Background: Behcet’s disease (BD) is an immune-mediated disease with ocular involvement in ~70% cases. Clinical assessment of uveitis activity can be challenging in special situations. The Systemic Immune-Inflammation Index (SII), a novel biomarker, may aid assessment but remains unstudied in BD uveitis. Objective: To evaluate the levels of SII and other potential inflammatory biomarkers derived from full blood count (FBC) in patients with active uveitis in BD. Methods: This is a case-control study that included 3 groups; an active uveitis group with a confirmed diagnosis of BD, an inactive disease group with BD without any activity for at least 3 months, and a control group of age and sex-matched healthy adults. Full blood count was done for all participants from a venous sample. Neutrophil–lymphocyte ratio (NLR), Platelet–lymphocyte ratio (PLR), and SII (neutrophils × platelets/lymphocytes) were calculated and compared between the groups. Results: 58 subjects were enrolled; 24 patients with BD and current active uveitis, 15 patients with inactive BD, and 19 healthy matched volunteers. The NLR and PLR were significantly higher in the active uveitis group than in the inactive group. SII was higher in the active uveitis group compared with the inactive group ( P < .001) and the healthy controls (P .002). The cutoff value for SII was > 701.72 with 79.17% sensitivity and 100% specificity. SII levels were higher in bilateral uveitis (1232.47) compared with unilateral active uveitis (870); however, the difference was not statistically significant. Conclusion: SII was highest in BD patients with active uveitis, significantly differing from those with inactive disease and healthy controls, supporting its potential as a biomarker for uveitis activity. Further research is needed to explore its correlation with disease severity.

Naglaa Afifi, M.D., Kareem Ahmed Abdelaziz Sabry, M.D., Dalia Salah Saif, M.D., Rasha Mohamed Hassan, M.D., Rahma Ahmed Elziaty, M.D.. J Rheum Dis 2025;32:283-91. https://doi.org/10.4078/jrd.2025.0016

Background: Microvascular alteration in scleroderma patients is well documented. Microcirculatory changes can be visualized by nailfold capillary microscopy (NFC) examination which is a safe and noninvasive technique. This study aims to identify possible association between neutrophil-to-lymphocyte ratio (NLR) and microvascular changes detected by nailfold capillaroscopic examination in scleroderma patients. Results: The study was conducted on 25 patients with systemic sclerosis. On studying the correlation of NLR with laboratory parameters, we found significant positive correlations with erythrocyte sedimentation rate “ESR” and C-reactive protein “CRP” values (p = 0.000). Regarding the clinical manifestations, higher NLR was significantly related to the presence of digital ulcer (p = 0.023) and Raynaud’s phenomenon (p = 0.015). There was significantly negative relation between NLR with cyclophosphamide treatment. Regarding NFC examination’s results, there was significant negative correlation of NLR with capillary number/mm (p = 0.000) and significant positive correlation of NLR with capillary width (p = 0.005), and a significant relation of NLR with the presence of capillary hemorrhage and presence of active scleroderma pattern (p = 0.010) was also reported. Conclusion: High N/L ratio as a marker of inflammation was found to reflect severity of systemic sclerosis and is associated with larger capillary diameter and lower capillary number in nailfold capillaroscopy. Active scleroderma pattern was associated with high N/L ratio. Further longitudinal studies are needed to determine the frequency of nailfold videocapillaroscopy and N/L ratio.

Background: Cognitive frailty is defined through a combination of physical frailty and cognitive impairment and is a growing concern in rheumatology. Rheumatoid arthritis is a lifelong disease, and the disease itself and the side effects of drug treatments may cause frailty. This study assessed the prevalence and risk factors for cognitive frailty and falls in people with rheumatoid arthritis. Results: A cross-sectional study involving 105 rheumatoid arthritis patients (aged 60 and older) was performed. Each participant received a comprehensive medical history review. The Simplified Disease Activity Index (SDAI), the Montreal Cognitive Assessment, and the Frail Scale were assessed. Sixty-one patients (58.1%) exhibited mild cognitive impairment. Forty-eight (45.7%) were categorized as frail. Among the frail patients, 41 (85.4%) showed mild cognitive impairment. Cognitive frailty was observed in 41 patients (39%). Compared to prefrail patients, frail patients were older (mean age 68.98 ± 4.01 vs 63.54 ± 2.63; p < 0.0001), had a longer disease duration (33.00 ± 6.05 vs 26.77 ± 5.29; p < 0.0001), displayed higher disease activity (median SDAI 24 vs 10; p < 0.0001), and experienced a greater number of falls (2 vs 0; p < 0.0001). Conclusion: Cognitive frailty is prevalent in RA patients. Age, level of education, disease duration, and disease severity are significant risk factors for frailty and cognitive impairment. RA patients who are frail are more prone to falls and therefore have a higher incidence of morbidity and adverse events.

Objective: 1. To develop a scoring system for the GCA Disease Activity 2. To validate the composite of the GCA Disease Activity Score (GCA-DAS). 3. To assess the GCA-DAS feasibility and effectiveness in the routine clinical setting for monitoring and assessment of treatment outcomes of GCA. Methods: The developed GCA-DAS includes acute temporal headache, visual deficit, physician global assessment of disease activity, patient global assessment of well-being, and ESR, rated on 0–10 scale. These variables have been identified as the main GCA outcome measures and criteria for improvement. Validation analyses were conducted on 124 patients and included assessment of construct validity, discriminant validity, and responsiveness to change. Results: The GCA-DAS was found to hold face and content validity, good construct validity, satisfactory internal consistency, appropriate dimensional structure, fair discriminative validity and strong responsiveness to clinically important change over time. The devised GCA-DAS was feasible and easily recorded in standard practice. This has been supported by the parallel significant improvement in the patients’ functional ability ( p < 0.001) and patient satisfaction (86.3%). Conclusion: The GCA-DAS was found to be a valid instrument for assessment of GCA disease activity and is potentially applicable in standard clinical care, observational studies, and clinical trials.