The aim of this study was to find the correlation between severity of dry eye and rheumatoid arthritis (RA) disease activity. Forty- two RA patients with dry eye were recruited from Rheumatology Outpatient Clinic in Minia University Hospital. Assessment of RA disease activity was performed using disease activity score (DAS-28). Ocular tests include Schirmer test I, tear film break up time (TBUT) and ocular staining score (OSS) was performed by ophthalmologist to find evidence of ocular dryness. Erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), anti SSA/Ro and anti SSB/La was also tested. Patients with severe dry (OSS ≥ 3) underwent minor salivary gland biopsy (MSGB) as suspected to have secondary Sjögren’s syndrome (SS). Of 42 RA patients, 30 had definite dry eye. DAS-28 did not show significant correlation with any of ocular tests for dryness while the duration of RA was significantly positively correlated with Schirmer test and OSS. The biopsy results of RA patients with severe dry eye show no evidence of SS. The severity of dry eye is not correlated with activity of RA but with its duration.

Purpose: To assess the frequency of Sjӧgren’s syndrome (SS), either primary or secondary to rheumatic disease, in a cohort of patients with aqueous-deficient dry eye and to determine the most accurate objective test for diagnosis of SS. Methods: A total of 111 patients with dry eye were recruited from Minia University’s ​Ophthalmology Outpatient Clinic (69 patients) and Rheumatology Outpatient Clinic (42 patients). The patients were screened for aqueous tear–deficient dry eye by abnormal test results of Schirmer test I (<10 mm) and tear-film break-up time (<10 seconds) in at least one eye. The diagnosis of SS was made according to the 2012 American College of Rheumatology​ criteria. A complete work up for SS was performed, including clinical examination, serological tests, ocular tests, and labial salivary–gland biopsy (LSGB). Results: Of the 111 patients, 58 had aqueous-deficient dry eye: 23 in the ophthalmology clinic cohort (group I) and 35 in the rheumatology clinic cohort (group II). Three patients had pSS, and its frequency was 13% in group I and 5.2% among all studied patients. The ocular staining score is the most diagnostic ocular test (sensitivity 100% and specificity 90.9%). Anti-SSA/Ro antibody is the most accurate serological method (sensitivity 33.3% and specificity 100%). LSGB histopathology is the most diagnostic method for SS, with sensitivity, specificity, and positive and negative predictive values of 100%. Conclusion: SS was detected with reasonable frequency among dry-eye patients, particularly pSS. Screening of dry eye for SS can select SS patients early in the disease course.

Background Fibromyalgia (FM) is a complex syndrome associated with significant impairment in the quality of life and function. The ability to evaluate and measure the severity of FM is likely to provide several benefits. Objective This study aimed to assess symptom severity in Egyptian FM patients using the Symptom Severity Scale (SS Scale), Revised Fibromyalgia Impact Questionnaire (FIQR), and Fibromyalgia Impact Questionnaire Visual Analog Scales (FIQ VASs). Patients and methods Twenty-four female patients who fulfilled the ACR-2010 criteria of FM were included in the present study. The SS Scale, FIQR, and FIQ VASs were used to assess symptom severity of FM. Results The respective mean of the SS Scale, FIQR, and FIQ VASs were 7.3 ± 2.4, 52.9 ± 22.1, and 39.3 ± 14.2, and they were positively correlated with measure of pain distribution [widespread pain index (WPI)] in our patients. The SS Scale, WPI, FIQR, and FIQ VASs scores were positively correlated with many regional pain distribution sites (upper arm pain and jaw pain at most) and somatic pain symptoms (central nervous system symptoms, musculoskeletal symptoms, otological and hypersensitivity symptoms). The high scores of the SS Scale, FIQR, and FIQ VASs and their positive correlations with most of the regional pain sites and distribution and somatic symptoms indicate the severity of symptoms in the studied population. The FIQ VAS was the only significant independent determinant of FM severity (P < 0.001) in backward/stepwise multiple linear regression models. Conclusion The SS Scale of the ACR-2010 criteria, FIQR, and FIQ VASs were excellent methods for assessment of symptom severity in our Egyptian FM patients.