The most frequent FHADs were diabetes mellitus (21.2%), JIA (18.5%), rheumatoid arthritis (12.7%). Among patients with FHADs, 140/189 (74.1%) achieved clinical remission, while 131/160 (81.9%) patients without FHDs had clinical remission (odds ratio [OR] = 1.2, 95% CI 0.97-1.5). Rate of consanguinity, enthesitis-related arthritis (ERA) and psoriatic arthritis were higher in patients with FHADs (OR = 0.6, 95% CI 0.4-0.9 and OR = 1.2, 95% CI 1.1-1.4). Also, articular JADI correlated significantly with presence of FHADs (OR = 1.1, 95% CI 1.0-1.1).

CONCLUSION: This study shows that autoimmune diseases cluster within families of patients with JIA with a high proportion of ERA and psoriatic arthritis. JIA patients with FHADs are likely to have more disease damage.

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