Ayah Boudal

Obstructive sleep apnea (OSA) is a challenging condition affecting 9% to 38% of people worldwide. However, its prevalence in patients with psoriatic arthritis (PsA) remains inconclusive. This study aimed to investigate the point-prevalence of OSA in patients with PsA using polysomnography (PSG) the gold-standard diagnostic method for OSA. Diagnosis of OSA was confirmed via standardized PSG utilizing the American Academy of sleep (AASM) recommendations. PsA disease activity was assessed using the disease activity index for psoriatic arthritis (DAPSA) and Health Assessment Questionnaire-Disability Index (HAQ-DI). The point-prevalence of OSA among the 42 PsA patients who underwent PSG was 50%, with 36% exhibiting moderate-to-severe OSA. No significant associations were identified between OSA occurrence and PsA disease activity assessed by DAPSA or HAQ-DI ( P > .05). Older age (OR = 1.17, 95% CI = 1.07–1.27, P = .001) as well as greater BMI, which showed a trend toward significance (OR = 1.23, 95% CI = 0.99–1.52, P = .055), were predictors of OSA in patients with PsA. Although there was no correlation between PsA disease activity and OSA, our study highlights a higher prevalence of OSA among patients with PsA compared with the population in the same region, as well as reported literature.

Interstitial lung disease (ILD) is an increasingly recognized complication of rheumatoid arthritis (RA) and is associated with significant morbidity and mortality. Many risk factors for RA-related ILD were reported. The current study aims to explore the features and risk factors of Saudi patients with RA-ILD. This is a multicenter, retrospective, observational study of patients with RA-ILD. Clinical and radiological data from patients with RA-ILD were obtained from electronic medical records, including demographics, clinical characteristics, laboratory tests, pulmonary function tests, ECHO, and HRCT images. Out of 732 patients, 57 had RA-ILD. The mean age at the time of ILD diagnosis was 61.9 (± 12.2) years. RA-ILD diagnosis was significantly less among females (p = 0.008). Patients who ever smoked had significantly more RA-ILD (p < 0.001). Patients with RA-ILD were more likely to present with medical comorbidities, namely diabetes (p < 0.001), hypertension (p < 0.001), ischemic heart disease (p < 0.001), and osteoarthritis (p = 0.030). The multivariate analysis revealed that the age (OR: 1.035, 95% CI: 48.45–52.86, p = 0.0001); gender (OR: 2.581, CI: 1.77–1.86, p = 0.001), DM (OR: 2.498, 95% Cl: 1.65–1.76, P = 0.0001), HTN (OR: 1.975, 95% Cl: 1.61–1.74, P = 0.019), IHD (OR: 6.043, 95% Cl: 1.89–1.93, P = 0.0001) have a significant positive association with RA-ILD. No significant differences were observed between seropositive parameters with or without RA-ILD (p > 0.05). The most common symptoms of RA-ILD were cough (55.6%) and dyspnea (30.2%), and the most common ILD pattern was Non-specific Interstitial Pneumonia (NSIP) (55.6%) followed by Usual Interstitial Pneumonia (UIP) (38.9%). Traction bronchiectasis (75.5%) and glass ground opacities (73.6%) were also observed. The mean FVC and DLCO at baseline were 64.6% and 53.3%, respectively. In this cohort of patients, Saudi RA-ILD patients had a predominant NSIP pattern conversely to what is seen globally. These findings could be explained by the lower rates of smoking in our patient population. Future prospective national studies are needed to confirm the current findings and better evaluate RA-ILD epidemiology and risk factors.

Sarcoidosis is an immune-mediated, inflammatory, non-caseating-granulomatous disease that can virtually infiltrate any organ. Cardiac sarcoidosis is a leading cause of death in patients with sarcoidosis. Its clinical presentation is highly heterogenous and unpredictable, ranging from asymptomatic to life-threatening conduction disturbances, such as ventricular arrhythmias, and heart failure. Herein, we report a case of isolated cardiac sarcoidosis presenting as sinus bradycardia with first-degree atrioventricular block and an episode of non-sustained polymorphic ventricular tachycardia in a 42-year-old male with non-ischemic cardiomyopathy. He was diagnosed by cardiac magnetic resonance imaging and positron emission tomography with fluorodeoxyglucose and treated with oral prednisone.