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

Doaa Nada,1 Rasha Gaber,2 Al Shymaa Mahmoud,3 Radwa Elkhouly,1 Doaa Alashkar1 1Rheumatology and Rehabilitation Department, Faculty of Medicine, Tanta University, Tanta, Al Gharbeia Governorate, Egypt; 2Medical Biochemistry Department, Faculty of Medicine, Tanta University, Tanta, Al Gharbeia Governo...

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Autores principales:	Nada D, Gaber R, Mahmoud AS, Elkhouly R, Alashkar D
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	rheumatoid arthritis uric acid inflammatory marker hyperuricemia Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/896c9a6bae89442ca38134bb0a1337ef
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spelling	oai:doaj.org-article:896c9a6bae89442ca38134bb0a1337ef2021-12-02T17:41:28ZHyperuricemia Among Egyptian Rheumatoid Arthritis Patients. Is It an Association or an Inflammatory Marker? A Cross-Sectional Observational Study1179-156Xhttps://doaj.org/article/896c9a6bae89442ca38134bb0a1337ef2021-10-01T00:00:00Zhttps://www.dovepress.com/hyperuricemia-among-egyptian-rheumatoid-arthritis-patients-is-it-an-as-peer-reviewed-fulltext-article-OARRRhttps://doaj.org/toc/1179-156XDoaa Nada,1 Rasha Gaber,2 Al Shymaa Mahmoud,3 Radwa Elkhouly,1 Doaa Alashkar1 1Rheumatology and Rehabilitation Department, Faculty of Medicine, Tanta University, Tanta, Al Gharbeia Governorate, Egypt; 2Medical Biochemistry Department, Faculty of Medicine, Tanta University, Tanta, Al Gharbeia Governorate, Egypt; 3Radiology Departments, Faculty of Medicine, Tanta University, Tanta, Al Gharbeia Governorate, EgyptCorrespondence: Doaa NadaRheumatology and Rehabilitation Department, Faculty of Medicine, Tanta University, Geish Street, Tanta, Al Gharbeia Governorate, EgyptTel +201069579672Fax +23286114040Email doaa.waseem@yahoo.comObjective: 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.Keywords: rheumatoid arthritis, uric acid, inflammatory marker, hyperuricemiaNada DGaber RMahmoud ASElkhouly RAlashkar DDove Medical Pressarticlerheumatoid arthritisuric acidinflammatory markerhyperuricemiaDiseases of the musculoskeletal systemRC925-935ENOpen Access Rheumatology: Research and Reviews, Vol Volume 13, Pp 305-314 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	rheumatoid arthritis uric acid inflammatory marker hyperuricemia Diseases of the musculoskeletal system RC925-935
spellingShingle	rheumatoid arthritis uric acid inflammatory marker hyperuricemia Diseases of the musculoskeletal system RC925-935 Nada D Gaber R Mahmoud AS Elkhouly R Alashkar D Hyperuricemia Among Egyptian Rheumatoid Arthritis Patients. Is It an Association or an Inflammatory Marker? A Cross-Sectional Observational Study
description	Doaa Nada,1 Rasha Gaber,2 Al Shymaa Mahmoud,3 Radwa Elkhouly,1 Doaa Alashkar1 1Rheumatology and Rehabilitation Department, Faculty of Medicine, Tanta University, Tanta, Al Gharbeia Governorate, Egypt; 2Medical Biochemistry Department, Faculty of Medicine, Tanta University, Tanta, Al Gharbeia Governorate, Egypt; 3Radiology Departments, Faculty of Medicine, Tanta University, Tanta, Al Gharbeia Governorate, EgyptCorrespondence: Doaa NadaRheumatology and Rehabilitation Department, Faculty of Medicine, Tanta University, Geish Street, Tanta, Al Gharbeia Governorate, EgyptTel +201069579672Fax +23286114040Email doaa.waseem@yahoo.comObjective: 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.Keywords: rheumatoid arthritis, uric acid, inflammatory marker, hyperuricemia
format	article
author	Nada D Gaber R Mahmoud AS Elkhouly R Alashkar D
author_facet	Nada D Gaber R Mahmoud AS Elkhouly R Alashkar D
author_sort	Nada D
title	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_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_sort	hyperuricemia among egyptian rheumatoid arthritis patients. is it an association or an inflammatory marker? a cross-sectional observational study
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/896c9a6bae89442ca38134bb0a1337ef
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Hyperuricemia Among Egyptian Rheumatoid Arthritis Patients. Is It an Association or an Inflammatory Marker? A Cross-Sectional Observational Study

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