Comorbid conditions play a pivotal role in rheumatoid arthritis management and outcomes. We estimated the percentage of comorbid illness among rheumatoid arthritis patients and explored the relationship between this comorbidity and different prescriptions. A cross-sectional study of patients with rheumatoid arthritis in three centers in Saudi Arabia was carried out. Comorbidity and antirheumatoid medication regimens prescribed were recorded on a specially designed Performa. The association between comorbidity and different drugs was analyzed. A total of 340 patients were included. The most comorbidities were hypertension 122 (35.9%), diabetes 105 (30.9%), osteoporosis 88 (25.8%), and dyslipidemia in 66 (19.4). The most common drug prescribed was prednisolone in 275 (80.8%) patients followed by methotrexate in 253 (74.4%) and biological therapy in 142 (41.5%) patients. Glucocorticoids were prescribed considerably more frequently in hypertensive and diabetic patients as well as in patients with osteoporosis and dyslipidemia. Most patients with rheumatoid arthritis suffered from comorbid diseases.

We selected the medicine research papers in English language published from the year 2005 to the date to determine the clinical significance of Takayasu's arteritis (TA) and to review the literature available on this condition. TA is a world-wide, chronic inflammatory disease of unknown etiology. It is more prevalent in Asian countries. There are no specific laboratory tests to diagnose TA as it usually presents with non-specific symptoms such as fatigue, fever, arthralgia, weight loss, malaise, weakness and vision changes. Angiographic imaging is considered to be the gold standard investigation in diagnosing TA. Steroids with subsequent tapering doses are the mainstay of medical treatment; however, for addressing the refractory cases additional therapy becomes necessary. Reconstructive vascular surgery is limited to the severe and irreversible stenotic lesions where surgery becomes inevitable.

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Chorea is a rare manifestation of systemic lupus erythematosus (SLE). We report on a young patient with chorea who was diagnosed initially with rheumatic fever. Follow up and further evaluation confirmed the diagnosis of SLE and anti-phospholipid syndrome. Of special interest were the negative antiphospholipid (aPL) antibodies and the initial diagnosis of rheumatic fever which is still not uncommon problem in our region. The rarity of such presentation with joint and non specific increase of antistreptolysin O (ASO) titer might be the factors that led to an incorrect diagnosis. Early diagnosis and treatment of SLE and anti-phospholipid syndrome are very crucial and should be considered with such presentation.

Background: It has been proven that a family history of systemic lupus erythematosus (SLE) is a risk factor for the development of the disease, and the risk increases with increasing number of relatives affected. In Saudi Arabia, high consanguinity rate leads to higher incidence of familial form than in other countries. We compare the percentage of familial versus sporadic SLE among Saudi patients. The second aim of the present study is to compare clinical characteristics between the two forms of the disease. Methods: This cross-sectional study includes 47 female patients whom are selected and investigated through three phases. We have added additional two categories of relatives, based on unconventional definition. We have examined and compared demographic characteristics of the patients with familial and sporadic SLE. We have also compared the percentage of familial vs. sporadic lupus and clinical characteristics of the two forms. Results: All the patients are females, aged between 18 and 43 years. The highest percentage of patients resides in the central region of Saudi Arabia (34%). The origin of the big family or tribe also most commonly occurs in the central region (34%). Data analysis results in 27.7% of patients with familial form of SLE. Sporadic form is found in 72.3% of patients. Consanguinity between patients' parents is noticed in both familial form (61.5%) and sporadic form (58.8%). Clinical manifestations are similar between patients with familial and sporadic form. Conclusion: Our results show a high percentage of familial lupus among Saudi patients. More research is required in order to estimate the inheritance pattern of familial SLE and involvement of genetic and environmental factors.

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