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Hyperuricemia Among Egyptian Rheumatoid Arthritis Patients. Is It an Association or an Inflammatory Marker? A Cross-Sectional Observational Study

OBJECTIVE: To detect the prevalence of hyperuricemia in Egyptian rheumatoid arthritis (RA) patients as well as to assess its association with the severity of joint inflammation and disease-modifying antirheumatic drugs (DMARDs) in those patients. METHODS: A total of 150 RA patients were recruited; a...

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Autores principales: Nada, Doaa, Gaber, Rasha, Mahmoud, Al Shymaa, Elkhouly, Radwa, Alashkar, Doaa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8502065/
https://www.ncbi.nlm.nih.gov/pubmed/34675698
http://dx.doi.org/10.2147/OARRR.S331488
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author Nada, Doaa
Gaber, Rasha
Mahmoud, Al Shymaa
Elkhouly, Radwa
Alashkar, Doaa
author_facet Nada, Doaa
Gaber, Rasha
Mahmoud, Al Shymaa
Elkhouly, Radwa
Alashkar, Doaa
author_sort Nada, Doaa
collection PubMed
description OBJECTIVE: To detect the prevalence of hyperuricemia in Egyptian rheumatoid arthritis (RA) patients as well as to assess its association with the severity of joint inflammation and disease-modifying antirheumatic drugs (DMARDs) in those patients. METHODS: A total of 150 RA patients were recruited; all patients were subjected to (1) clinical and functional assessment by disease activity score in 28 joints (DAS28) and modified health assessment questionnaire (MHAQ). (2) Laboratory investigations: serum uric acid (SUA) level, complete blood count (CBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP), tumor necrosis factor α (TNF-α), interleukin 1 (IL1), and interleukin 6 (IL6) levels. (3) Radiological evaluation: (A) plain X-ray of both hands and feet; (B) musculoskeletal ultrasound (MSUS) of both wrists, hands, shoulder, ankle, and knee joints. RESULTS: SUA was significantly correlated with disease activity by DAS28. Acute-phase reactants and inflammatory markers (IL1β, IL6, and TNF-α) were also significantly elevated in RA patients with low and high hyperuricemia compared to those with normal SUA. A total of 90% of RA patients with low hyperuricemia had synovial proliferation with power Doppler (1+ and 2+), and 30 patients had mild effusion (1+), while nearly all patients with high hyperuricemia had hypoechoic synovial proliferation (2+ and 3+), and 20 patients had moderate effusion. However, 70% RA patients with normal serum uric acid showed mild synovitis and effusion (1+). No significant association was found between the administered DMARDs and levels of SUA as well as inflammatory markers; however, high-dose steroid treatment was associated with high SUA level. CONCLUSION: Elevation of serum uric acid levels in Egyptian RA patients was prevalent and might be an inflammatory marker for severity of joint inflammation. Moreover, higher doses of steroids could be considered a cause of hyperuricemia.
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spelling pubmed-85020652021-10-20 Hyperuricemia Among Egyptian Rheumatoid Arthritis Patients. Is It an Association or an Inflammatory Marker? A Cross-Sectional Observational Study Nada, Doaa Gaber, Rasha Mahmoud, Al Shymaa Elkhouly, Radwa Alashkar, Doaa Open Access Rheumatol Original Research OBJECTIVE: To detect the prevalence of hyperuricemia in Egyptian rheumatoid arthritis (RA) patients as well as to assess its association with the severity of joint inflammation and disease-modifying antirheumatic drugs (DMARDs) in those patients. METHODS: A total of 150 RA patients were recruited; all patients were subjected to (1) clinical and functional assessment by disease activity score in 28 joints (DAS28) and modified health assessment questionnaire (MHAQ). (2) Laboratory investigations: serum uric acid (SUA) level, complete blood count (CBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP), tumor necrosis factor α (TNF-α), interleukin 1 (IL1), and interleukin 6 (IL6) levels. (3) Radiological evaluation: (A) plain X-ray of both hands and feet; (B) musculoskeletal ultrasound (MSUS) of both wrists, hands, shoulder, ankle, and knee joints. RESULTS: SUA was significantly correlated with disease activity by DAS28. Acute-phase reactants and inflammatory markers (IL1β, IL6, and TNF-α) were also significantly elevated in RA patients with low and high hyperuricemia compared to those with normal SUA. A total of 90% of RA patients with low hyperuricemia had synovial proliferation with power Doppler (1+ and 2+), and 30 patients had mild effusion (1+), while nearly all patients with high hyperuricemia had hypoechoic synovial proliferation (2+ and 3+), and 20 patients had moderate effusion. However, 70% RA patients with normal serum uric acid showed mild synovitis and effusion (1+). No significant association was found between the administered DMARDs and levels of SUA as well as inflammatory markers; however, high-dose steroid treatment was associated with high SUA level. CONCLUSION: Elevation of serum uric acid levels in Egyptian RA patients was prevalent and might be an inflammatory marker for severity of joint inflammation. Moreover, higher doses of steroids could be considered a cause of hyperuricemia. Dove 2021-10-05 /pmc/articles/PMC8502065/ /pubmed/34675698 http://dx.doi.org/10.2147/OARRR.S331488 Text en © 2021 Nada et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Nada, Doaa
Gaber, Rasha
Mahmoud, Al Shymaa
Elkhouly, Radwa
Alashkar, Doaa
Hyperuricemia Among Egyptian Rheumatoid Arthritis Patients. Is It an Association or an Inflammatory Marker? A Cross-Sectional Observational Study
title Hyperuricemia Among Egyptian Rheumatoid Arthritis Patients. Is It an Association or an Inflammatory Marker? A Cross-Sectional Observational Study
title_full Hyperuricemia Among Egyptian Rheumatoid Arthritis Patients. Is It an Association or an Inflammatory Marker? A Cross-Sectional Observational Study
title_fullStr Hyperuricemia Among Egyptian Rheumatoid Arthritis Patients. Is It an Association or an Inflammatory Marker? A Cross-Sectional Observational Study
title_full_unstemmed Hyperuricemia Among Egyptian Rheumatoid Arthritis Patients. Is It an Association or an Inflammatory Marker? A Cross-Sectional Observational Study
title_short Hyperuricemia Among Egyptian Rheumatoid Arthritis Patients. Is It an Association or an Inflammatory Marker? A Cross-Sectional Observational Study
title_sort hyperuricemia among egyptian rheumatoid arthritis patients. is it an association or an inflammatory marker? a cross-sectional observational study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8502065/
https://www.ncbi.nlm.nih.gov/pubmed/34675698
http://dx.doi.org/10.2147/OARRR.S331488
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