Abeer Laz

Professor of Rheumatology
Cairo University

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Life Changer; Shready Scaley Lesion Force a Father to Leave Home

Molecular Therapy Revolutionized Disease Outcome

PsA pt. 61 yrs. old, male Obese, Diabetic, Smoker.

Collagenous Colitis; recurrent severe diarrhea, weight loss and anorexia, Calprotectin 752 ug/mg (50-200). Mildly elevated CRP and ESR.

Responded to Gueslkumab (IL-23 p19 antagonist) 100mg SC per 8 weeks & Methotrexate 25mg/week SC

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Fatima AlKindi

Internal Medicine
Tawam Hospital – Seha

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Chronic Gouty Arthritis and Hypercalcemia

58 years old male, bedbound post ischemic stroke with left sided hemiplegia. He also has hypertension, diabetes mellitus, dyslipidemia, morbid obesity, hyperuricemia and chronic kidney disease stage IV. He presented to hospital 2 days history of fever URTI symptoms , cough and tonic clonic episode of seizure prior to admission. Laboratory investigations showed acute kidney injury ( creatitine 400 micromol/L) on top of CKD, metabolic acidosis, lactic acidosis, hypercalcemia (2.97 mmol/L), and elevated uric acid 603 micromol/L. He was diagnosed with acute influenza A infection leading to seizure. He also had chronic right foot pain with deformity and touphus deposition. (image 1) X ray of right foot ruled out fracture, but showed large calcified nodule is are noted predominantly around the first MTP joint and the TMT joints. (image 1)Evaluation of hypercalcemia revealed high PTH 172.0 pmol/L, normal phosphate level 1.08 mmol/L, and NM parathyroid scan showed: Parathyroid adenoma posterior to the lower pole of the right thyroid lobe. ( image 1). He was managed with Tamiflu, intravenous hydration, and Cinacalcet 30mg.

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