Manifestations Of Rheumatic Diseases Research Articles

Celecoxib in rheumatic diseases: possibilities and prospects. Brief descriptive survey

Chronic pain is the main manifestation of rheumatic diseases (RD), it determines the main complaints and worsens the quality of life of patients. The problem of effective control of chronic pain in rheumatology remains a current issue despite the successes in the development of new drugs for pathogenetic therapy, especially in immunoinflammatory RD. For example, 40-50% of patients with rheumatoid arthritis (RA), even those receiving biologic disease-modifying antirheumatic drugs and Janus kinase inhibitors, require analgesics. According to several population studies, about 50% of patients with the most common RD, osteoarthritis (OA) are forced to take various analgesics on a regular basis.The most popular class of analgesics with proven efficacy in RA, spondyloarthritis (SpA) and OA are non-steroidal anti-inflammatory drugs (NSAIDs). As has been shown in several meta-analyses, NSAIDs are superior to placebo and paracetamol in their therapeutic effect, are not inferior to opioids and are better tolerated overall. However, the use of NSAIDs can be associated with the development of dangerous adverse events (AEs), which requires careful monitoring of the patient's condition, considering comorbid diseases and risk factors. It is very important to choose a drug with a balanced ratio of efficacy and low risk of gastrointestinal and cardiovascular AEs. One such drug is celecoxib, whose therapeutic potential and relative safety have been confirmed in RA, SpA and OA. A differentiated approach to celecoxib prescription makes it possible to achieve a maximum therapeutic result with a minimum risk of AEs. For severe pain, treatment starts with a dose of 400 mg/day, followed by a switch to a maintenance dose of 200 mg/day.

Anesthetic management in orthopaedic surgery for rheumatic patients

Patients with rheumatic diseases frequently require orthopaedic surgeries due to progressive joint damage and deformities. These patients pose unique challenges for anesthesiologists due to systemic involvement, altered anatomy, and chronic pain management needs. This review explores optimal anesthetic strategies to improve surgical outcomes and enhance patient safety in this vulnerable population. Preoperative assessment is crucial for identifying systemic manifestations of rheumatic diseases, including cardiovascular, respiratory, and renal involvement, which can significantly impact anesthetic management. A thorough evaluation helps tailor the anesthetic plan to individual patient needs, ensuring better perioperative care.Regional anesthesia, particularly neuraxial blocks and peripheral nerve blocks, offers significant benefits over general anesthesia in this population. These techniques can reduce postoperative pain, enhance recovery times, and decrease opioid consumption. However, the presence of spinal deformities and anticoagulation therapy in these patients requires careful consideration and meticulous planning. Multimodal analgesia, combining regional techniques with systemic medications, is recommended to manage chronic pain and minimize opioid use postoperatively. Effective pain management strategies are essential for improving postoperative outcomes and patient satisfaction.

The Diagnostic Role of Skin Manifestations in Rheumatic Diseases in Children: A Critical Review of Paediatric Vasculitis.

Skin lesions are frequently observed in children with rheumatic diseases, particularly in conditions such as IgA vasculitis (IgAV) and Kawasaki disease (KD). In paediatric vasculitis, the presence of skin lesions serves as an early indicator, emphasising the importance of timely diagnosis to prevent complications, such as cardiac or renal involvement. Conversely, autoinflammatory disorders like juvenile systemic lupus erythematosus (SLE) and juvenile dermatomyositis (DM) may manifest with cutaneous manifestations either at the onset of disease or during its progression. Identifying these skin lesions prior to the appearance of systemic symptoms offers an opportunity for early diagnosis and treatment, which has a positive influence on the outcomes. Additionally, it is noteworthy that specific rheumatological conditions, such as acute rheumatic fever (ARF) or oligoarticular or polyarticular forms of juvenile idiopathic arthritis (JIA), may exhibit occasional, but significant skin involvement, which is strongly correlated with an unfavourable prognosis. The assessment of skin is important in the holist approach to assessing patients for potentially systemic/multisystem disorder and helps distinguish discrete conditions.

UVEITIS: OCULAR MANIFESTATIONS OF RHEUMATIC DISEASES AND MULTIDISCIPLINARY APPROACHES.

Uveitis, an ocular inflammation that affects the uvea, is often associated with rheumatic diseases such as rheumatoid arthritis and systemic lupus erythematosus. This intersection between ophthalmology and rheumatology demands a multidisciplinary approach for adequate diagnosis and treatment. Understanding the ocular manifestations of these rheumatic diseases is crucial to prevent permanent damage to vision and improve patients' quality of life. Objective: This study aims to conduct a systematic review of the literature to analyze the ocular manifestations of rheumatic diseases, with a focus on uveitis, and explore the multidisciplinary approaches used for its management. Methodology: Using the PRISMA checklist, we searched the PubMed, Scielo and Web of Science databases for articles published in the last 10 years. The descriptors used were "uveitis", "rheumatic diseases", "ocular manifestations", "multidisciplinary approach" and "treatment". The inclusion criteria were original studies and reviews that addressed the relationship between uveitis and rheumatic diseases, while the exclusion criteria were duplicate studies, unrelated to the topic and with inadequate methodology. Results: The results highlighted the prevalence of uveitis in several rheumatic diseases, the different types of associated ocular inflammation and the multidisciplinary therapeutic strategies adopted. Effective treatments have been identified to control inflammation and preserve vision, emphasizing the importance of collaboration between ophthalmologists and rheumatologists. Conclusion: A multidisciplinary approach is fundamental in the management of uveitis associated with rheumatic diseases, allowing early diagnosis, effective treatment and prevention of complications. This review highlights the importance of working together between medical specialties to improve clinical outcomes and quality of life for patients affected by this condition.

Early Recognition and Institution of Treatment is Associated with a Good Prognosis in Peripheral Ischemic Lesions in Rheumatic Diseases

Introduction: Peripheral ischemic lesions in rheumatic diseases have variable presentations, prognoses and outcomes that have not been well studied in published literature. The present study aimed to investigate the clinical presentation, aetiology, prognosis and outcomes of peripheral ischemic lesions in rheumatic diseases. Material and methods: A medical records review of all patients who presented with peripheral ischemic lesions was conducted in the Department of Clinical Immunology and Rheumatology of a tertiary care institution in Northern India. Data from March 2013 to December 2017 was collected in the form of demographic and clinical details, investigations, treatment and outcomes. Results: Of 103 patients that presented with peripheral ischemic lesions, 80 (77.6%) had an underlying rheumatic disease. In the group with rheumatic causes, the mean age was 29.31 years, and the majority (87%) presented in the winter season. The most common rheumatic cause was vasculitis (55%) followed by systemic sclerosis (17.5%), systemic lupus erythematosus (15%) and primary antiphospholipid antibody syndrome (6, 7.5%). Amputation (either surgical or auto-amputation) was observed in 55% of the cases, while the remaining recovered completely or near completely with medical treatment. Conclusions: Peripheral ischemic lesions may present as the initial or predominant manifestation of rheumatic disease with vasculitis being the most common cause. Late referral or presentation to the hospital, delayed specific management and presentation as gangrene resulted in poorer outcomes in these patients.

Cerebrospinal Fluid Analysis in Rheumatological Diseases with Neuropsychiatric Complications and Manifestations: A Narrative Review

The analysis of cerebrospinal fluid (CSF) remains a valuable diagnostic tool in the evaluation of inflammatory and infectious conditions involving the brain, spinal cord, and meninges. Since many rheumatic inflammatory diseases can involve the central and peripheral nervous system, the aims of this narrative review were to summarize the latest evidence on the use of CSF analysis in the field of neuropsychiatric manifestations of rheumatic diseases. Routine CSF parameters were taken into consideration for this review: appearance; total protein and cellular content (pleocytosis); lactate and/or glucose; CSF/serum albumin quotient; intrathecal synthesis of IgG. Data regarding the role of CSF analysis in the clinical management of neuropsychiatric systemic lupus erythematosus, primary Sjogren’s syndrome, rheumatoid arthritis, and Behçet’s syndrome are presented. Although no disease-specific picture has been identified, CSF analysis remains a useful diagnostic tool to confirm the presence of a neuro-inflammatory state or, conversely, to exclude the concomitant presence of other inflammatory/infectious diseases affecting the CNS in the context of systemic rheumatologic conditions.

Ocular manifestations of rheumatic diseases

Rheumatic diseases are a large group of conditions of various origins, predominantly systemic in nature, with persistent or transient joint syndrome and involvement of other organs and systems, including the eyes. Many rheumatic diseases are characterized by specific types of ocular inflammation, which manifests through its localization, symmetry, and clinical features.

Juvenile idiopathic arthritis presenting as diffuse alveolar hemorrhage at onset: A case series.

The etiology of diffuse alveolar hemorrhage (DAH) in childhood is often unknown, and it may be an early manifestation of rheumatic disease. Juvenile idiopathic arthritis (JIA) is one of the most common rheumatic diseases in children, but DAH as an onset manifestation of JIA is rare. This study summarizes the clinical characteristics of patients with JIA presenting as DAH. We retrospectively analyzed the age of onset, clinical manifestations, imaging features, treatments, and prognosis of five cases of JIA presenting as DAH. Themedian age at DAH onset was 6 months (range, 2 months-3 years). Pallor was the most common manifestation of onset (5/5). Other symptoms included cough (2/5), tachypnea (2/5), hemoptysis (1/5), cyanosis (1/5), and fatigue (1/5). Imaging showed ground-glass opacity (GGO) (5/5), subpleural or intrapulmonary honeycombing (4/5), consolidation (3/5), interlobular septal thickening (2/5), and nodules (1/5). Anticitrullinated protein antibodies (ACPA) and rheumatoid factor (RF) were positive in five children (5/5), and antinuclear antibody (ANA) was positive in four children (4/5). ANA in three children and ACPA/RF in one child were positive before the onset of joint symptoms. The median age at the onset of joint symptoms was 3 years and 9 months (2 years and 6 months-8 years). Joint symptoms were mainly characterized by joint swelling, pain, and difficulty walking, and the most commonly affected joints were the knees, ankles, and wrists. After the diagnosis of DAH, the five patients were treated with glucocorticoids. Alveolar hemorrhage was effectively controlled in three cases, but the other two patients still had anemia and poor improvements in chest imaging. After joint symptoms, the patients were treated with glucocorticoids combined with diclofenac, disease-modifying antirheumatic drugs, and biological agents. Alveolar hemorrhage was in remission, and joint symptoms were relieved in the five cases. DAH can be the first clinical manifestation of JIA, and joint involvement occurs 1-5 years later. Children with DAH who are positive for RF, ACPA, and/or ANA and have GGO accompanied by honeycombing on imaging should be concerned about their joint involvement in future.

Raynaud’s Phenomenon as the Initial and Only Manifestation of Non-Hodgkin Lymphoma: A Case Report

Raynaud’s phenomenon is one of the commonest manifestations of rheumatic diseases. However, it can be caused by non-Rheumatic conditions as well. Among non-rheumatic causes, cancers are widely reported as the culprit”. Raynaud’s phenomenon caused by non-rheumatic diseases are commonly resistant to standard treatment options They are associated with more severe infections. Among non-rheumatic causes, cancers are widely reported as the culprit. We present a case of non-Hodgkin lymphoma presenting solely with Raynaud’s phenomenon.

Rheum-CoV-2 Vaccination Case Series.

In this case series, we present 5 cases of autoimmune rheumatic disease onset shortly after receiving mRNA vaccination against coronavirus disease 2019 (COVID-19). We identified 5 patients from Brooke Army Medical Center who developed new manifestations of rheumatic disease following the second dose of the Pfizer-BioNTech or Moderna COVID-19 vaccinations. All patients were initially seen in primary care and then referred to rheumatology for further evaluation and management. Clinical data were obtained through review of the electronic medical record. Three cases involve elderly women with insidious onset of symmetric wrist and hand polyarthritis with seropositivity for rheumatoid factor. One case involves an elderly woman with a subacute onset of lower extremity-predominant, symmetric polyarthritis. One case involves an elderly man with insidious onset of bilateral shoulder and hip stiffness and arthralgias in the setting of elevated erythrocyte sedimentation rate and a rapid response to glucocorticoid therapy. Whether there exists a causal or contributory relationship between COVID-19 mRNA vaccination and the development of autoimmune rheumatic disease remains to be determined. Ultimately, further research is needed to establish if there is a true connection between the two.

КЛИНИКО-ГЕНЕТИЧЕСКАЯ ХАРАКТЕРИСТИКА БОЛЬНЫХ С TRAPS (ПЕРИОДИЧЕСКИЙ СИНДРОМ, АССОЦИИРОВАННЫЙ С РЕЦЕПТОРОМ ФАКТОРА НЕКРОЗА ОПУХОЛИ) ПО ДАННЫМ ФЕДЕРАЛЬНОГО РЕВМАТОЛОГИЧЕСКОГО ЦЕНТРА

The tumor necrosis factor receptor-associated periodic syndrome (TRAPS) is a rare autosomal dominant disease associated with a mutation in the TNFRSF1A gene. It belongs to the group of monogenic autoinflammatory diseases (mAIDs) characterized by the repeated and prolonged episodes of fever, skin rashes, musculoskeletal, ophthalmic symptoms and an increase in the level of acute phase markers. The main targeted therapy is inhibitors of interleukin-1 (IL-1). The purpose of the study was to present the clinical and genetic characteristics of patients with TRAPS according to the data from the V.A. Nasonova Research Institute of Rheumatology (Moscow, Russia). The study included 28 patients from 2013 till 2021 with a clinical diagnosis of TRAPS from a selection of 162 (both pediatric and adult) patients with mAIDs: 17 females/11 males aged 2.5 to 65 years old (Me 9.0 y/o [7.9; 14.5]); 7 adults/21 children. All of them have underwent molecular genetic analysis for mutations in the TNFRSF1A gene. Results: the TRAPS was diagnosed in 28 (17.3%) among 162 patients with mAIDs. The age of onset ranged from 1 month till 28 years old (Me 4.0 y/o [1.0; 7.1]). Most patients fell ill prior to the age of 10 years old (89.3%), of which 8 (28.6%) before 1 year old, 7 (25%) from 1 to 5 years old, 1 (3.6%) from 5 to 10 years old, 10 (35.7%) from 10 to 18 years old and 2 (7.1%) from 21 to 28 years old. The duration of the disease and the delay in diagnosis at the time of inclusion ranged from 3 months till 59 years old. The diagnosis was made within the first year of illness in 4 (14.3%) of observed cases; within 1 to 10 years in 18 (64.3%); in 8 (28.6%) there was a delay in diagnosis of over 10 years; and in 4 (14.3%) the delay was more than 20 years of illness. The duration of attacks varied from 10 to 30 days, the intervals between the attacks ranged from 2 weeks till 6 months. The clinical manifestations were as follows: fever in 96.4% of cases, skin rashes in 71.4%, musculoskeletal symptoms in 18 (64.3%) cases, oligoarthritis in 9 (32.1%), polyarthritis in 2 (7.1% ), gastrointestinal manifestations in 18 (64.3%), lymphadenopathy of various groups in 10 (35.7%), ophthalmological manifestations in 8 (28.6%). The less often were the different nervous system manifestations, which accounted for 6% to 21% of cases, pharyngitis in 4 (14.3%) and stomatitis in 2 (7.1%). An increase in the sedimentation rate of erythrocytes was noted in 23 (82.1%), C-reactive protein in 20 (71.4%), leukocytosis in 11 (39.3%). The diagnosis in all patients was confirmed genetically. 10 patients had a low-penetrance mutation of р.Arg121Gln (р.Arg92Gln according to the old nomenclature). 5 familial cases were identified, the total number of sick family members was 12, from 2 to 4 in each family; 4 cases of amyloidosis (the all four were adults). Treatment: glucocorticoids in 19 (67.9%) cases, Cyclosporine A in 1, Colchicine in 5. 15 patients (53.6%) received genetically engineered biological preparations, the IL-1 (Canakinumab) was prescribed in 10 (35.7%) patients with the duration of admission from 1 to 9 years, Etanercept in 1, Adalimumab in 1 and Tocilizumab in 3. Conclusion: due to the similarity of clinical and laboratory symptoms with manifestations of rheumatic diseases, patients with TRAPS can be encountered in the rheumatologists’ practice. Most patients in the studied cohort had an early onset of the disease (prior to 10 years old), and the diagnosis delay of 10+ years was noted in 1/3 of patients. All patients had a specialized inflammatory phenotype coupled with genetic mutations. About half had required the appointment of biological drugs, IL-1 mainly. A complete response to the therapy in most patients and a good tolerability of treatment were noted, which allows the authors to consider this as the basis in the treatment and management of patients with TRAPS.

Race, Ethnicity, and Disparities in Rheumatology Educational Materials.

To characterize the representation of dark skin color in clinical images across 4 major rheumatology training resources. We gathered images of patients with rheumatic diseases from the American College of Rheumatology Image Library, UpToDate, the New England Journal of Medicine Images in Clinical Medicine and Clinical Cases filtered by "Rheumatology," and the 9th edition of Kelley's Textbook of Rheumatology. Investigators used Fitzpatrick's skin phototypes to independently code images depicting visible skin as "light" (skin types I to IV), "dark" (skin types V to VI), or "indeterminate." The representation of dark skin in clinical images was compared to the representation of Asian, Native American, and Black individuals within the US Census population and within lupus cases nationally. Of the 1,043 patient images included in the study, 13.4% had dark skin, 84.0% light skin, and 2.6% indeterminate skin color. Dark skin was underrepresented significantly in rheumatology educational materials and lupus images when compared with the representation of Asian, Native American, and Black individuals within the US Census population (13.4% versus 20.6%; χ2 =32.8, P < 0.001) and in published studies of patients with systemic lupus erythematous (22.6% versus 44.2%; χ2 =20.0, P < 0.001). Darker skin tones are significantly underrepresented in major rheumatology clinical image banks. Improving representation of racial and ethnic minorities in rheumatology education materials can better equip trainees to recognize and diagnose cutaneous manifestations of rheumatic diseases in these groups.

Diacerein in the treatment of chronic musculoskeletal pain

Chronic musculoskeletal pain (MSP) is the most painful manifestation of rheumatic diseases (RD), the main cause of disability, a decrease in the quality and life expectancy of patients, which determines not only the high medical, but also the social significance of this problem. The chronic nature of the pain forces patients with MSP to use analgesic therapy for a long time. At the same time, non-steroidal anti-inflammatory drugs (NSAIDs) are the first-line treatment for MSP. However, it is well known that the use of this group of drugs is associated with significant difficulties, mainly due to the comorbid pathology that is common in middle-aged and elderly people. In this regard, there are continuing attempts at searching for alternative agents for chronic MSP control, which have analgesic and anti-inflammatory activity similar to NSAIDs, but lack their side effects. Some researchers believe that diacerein can become such drug.

Psychiatric manifestations of rheumatic diseases

Introduction and purpose of the work: Rheumatic diseases are chronic diseases that cause symptoms in many systems of the human body. Their most common symptoms include pain and symptoms of arthritis, their deformities, fatigue, and malaise. The aim of the article is to present the symptoms and mental disorders occurring in the course of selected rheumatic diseases.&#x0D; State of knowledge: The psychological symptoms are characteristic of systemic lupus erythematosus. Specified is a form of lupus called NSPLE (neuropsychiatric systemic lupus erythematosus), which includes neuropsychiatric symptoms in the course of systemic lupus erythematosus. Psychiatric symptoms are also present in the course of other rheumatic diseases. Neuropsychiatric symptoms may affect up to 80% of patients with primary Sjogren's syndrome, with 50% to 80% ahead of diagnosis. It has been proven that systemic slcerosis causes microvascular damage, which may cause neuropsychiatric symptoms in the form of mood disorders, anxiety and cognitive disorders. In one study, 59% of patients with fibromyalgia experienced mania, which was more than twice as high as in the control group.&#x0D; Summary: In the course of all rheumatic diseases presented by us, there are symptoms and mental disorders. They are often mood, cognitive and sleep disturbances. It should be emphasized that the etiology of psychiatric symptoms is multifactorial.

OCULAR MANIFESTATIONS OF RHEUMATIC DISEASES: A HOSPITAL-BASED STUDY

Background: Ocular manifestations in rheumatic diseases may result from the inflammatory process because of immune- mediated ocular inflammation which causes severe debilitation and visual loss. Therefore, by understanding the various ocular presentations of these systemic inflammatory diseases is vital to arrive expeditiously at the correct diagnosis and treatment plan with the goal of preserving visual function. Methods: A cross sectional study was done on patients over a period from June 2019 to March 2021. A total of 100 patients with rheumatic disease were investigated for any ocular manifestations after obtaining informed written consent. ACR (American College of Rheumatology) criteria was used for the diagnosis of Rheumatic Diseases. Ocular investigation for dry eye included Schirmer's test and Tear film breaks up time test (TBUT). Positivity for Immunological factors and their association to ocular manifestations statistically analysed. Results: The overall incidence of ocular manifestations of the rheumatic disease process in the study was 65%. Uveitis incidence was 35%, being the commonest ocular abnormality detected followed by KCS of 20%. The total number of cases with ANA positivity in Rheumatic disease is 20, those with ocular manifestations and ANA positivity is 16 out of 20 (80%). Six (50%) of the twelve patients with Keratoconjunctivitis sicca had high Rheumatoid factor titre values by slide agglutination or Anti Citrullinated peptide Antibody positive Conclusion: Therefore, following a multidisciplinary approach by ophthalmologists, rheumatologists, physicians, and paediatrician would help for an early intervention to preserve vision where possible.

The problem of long-term pain control in chronic rheumatic diseases

Pain is one of the main symptoms and the most distressing manifestation of rheumatic diseases (RD). Currently, non-steroidal anti-inflammatory drugs (NSAIDs) are widely used for the symptomatic treatment of RD in real clinical practice, but the effectiveness and tolerability of their longterm use remain insufficiently studied. Many patients with RD require long-term use of NSAIDs. In this case, the presence of comorbid pathology and risk factors for the development of drug complications should be taken into consideration, so the choice of NSAIDs should be based primarily on considerations of patient safety. Aceclofenac (Aertal®) has a pronounced analgesic potential and a good safety profile, which allows us to recommend it for long-term use.

Scleroderma – Lupus Erythematosus Overlap or Lupoderma: Reporting an Uncommon Association

Overlap syndromes are distinct entities with manifestations of rheumatic diseases in a patient that are not restricted to a particular disease. Rheumatoid arthritis, systemic lupus erythematosus (SLE), scleroderma, Sjogren's syndrome, and idiopathic inflammatory myositis (IIM) are definite connective tissue diseases that can have symptoms with significant overlap. If the clinical, biochemical, and serological parameters do not fulfill the criteria of any of the four diseases, it is termed as undifferentiated connective tissue disease. On the contrary, mixed connective tissue disease is a distinct clinical entity with specific parameters and positive U1RNP titers. Although scleroderma and SLE have their overlap profiles with other inflammatory rheumatic conditions, overlap with IIMs has been the commonest co-association in both the conditions. SLE-scleroderma overlap has been infrequently reported in the literature and can be considered as the rarest overlap as far as prevalence is concerned. We report a case of SLE-scleroderma overlap in a 21-year-old female along with discussing various aspects of the manifestations and complications of the overlap along with the challenges faced by the clinician in managing this relatively rare entity.

Dermatological manifestations of rheumatic diseases

<h3></h3> В обзоре подробно рассмотрены кожные изменения и изменения придатков кожи при ревматической лихорадке, ревматоидном артрите, больших коллагенозах — системной красной волчанке, узелковом периартериите, системном склерозе, дерматомиозите, системных васкулитах, саркоидозе, подагре и других, более редко встречающихся ревматических заболеваниях. Кожные проявления при ревматических заболеваниях, такие как ревматические узелки, кольцевидная эритема, узловатая эритема и др., могут быть первыми проявлениями, а также показателем активности заболевания. Ведущим клиническим проявлением ревматических заболеваний является суставной синдром, но именно внесуставные проявления, такие как поражение кожи, ногтей, волос, слизистых оболочек, глаз, могут свидетельствовать о генерализованной воспалительной реакции. Кожный васкулит может быть внесуставным проявлением, обусловленным повреждением цитокинами и аутоантителами эндотелиальной стенки сосудов в активную фазу воспаления. Ревматические заболевания, как правило, характеризуются дебютом в молодом возрасте, системностью поражения, хроническим, неуклонно прогрессирующим течением, ранней инвалидизацией и развитием жизнеугрожающих осложнений. В этой связи целью междисциплинарного взаимодействия между дерматологами, ревматологами и терапевтами, является повышение эффективности диагностики и лечения больных с такой патологией, является особенно актуальным.

Modern insights into ophthalmic manifestations of rheumatic diseases

This literature review is devoted to the analysis of modern insights into ophthalmological manifestations (according to the data of foreign scientific literature in the PubMed system for 20172020) of the most common rheumatic diseases (rheumatoid arthritis, ankylosing spondylitis, systemic lupus erythematosus, systemic scleroderma, systemic vasculitis), which are characterized by damage to all structures of the eye and its adnexa: eyelids, orbital tissues, eyeball tunics, vessels, optic nerve and vitreous. Ocular lesion may be an onset, one of the diagnostic signs, or a biomarker of underlying medical condition.

Ураження нирок при деяких ревматичних хворобах

Ревматичні хвороби з вісцеральними проявами, зокрема з ураженням нирок, або формування ниркових ускладнень в разі ізольованих кісткових, м’язових або суглобових проявів ревматичної хвороби становлять потенційну загрозу як перебігу хвороби, так і її прогнозу. Гломерулярні імунозапальні хвороби виникають у випадках, коли ревматична хвороба наближається за своїм перебігом до системного запального процесу; АА-амілоїдоз — у випадках тривалого активного суглобового процесу; тубулоінтерстиціальні ураження — при лікуванні нестероїдними протизапальними препаратами та аналгетиками. Прогресуючий характер уражень нирок при ревматичних хворобах у напрямку ниркової недостатності та розвиток термінальної її стадії становлять проблему для індивідуума щодо життєдіяльності в умовах замісної ниркової терапії.