Publications by authors named "Hamida Azzouzi"

7 Publications

  • Page 1 of 1

Bone Loss and Radiographic Damage Profile in Rheumatoid Arthritis Moroccan Patients.

J Bone Metab 2021 May 31;28(2):151-159. Epub 2021 May 31.

Department of Rheumatology, Mohammed VI University Hospital, Faculty of Medicine, Mohammed I University, Oujda, Morocco.

Background: Rheumatoid arthritis (RA) is a known cause of joint destruction and systemic bone loss. In this study, we aimed to evaluate the bone damage and bone loss profiles of established RA patients.

Methods: We designed a cross-sectional study on a cohort of established RA patients. The bone evaluation was performed by obtaining standard X-ray images of hands and feet combined with bone mineral density (BMD) measurements. Radiographic joint damage was calculated by the modified total Sharp /van der Heijde score (mTSS). BMD was obtained by performing dual energy X-ray absorptiometry of the lumbar spine and femoral neck. Data on age, smoking, alcoholism, steroid prescription, body mass index (BMI), disease duration, disease activity, and functional disability were collected.

Results: A total of 93 RA patients were recruited. Their mean age was 51.59±12.38 years, with a mean disease duration of 12.07±9.19 years. A total of 36.6% of patients had osteoporosis, and the mean mTSS was 70.33±48.93. Both hip (P=0.0005) and lumbar BMD (P=0.0005) were correlated with mTSS. Backward regression analyses determined that bone damage was associated with high titers of rheumatoid factor, low lumbar BMD, and low BMI. General bone loss was associated with gender, steroid dose, steroid duration, menopause, and BMI.

Conclusions: Bone damage was associated with low BMI and axial bone loss in our RA population.
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May 2021

Seasonal and Weather Effects on Rheumatoid Arthritis: Myth or Reality?

Pain Res Manag 2020 7;2020:5763080. Epub 2020 Sep 7.

Rheumatology Department, Mohammed VI University Hospital, Faculty de Medicine, Mohammed I University, Oriental, Oujda, Morocco.

Introduction: Many of our rheumatic patients report that weather and seasons affect their symptoms.

Objective: The purpose of this study was to examine the effect of meteorological parameters within seasons on rheumatoid arthritis (RA) symptoms.

Methods: A retrospective longitudinal study from July 2017 to August 2018 was conducted. Data from three consultations for three seasons were collected and included a tender and swollen joint count, a disease activity score for 28 joints (DAS28), and patient's pain assessment from their computerized medical record. The weather conditions (minimum and maximum temperature, precipitation, humidity, atmospheric pressure, and wind speed) registered during the same day of consultation for each patient were obtained. Then, the statistical correlation between each meteorological parameter and RA parameters was determined using the multiple linear regression analysis.

Results: The data of 117 patients with a mean age of 50.45 ± 12.17 years were analyzed. The mean DAS28 at baseline was 2.44 ± 0.95. The winter in Oujda is cold (average temperature between 10°C and15°C) compared to summer (24.5°C-32.7°C). The spring is wetter with a 71% average humidity. Overall, the tender joint count was significantly correlated with hygrometry (=0.027) in winter. A similar result was obtained in summer with precipitation (=0.003). The pain intensity in the summer was negatively correlated with minimum temperatures and atmospheric pressure. However, there was no correlation between meteorological parameters and disease objective parameters for all seasons. Multiple linear regression analysis showed that weather parameters appeared to explain the variability in four RA predictors in the summer. No significant associations were observed in the spring.

Conclusion: Our study supported the physicians' assumption regarding the effect of climate on pain in RA patients.
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January 2021

Spinal Cοrd Compression Secondary to Brοwn Tumοr as First Manifestation of Primary Hyperparathyroidism.

World Neurosurg 2020 05 24;137:384-388. Epub 2020 Feb 24.

Department of Rheumatology, Mohammed VI University Hospital, Mohammed I University, Oujda, Morocco.

Background: Brown tumors (BTs) represent the typical nonmalignant lesions of hyperparathyroidism. Mandibles, ribs, and large bones are the most usual localization of BT. The diagnosis of these tumors requires biological and radiologic assessments. Their treatment is essentially based on parathyroidectomy.

Case Description: The present case report describes a patient with primary hyperparathyroidism who developed a cervical BT revealed by slow spinal compression.

Conclusions: The brown tumor, when localized at the level of the spine, can be life-threatening and must be managed as soon as possible.
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May 2020

[Ankylosing spondylitis associated with Still's disease: should it be considered a pathophysiologic link or a simple association?]

Pan Afr Med J 2017 10;28:132. Epub 2017 Oct 10.

Faculté de Médecine, Université Sidi Mohamed Ben Abdallah, Service de Rhumatologie, Centre Hospitalier Universitaire Hassan II, Fès, Maroc.

Ankylosing spondylitis is a chronic inflammatory rheumatism; it is part of the group of spondyloarthrites. General signs such as fever and weight loss are of little importance. Adult Still's disease is a rare systemic condition, a diagnosis of exclusion commonly characterized by high hectic fever, rash, arthritis and various systemic manifestations. Few cases of ankylosing spondylitis associated with adult Still's disease have been described in the literature. We here report the case of a 31-year old patient followed up for ankylosing spondylitis presenting with fever which had lasted for a long time and clinico-biological signs compatible with adult Still's disease. A possible pathophysiologic link between the two diseases may be suggested, even if their simultaneous occurrence has been rarely reported in the literature.
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March 2018

An unusual cause of medial foot pain: The cornuate navicular.

Eur J Rheumatol 2015 Mar 20;2(1):33-34. Epub 2014 Dec 20.

Department of Rheumatology, Hassan II University Hospital, Fez, Morocco.

The accessory navicular bone (ANB) is a secondary ossification center of the navicular bone and is rarely observed. Three distinct types of accessory navicular bones have been described. The type III, known as the cornuate navicular, is a rare morphological entity of the accessory navicular bone. We report the case of a patient, 48 years old, who presented with chronic swelling and pain in her left foot. Radiological examination permitted the diagnosis and showed a conflict between the tibial posterior tendon and the cornuate navicular, responsible for the symptoms. Surgical treatment led to symptoms relief.
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March 2015

Celiac disease causing severe osteomalacia: an association still present in Morocco!

Pan Afr Med J 2014 19;19:43. Epub 2014 Sep 19.

Department of Rheumatology, CHU Hassan II, Fès, Morocco.

Celiac disease (CD), a malabsorption syndrome caused by hypersensitivity to gliadin fraction of gluten. CD can manifest with classic symptoms; however, significant myopathy and multiple fractures are rarely the predominant presentation of untreated celiac disease. Osteomalacia complicating celiac disease had become more and more rare. We describe here a case of osteomalacia secondary to a longstanding untreated celiac disease. This patient complained about progressive bone and muscular pain, weakness, fractures and skeletal deformities. Radiological and laboratory findings were all in favor of severe osteomalacia. Improvement of patient's weakness and laboratory abnormalities was obvious after treatment with gluten free diet, vitamin D, calcium and iron. This case affirms that chronic untreated celiac disease, can lead to an important bone loss and irreversible complications like skeletal deformities.
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September 2015

Does Metabolic Syndrome or its Individual Components Affect Pain and Function in Knee Osteoarthritis Women?

Curr Rheumatol Rev 2015 ;11(1):8-14

Rheumatology Department, Hassan II University Hospital, Fez, Morocco.

Background: Current studies and research support the role of metabolic syndrome (MetS) in knee osteoarthritis (OA). However, few studies have focused on its impact on knee OA parameters. The aim of this study was to investigate if metabolic syndrome or its individual components affect the intensity of pain, functional disability, and radiographic severity in knee osteoarthritis women.

Materials And Methods: We conducted a cross sectional study including confirmed radiographic knee osteoarthritis according to Kellgren and Lawrence scale, with and without metabolic syndrome according to the National Cholesterol Education Program Adult Treatment Panel III criteria. The two groups were compared for pain Visual Analogue Scale (VAS), Lequesne index, Womac function, and radiological grade after adjusting for significant covariates. Multiple regression analysis was used to identify the independent effects of each specific component for metabolic syndrome on knee osteoarthritis parameters.

Results: One hundred thirty women were included. The mean age was 56.68 ±8.07 [34-75] years, and the mean BMI was 32.54±2.92 [23-37] kg/m2. The prevalence of metabolic syndrome was 48.5%. Women with and without metabolic syndrome had similar knee osteoarthritis parameters. However, accumulation of MetS components was associated with higher level of pain (OR = 3.7, CI = [1.5-5.9], p=0.001), independently of age and BMI. Multiple regression analyses showed, after adjusting for all covariates, that hyperglycemia had a positive impact on pain (p=0.009), waist circumference was positively associated with Lequesne index (p=0.04), high triglycerides level was significantly associated with increased pain (p=0.04) and higher Lequesne score (p=0.05), and Systolic blood pressure was positively correlated with Lequesne index (p=0.01).

Conclusion: In addition to weight reduction, appropriate treatment of metabolic syndrome needs to become an important management strategy for knee pain and functional impairment.
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January 2015