Mediterranean Journal of Rheumatology最新文献

Background: Systemic sclerosis (SSc) is an autoimmune disorder characterised by skin fibrosis leading to skin tightening and disfigurement. However, there is no definite treatment for SSc and its skin complications. Fractional carbon dioxide laser has been widely used for different cutaneous pathologies. This study aims to evaluate the benefits of CO2 laser resurfacing on microstomia and peri-oral rhytids in systemic sclerosis patients.

Method and patients: 33 systemic sclerosis patients were enrolled. Four sessions of CO2 laser treatment were performed at an interval of four weeks. Patients were evaluated monthly. The interincisal distance (IID) measurement was used to evaluate maximal mouth opening capacity, and the mouth handicap in systemic sclerosis (MHISS) scale was used to assess the improvement after treatment.

Results: All of the participants were female with a mean age of 47.46 and a standard deviation of 7.11. The mean disease duration was 12.35. The mean total core of the MHISS scale was 25.24, and the mean IID was 48.11 millimetres before the treatment with CO2 laser. The MHISS score decreased, and patient satisfaction increased after treatment. However, observed differences in the results of IID were not statistically significant.

Conclusion: In conclusion, it seems that the fractional carbon dioxide laser is effective in the improvement of perioral rhytids, patient satisfaction based on the MHISS score, and mouth disability in SSc patients.

Sjögren's syndrome (SS) is less frequently diagnosed in childhood than in adults, and central nervous system (CNS) disease is among the rarest systemic involvements. Thus, the clinical spectrum of CNS diseases and their management strategies have not been fully defined. In this article, we present the case of a 16-year-old girl who was referred for severe headache and diagnosed with SS with CNS involvement. Several immunosuppressive treatments failed to improve her neurological symptoms until the rituximab treatment. When we systematically reviewed the literature on cases of CNS involvement in childhood-onset SS, we found that CNS involvement was the presenting feature at the diagnosis of SS in the majority of published cases. While headache and fever were the most frequent complaints at presentation, most of the children displayed features of neuromyelitis optica spectrum disorder. CNS disease showed a variable response to immunosuppressives, and residual neurological deficits were not rare. Additionally, a significant number of cases required treatment with rituximab due to the treatment failures or subsequent flares. Sjögren's syndrome should be considered in children presenting with predominant neurological symptoms, and careful evaluation of glandular features might help in the prompt diagnosis of childhood-onset SS in children with CNS disease.

COVID-19, caused by a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), can lead to severe infection and has been suggested to induce autoimmune phenomena. We report three cases of rheumatoid arthritis (RA) occurring after COVID-19 infection and we present a systematic review of the literature of cases of RA post COVID-19. Our findings suggest that RA may be trigged by COVID-19 infection in genetically predisposed individuals.

The present commentary critically evaluates the role of glucosamine in joint health, specifically exploring the potential of vegan glucosamine as an alternative of crustacean glucosamine. While acknowledging glucosamine's established benefits in managing osteoarthritis, this commentary underscores concern regarding the limited data supporting the clinical use of vegan glucosamine. Methodological flaws in the bioequivalence study, lax quality parameters, and the absence of safety data for E. coli-derived vegan glucosamine are highlighted. The commentary calls for caution in endorsing vegan glucosamine for osteoarthritis patients, stressing the need for further research and a thorough evaluation of its efficacy and safety before widespread clinical adoption.

Introduction: Aberrant activation of the IL-23/IL-17 axis leads to inflammatory phenotypes with overlapping clinical characteristics. Inhibition of IL-17 has mostly an anti-inflammatory effect, but sporadic cases of new-onset IBD have been reported.

Case description: We present the case of a 65-year-old male patient with new-onset Crohn's-like disease after treatment with secukinumab for skin psoriasis. Discontinuation of the IL-17 inhibitor and high-dose corticosteroid treatment were efficient initially, but a relapse was noted during corticosteroid tapering. Administration of certolizumab pegol did partially relieve the patient, but disease remission was only achieved with subcutaneous risankizumab therapy.

Discussion: Clinical trials and real-world data indicate sporadic cases of new-onset IBD in patients receiving IL-17 inhibitors. Interestingly, our case is a "treatment-resistant" one since treatment with a biologic disease-modifying drug (bDMARD) usually leads to disease remission. As such, it is crucial to investigate the special characteristics of this clinical entity.