Background
Ocular manifestations in systemic lupus erythematosus (SLE) can be the presenting symptom of the disease or a sight-threatening complication.
Objectives
To detect different structural retinal changes in patients with SLE who had no ophthalmological symptoms and investigate the relationship between different retinal changes and the disease activity assessed by the Systemic Lupus Erythromatosus Disease Activity Index score.
Study Design
A descriptive pilot study from January 2016 to January 2017.
Methods
Fifty-two eyes of 26 patients diagnosed to have SLE were examined using visual acuity assessment, fundus examination, optical coherence tomography (OCT), and fundus fluorescein angiography (FFA).
Results
Fundus fluorescein angiography showed different changes in the form of venular occlusion and optic nerve leakage. There were also degenerative changes in the form of alternating hyperfluorescent and hypofluorescent areas outside the arcades as well as peripapillary areas and capillary dropout. Optical coherence tomography detected signs of degenerative thinning, incomplete posterior vitreous detachment, and epiretinal membrane. A significant correlation was found between SLE activity and the changes detected by FFA (p = 0.017). However, there was no significant correlation between disease activity and changes detected by OCT. Optical coherence tomography changes were significantly correlated with the duration of hydroxychloroquine use of more than 5 years (p = 0.032). There was no correlation between FFA or OCT changes and proteinuria or antiphospholipid antibodies.
Conclusions
Fundus fluorescein angiography is more sensitive in detecting early subclinical retinal changes in patients with SLE, which correlates with disease activity, whereas OCT is more sensitive in detecting changes resulting from hydroxychloroquine use.
Familial Mediterranean fever (FMF) is a one of genetically basis auto inflammatory disease characterized by recurrent episodes of fever, serositis & musculoskeletal involvement. Protracted febrile myalgia syndrome (PFMS) is characterized by severe paralyzing myalgia, high fever, abdominal pain, diarrhea, arthritis/arthralgia, and transient vasculitic rashes. We report a 15year-old girl with PFM as non classical presenting symptoms of FMF, and discuss the course of management of this case.We reviewed the literature and mostly recorded all case reports of PFM affected adolesecent and adult patients over the past years to give special prominence to muscle affection in FMF particularly PFM Citation: Menyawi ME, Essam M, Shaker A, et al. Protracted febrile myalgia syndrome in patient with familial mediterranean fever.
When a physically active growing child presented with heel pain without specific radiographic findings, Sever's disease is usually perused. Sever's disease or calcaneal apophysitis is a subset of osteochondrosis occurring at the posterior calcaneal apophysis at the site of attachment of Achiles tendon. The diagnosis is mainly based on the clinical assessment. Imaging may be needed to exclude alternative diagnosis such as planter fasciitis, Achilles tendon Injuries, calcaneus fractures, osteomyelitis & tarsal coalition. No sign has been accepted as pathognomonic for sever diagnosis by plain radiography. We present a case of Sever's disease complicated with calcaneal osteomyelitis and discussed the role of ultrasonography.
We present a case of congenital short femur with scleredema Diabeticorum (SD) in a patient with diabetic neuropathy with unusual skin lesion distribution. Gait symptoms progressively worsened. The atypical distribution of the skin lesions is quite unusual. This case express rare complications of diabetes mellitus in two faces, first the maternal diabetes which had disrupted in part the development of skeletal system of the offspring who in turn developed a rare dermatologic complications i.e. SD. This case will leave inedible memory for every diabetologist not to miss the skeletal and dermatologic manifestations of DM. The combination of this congenital proximal femoral hypoplasia with complicating diabetes makes the question if there is a link with similar genetic predilection or just an association.
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