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Introduction: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can involve any organ system, and may lead to significant morbidity and even mortality. Down syndrome (DS) is the most frequent genetic cause of intellectual disabilities, typically caused by the presence of an extra chromosome 21. Case presentation: A 47-year-old Syrian female of DS who complained of low-grade fever, oral aphthae, fatigue, and arthralgia three months before presentation. Although the patient was diagnosed with phenotypically and gynogenically DS, a milder mosaic type was identified. She appeared fatigued with a blood pressure 110/70 mmHg, pulse 104/min, temp 100 F, having oral ulcers, tenderness of joints on palpation, haemoglobin 9.4 g/dl, white blood cells 10.9/mm3, platelets 87 000×109/cm with C-reactive protein of 2,3 mg/dl, and an erythrocyte sedimentation rate of 68. Urea 33 mg/dl with creatinine 0.9. The rest of the tests were unremarkable. Urine analysis was normal. Discussion: The prevalence of SLE in DS in the literature was found only in five cases, with different presentations, in the last 36 years. In our case the patient presented with mild lupus manifestations and responded well to steroids and hydroxychloroquine. Also, In our case, an onset of SLE in an old DS (DS female patient), whereas SLE is more frequent in childbirth-aged women, in addition to that DS patients had a short life expectancy. Conclusions: DS is associated with a predisposition to developing connective tissue disorders, especially in young females. unfortunately, patients were not diagnosed in all five cases until later with a flare because of the cognitive defect.
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Introduction and importance: Rhupus syndrome is a very rare combination of systemic lupus erythematosus and rheumatoid arthritis. It is characterized by the presence of erosive arthritis with symptoms and signs of systemic lupus erythematosus. Rheumatoid nodules and neurological and renal involvement are further complications of Rhupus syndrome, leading to a worse prognosis. Case presentation: The authors presented a young female patient diagnosed with lupus erythematosus, who laterally, developed clinical signs and biomarkers that led to the diagnosis of Rhupus syndrome. This is believed to be of relevance to the knowledge of the medical community. Conclusion: Despite being a rare entity, it is important to know its early diagnosis, and treatment to reduce the complications.
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Guillain-Barré syndrome (GBS) is a rare immune status, which affects the nerves, leading to muscle weakness and tingling, and, in some cases, paralysis. Our case showed that GBS may happen after knee infectious arthritis.
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Introduction: Low back pain related to pregnancy occurs in 60%-70% of pregnancies, at any time during pregnancy. During pregnancy, many factors such as weight gain, and others are the causes of the back pain. In Syria, due to the circumstances of the war, many pregnant women may be exposed to increase the risk of lower back pain, so this study will determine the prevalence of lower back pain among pregnant women and its potential risk factors. We aimed to evaluate the prevalence of low back pain in pregnant women and to assess the risk factors related to it. Methods: A cross-sectional, observational study was conducted between May 2020 and December 2022 at Obstetrics and Gynecology University Hospital in Damascus, Syria. Pregnant women aged over 18 years were selected from the outpatient clinic. Participants, after signing the informed consent, fill out the survey, which included the following parameters: age, weight, height, body mass index (BMI), education, parity, shoe type, weekly walking hours, occupation, low back pain, in which semester, radiation, onset, alleviating and aggravating factors, disability, and pain in previous pregnancies. We used Excel 2010, and the Statistical Package for the Social Sciences version 23.0. p < 0.05 was considered statistically significant, and we used the Chi-square test (χ 2 test), t student test to test the basal differences between groups. Results: A number of 551 pregnant participants were included and low back pain prevalence was 62%. There was a statistically significant relation between low back pain and each of the following: Obesity, weekly walking hours, pain in previous pregnancies, and occupation. Conclusion: Low back pain is prevalent during pregnancy and the most important risk factors include obesity and pain in previous pregnancies whereas walking and employment are protective measures to prevent low back pain.
