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Gheita, T. A., S. Sayed, W. Hammam, and G. A. Hegazy, "Subclinical hypovitaminosis D and osteoporosis in breast cancer patients", Middle East J of Internal Medicine, vol. 8, issue 2, pp. 12-17, 2015.
Gheita, T., H. Gheita, and S. Kenawy, "The potential of genetically guided treatment in Behçet's disease.", Pharmacogenomics, vol. 17, issue 10, pp. 1165-74, 2016.
Eldefrawy, A., T. Gheita, H. Raslan, and M. El-Ansary-etal, "Serum and synovial cartilage oligomeric matrix protein levels in early and established rheumatoid arthritis", Z Rheumatol, vol. 75, issue 9, pp. 917-923, 2016.
Gheita, T., S. Sayed, H. Gheita, and S. Kenawy, "Vitamin D status in rheumatoid arthritis patients: relation to clinical manifestations, disease activity, quality of life and fibromyalgia syndrome.", Int J Rheum Dis, vol. 19, issue 3, pp. 294-9, 2016.
Bassyouni, I. H., S. Fawzy, and T. A. Gheita, "Clinical Association of a Soluble Triggering Receptor Expressed on Myeloid Cells-1 (sTREM-1) in Patients with Systemic Lupus Erythematosus.", Immunol Invest, vol. 46, issue 1, pp. 38-47, 2017.
Khalil, H. M., H. A. El-Gendy, H. A. Raafat, and T. A. Gheita, "The Effectiveness of Pre- and Postoperative Infliximab in Controlling Behçet's Disease Posterior Uveitis in Patients Undergoing Vitrectomy: A Preliminary Study.", J Ophthalmol, vol. 2017, issue 8168369, pp. 1-10, 2017.
Gheita, T. A., S. M. El-Rabbat, and N. K. Mahmoud, "Fibromyalgia and Rheumatic Diseases. ", Fibrom Open Access, vol. 2, issue 1, pp. 1-5, 2017.
Gheita, T. A., and H. M. Fathi, "Hearing loss in systemic sclerosis – Clinically important, potentially treatable and often overlooked", Int. J. Clin. Rheumatol. , vol. 12, issue 6, pp. 151-153, 2017.
Hammam, N. H., and T. A. Gheita, "Impact of secondhand smoking on disease activity in women with rheumatoid arthritis.", Clin Rheumatol, vol. 36, issue 11, pp. 2415-2420, 2017.
Gheith, R. E., I. I. El-Gazzar, H. S. El-Fishawy, and T. A. Gheita, "Juvenile and juvenile-onset systemic lupus erythematosus patients: Clinical characteristics, disease activity and damage", Egyptian Pediatric Association Gazette, vol. 65, issue 2, pp. 49-53, 2017.
Gheita, T. A., "Targeted gene therapy in the management of osteoarthritis: back to the future with great expectations. ", Int. J. Clin. Rheumatol. , vol. 12, issue 4, pp. 105-107, 2017.
Gheita, T. A., S. Sayed, G. S. Azkalany, N. Abaza, N. Hammam, and A. H. Eisa, "Toll-like receptor 9 in systemic sclerosis patients: relation to modified Rodnan skin score, disease severity, and functional status.", Clinical Rheumatology, vol. 37, issue 3, pp. 757-763, 2017.
El-Gazzar, I. I., H. M. Fathy, T. A. Gheita, and S. A. Kenawy, "Tumor necrosis factor-α -308 A/G gene polymorphism in children with juvenile idiopathic arthritis: relation to disease activity, damage, and functional status.", Clin Rheumatol, vol. 36, issue 8, pp. 1757-1763, 2017.
Gheita, T. A., E. A. El-Latif, I. I. El-Gazzar, N. Samy, N. Hammam, R. A. Abdel Noor, E. El-Shebeiny, A. R. El-Najjar, N. N. Eesa, M. N. Salem, et al., "Behçet's disease in Egypt: a multicenter nationwide study on 1526 adult patients and review of the literature.", Clinical rheumatology, vol. 38, issue 9, pp. 2565-2575, 2019. Abstract

OBJECTIVES: The present work was conducted to estimate the prevalence of adult Behçet's disease (BD) in adult Egyptian and to study the clinical pattern and influence of age at-onset and sex on disease phenotype. Also, we investigated the spectrum of presentation and frequencies along the north-to-south gradient of the country.

PATIENTS AND METHOD: The population-based, multicenter, cross-sectional study included 1526 adult BD patients from 26 specialized Egyptian rheumatology centers. Demographic, clinical, and therapeutic data are assessed for all patients.

RESULTS: The mean age of patients was 35.7 ± 9.84 years, disease duration 6.58 ± 5.25 years, and age at onset 29.37 ± 8.6 years; 91 were juvenile-onset (JoBD). There were 1102 males and 424 females (M:F 2.6:1). Regarding co-morbidities, 19.92% were diabetic, and 26.05% were hypertensive. The mean body mass index was 27.57 ± 5.24 (43.1% overweight; 25.9% obese). The mean BD current activity form was 4.48 ± 4.28. Regarding the medications use, systemic steroid and colchicine were the most common drugs used (947 (90.2%) and 611 (82.7%), respectively). The overall estimated prevalence of BD in Egypt was 3.6/100,000 population being highest in the two main cities: Alexandria (15.27) and Cairo (8.72). Pathergy test was positive in 43.4%. 90.2% were receiving systemic steroids and 8.3%, biologics. Disease characteristics were comparable between JoBD and adult-onset BD cases. Central nervous system (CNS), deep venous thrombosis (DVT), and gastrointestinal (GIT) involvement were significantly higher in males (p = 0.01, p = 0.001, and p = 0.001 respectively) while joint affection (p = 0.001) and disease activity (p = 0.011) were increased in females.

CONCLUSIONS: This study provides current prevalence of BD in Egypt; 3.6/100,000 with no remarkable north-to-south gradient. The sex influences the disease phenotype with the CNS, DVT, and GIT involvement are higher in males, while the joint affection and disease activity were increased in females.

KEY POINTS: • The prevalence and phenotype of Behçet's disease across Egypt is presented in a multicenter nationwide study. • The potential influence of the age at onset and sex on disease phenotype is highlightened. • A review of the literature worldwide is presented allowing comparisons with studies from other nations.

Retamozo, S., N. Acar-Denizli, A. Rasmussen, I. F. Horváth, C. Baldini, R. Priori, P. Sandhya, G. Hernandez-Molina, B. Armagan, S. PRAPROTNIK, et al., "Systemic manifestations of primary Sjögren's syndrome out of the ESSDAI classification: prevalence and clinical relevance in a large international, multi-ethnic cohort of patients.", Clinical and experimental rheumatology, vol. 37 Suppl 118, issue 3, pp. 97-106, 2019. Abstract

OBJECTIVES: To analyse the frequency and characterise the systemic presentation of primary Sjögren's syndrome (SS) out of the ESSDAI classification in a large international, multi-ethnic cohort of patients.

METHODS: The Big Data Sjögren Project Consortium is an international, multicentre registry based on world-wide data-sharing and cooperative merging of pre-existing clinical SS databases from leading centres in clinical research in SS from the five continents. A list of 26 organ-by-organ systemic features not currently included in the ESSDAI classification was defined according to previous studies; these features were retrospectively recorded.

RESULTS: Information about non-ESSDAI features was available in 6331 patients [5,917 female, mean age at diagnosis 52 years, mainly White (86.3%)]. A total of 1641 (26%) patients had at least one of the ESSDAI systemic features. Cardiovascular manifestations were the most frequent organ-specific group of non-ESSDAI features reported in our patients (17% of the total cohort), with Raynaud's phenomenon being reported in 15%. Patients with systemic disease due to non-ESSDAI features had a lower frequency of dry mouth (90.7% vs. 94.1%, p<0.001) and positive minor salivary gland biopsy (86.7% vs. 89%, p=0.033), a higher frequency of anti-Ro/SSA (74.7% vs. 68.7%, p<0.001), anti-La/SSB antibodies (44.5% vs. 40.4%, p=0.004), ANA (82.7% vs. 79.5%, p=0.006), low C3 levels (17.4% vs. 9.7%, p<0.001), low C4 levels (14.4% vs. 9.6%, p<0.001), and positive serum cryoglobulins (8.6% vs. 5.5%, p=0.001). Systemic activity measured by the ESSDAI, clinESSDAI and DAS was higher in patients with systemic disease out of the ESSDAI in comparison with those without these features (p<0.001 for all comparisons).

CONCLUSIONS: More than a quarter of patients with primary SS may have systemic manifestations not currently included in the ESSDAI classification, with a wide variety of cardiovascular, digestive, pulmonary, neurological, ocular, ENT (ear, nose, and throat), cutaneous and urological features that increase the scope of the systemic phenotype of the disease. However, the individual frequency of each of these non-ESSDAI features was very low, except for Raynaud's phenomenon.

Gheita, T. A., B. R. Sakr, R. E. Rabea, and S. M. Abdel Hamid, "Value of hematological indices versus VEGF as biomarkers of activity in Behçet's disease.", Clinical rheumatology, vol. 38, issue 8, pp. 2201-2210, 2019. Abstract

OBJECTIVE: The aim of this study is to investigate the value of several hematological indices, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), red blood cell distribution width (RDW), and mean platelet volume (MPV), versus vascular endothelial growth factor (VEGF) as biomarkers of activity in Behçet's disease (BD).

METHODS: This study included 96 adult BD patients recruited from the Rheumatology Outpatient Clinic, Kasr Al-Ainy Hospital, Cairo University, and 60 healthy subjects as controls. Assessment of BD activity was done using the Behçet's Disease Current Activity Form (BDCAF). The CBC was measured by COULTER LH 750 assay analyzer with special consideration to the NLR, PLR, MPV, and RDW. Serum VEGF level was measured by enzyme-linked immunosorbent assay (ELISA) technique.

RESULTS: The NLR, RDW, and PLR were significantly higher in BD patients when compared with healthy controls (p = 0.011, < 0.001, < 0.001, respectively), while there was no statistical difference in MPV or VEGF between patients and controls (p = 0.82, 0.46). NLR and PLR were significantly higher in BD patients with vascular activity (p = 0.03, 0.01). RDW was significantly higher, while MPV was significantly lower in patients with vascular manifestations (p = 0.04, 0.004). NLR and PLR were the most valuable predictors of vascular activity (p = 0.033, 0.018). PLR was more powerful as a predictor of vascular activity, but it had a lower specificity than NLR.

CONCLUSION: The NLR, PLR, and RDW are significantly higher in BD patients, suggesting their value as promising inflammatory biomarkers in BD. NLR and PLR are the most valuable predictors of vascular activity, while RDW and MPV were not valuable predictors of BD activity, rather implicated in the ongoing vascular inflammatory process in BD. The VEGF was neither a surrogate biomarker of BD activity nor reflecting the ongoing inflammatory process in BD.