Ruxandra Ionescu

• MD, PhD
• Head of Department at Carol Davila University of Medicine and Pharmacy

Background: Intra-articular hyaluronic acid (IAHA) products are often used in the treatment of adults with mild-to-moderate knee osteoarthritis (KOA). The International Symposium on Intra-Articular Treatment (ISIAT) convened a multidisciplinary technical expert panel to define characteristics for an innovative IAHA product that should answer unmet...

Background The deficiency of adenosine deaminase 2 (DADA2) is an autosomal recessively inherited disease resulting from loss‐of‐function mutations in ADA2, formerly named CECR1 (cat eye syndrome chromosome region, candidate 1) gene. Disease manifestations could be separated into three major phenotypes: inflammatory/vascular, immune dysregulatory, a...

Extraglandular manifestations (EGMs) in primary Sjogren’s syndrome (pSS) represent the clinical expression of the systemic involvement in this disease. EGMs are characterized by a wide heterogeneity; virtually any organ or system can be affected, with various degrees of dysfunction. The existing gaps of knowledge in this complex domain of extraglan...

Background The significance of anti-Ro antibodies in systemic sclerosis (SSc) is still unclear as their presence could represent an epiphenomenon of the strong immune response in severe visceral involvement or directly participate in tissue damages in SSc patients. Recent data suggest that the presence of anti-SSA/Ro antibodies is an independent ri...

Background In systemic sclerosis (SSc), a specific nailfold videocapillaroscopy (NVC) pattern is observed in 90% of cases and seems to be associated with severity and progression of the disease. Data about SSc patients with normal/nonspecific NVC are scarce [1]. Objectives This study aims to investigate the clinical and immunologic characteristics...

Background: Primary Sjögren syndrome (pSS) is a multisystem disorder of autoimmune etiology, frequently involving peripheral nerves. Early detection of peripheral neuropathy (PN) manifestations might improve prognosis and disease control. The purpose of the study was to evaluate the predictive potential of hematological and immunological parameter...

Background Several studies described the cross-sectional characteristics of systemic sclerosis patients and coexisting primary biliary cholangitis, but longitudinal prognostic data are lacking. Aims To describe the systemic sclerosis–primary biliary cholangitis phenotype, including baseline characteristics and outcomes. Methods We performed a mul...

Cutaneous disease is one of the most frequent manifestations of systemic lupus erythematosus (SLE), being classified as LE-specific and LE-nonspecific. LE-specific skin lesions are divided into acute cutaneous lupus erythematosus (ACLE), subacute cutaneous lupus erythematosus (SCLE) and chronic cutaneous lupus erythematosus (CCLE). The association...

Background Early stage of osteoarthritis (OA) is characterized by joint stiffness and pain as well as by subclinical structural changes that may affect cartilage, synovium, and bone. At the moment, the lack of a validated definition of early osteoarthritis (EOA) does not allow to make an early diagnosis and adopt a therapeutic strategy to slow dise...

Objective To investigate the distribution of patient-reported outcomes (PROs) in axial spondyloarthritis (axSpA) patients initiating a tumor necrosis factor inhibitor (TNFi), to assess the proportion reaching PRO "remission" across registries and treatment series, and to compare patients registered to fulfill the New York criteria for ankylosing sp...

Although perceived as an adaptative immune disorder, mainly related to Lymphocyte B and T, last years focus on Systemic Lupus Erythematosus (SLE) pathogeny emphasised the important role of innate immunity. This should not take us by surprise since the lupus cell described by Hargraves and colleagues in 1948 was a neutrophil or macrophage with speci...

Interstitial lung diseases (ILD), of which the most well-known is idiopathic pulmonary fibrosis (IPF), are a heterogeneous group of diseases, with similar, inflammatory and/or fibrosing mechanisms, which lead to the rapid decline of lung function and implicitly to a high degree of morbidity and mortality. Besides IPF, other interstitial lung diseas...

Background: The deficiency of adenosine deaminase 2 (DADA2) is an autosomal recessively inherited disease resulting from loss-of-function mutations in ADA2, formerly named CECR1 (cat eye syndrome chromosome region, candidate 1) gene. Disease manifestations could be separated into three major phenotypes: inflammatory/vascular, immune dysregulatory a...

Background: In primary Sjögren’s Syndrome (pSS), cutaneous vasculitis lesions (CVL) are extraglandular manifestations with an important clinical and prognostic impact and their early detection might contribute to the improvement of disease control and even patients’ survival. The aim of this study was to evaluate the predictive potential of hematol...

Systemic Lupus Erythematosus is the hallmark of autoimmune diseases, being characterized by multiple organ involvements and immune abnormalities, amongst which the presence of antiphospholipid antibodies with or without specific clinical manifestations (vascular thromboses and pregnancy morbidities) has a significant impact on the disease course, b...

Objective There is a lack of real‐life studies on interleukin‐17 (IL‐17) inhibition in psoriatic arthritis (PsA). We assessed real‐life 6‐ and 12‐month effectiveness (i.e., retention, remission, low disease activity [LDA], and response rates) of the IL‐17 inhibitor secukinumab in PsA patients overall and across 1) number of prior biologic/targeted...

Nutrition has been identified as playing a significant role in inflammatory rheumatic conditions. Available recommendations for managing these diseases have recently included lifestyle changes as well as dietary advice as complementary to pharmacological treatments. This is a summary of the first dietary recommendations for patients suffering from...

Objectives Many axial spondylarthritis (axSpA) patients receive a conventional synthetic disease-modifying anti-rheumatic drug (csDMARD) in combination with a tumour necrosis factor inhibitor (TNFi). However, the value of this co-therapy remains unclear. The objectives were to describe the characteristics of axSpA patients initiating a first TNFi a...

Objective Current literature indicates a connection between sarcoidosis and malignancy, prompting advanced screening in uncertain cases. Solid pseudopapillary tumors (SPT) of the pancreas are rare entities that can be confirmed by adding imaging results to immunohistochemistry staining. The aim of this article is to describe a rare association of s...

Background and Objectives: The occurrence of rheumatological side effects in a patient after receiving immunotherapy for cancer is becoming increasingly common. Oncologists often fail to diagnose and refer affected patients to rheumatologists. This paper presents the various rheumatological adverse events that occur after immunotherapy in patients...

Impaired fertility is an important public health concern, especially in patients with immune-mediated rheumatic conditions. Frequency of infertility /subfertility vary among rheumatic diseases – higher in systemic lupus erythematosus or rheumatoid arthritis, than in other autoimmune diseases. Risk factors like age, nulliparity, disease activity or...

Objective. The spondyloarthritis group comprises chronic inflammatory conditions that share clinical, genetic and radiographic features. The impact of comorbidities on disease activity is not entirely known. The aim of this study is to identify the frequency and management of comorbidities in SpA patients. Materials and methods. A six-month retrosp...

Dermatomyositis (DM) is a rare autoimmune disorder defined by weakness of the striated muscles and a distinctive skin rash. Dysphagia is a serious symptom that can be difficult to manage, severely impacting quality of life and long-term survival. The aim of this report is to highlight a case of an anti-NXP-2 positive DM with severe dysphagia refrac...

Objectives: To investigate time trends in baseline characteristics and retention, remission and response rates in bio-naïve axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) patients initiating tumour necrosis factor inhibitor (TNFi) treatment. Methods: Prospectively collected data on bio-naïve axSpA and PsA patients from routine car...

Objectives: To investigate time trends in baseline characteristics and retention, remission and response rates in bio-naïve axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) patients initiating tumour necrosis factor inhibitor (TNFi) treatment. Methods: Prospectively collected data on bio-naïve axSpA and PsA patients from routine care i...

Systemic sclerosis is a complex autoimmune disorder marked by heterogeneous clinical manifestations and variable disease course. We present the case of a patient with diffuse cutaneous systemic sclerosis with anti-PM/Scl antibodies and associated calcinosis cutis. Currently, there is no uniformly effective therapy for calcinosis, but in the present...

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease, characterized by multiorgan involvement, most commonly targeting the skin, joints and kidneys. Late-onset disease occurs in patients over the age of 50 and represents a diagnostic challenge, as it is less frequently encountered and it may exhibit a more unusual clinical and paracli...

Background: No fully validated index is available for assessing overall disease activity in systemic sclerosis (SSc). Objectives: To estimate the effect of disease activity as measured by different disease activity indices on the risk of subsequent organ damage. Methods: The European Systemic sclerosis study group activity index (EScSG AI), th...

Immunotherapy has revolutionized cancer treatment. Immune checkpoint inhibitors (ICIs) including antibodies targeting cytotoxic T lymphocyte associated antigen-4 and programmed cell death 1 have been shown to be effective in the treatment of certain types of cancer. The benefit of these therapies is to prolong life expectancy in the case of metasta...

Systemic sclerosis is a chronic autoimmune disorder characterized by multiorgan involvement, most notably of the skin through fibrosis and vasculopathy. One of its most feared complications requiring rapid intervention is scleroderma renal crisis, as it can be fatal in the absence of prompt treatment. A 34-year old woman presents with a history of...

Introduction. Treat-to-target concept in spondyloarthritis (SpA) is a highly disputed subject. Up to the present, there is no evaluation score that integrates the clinical and laboratory/imaging results for defining remission in SpA. This issue generates the need of identifying predictive factors of remission in SpA patients. Aim. The aim of this s...

Introduction. The low overall prevalence of systemic sclerosis (SSc) and the low proportion of male patients have resulted in a scarcity of studies assessing sex differences in SSc patients, and contradictory results have often been observed. Material and method. We performed a retrospective observational study using data extract from the EULAR scl...

Background Comedication with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) during treatment with tumour necrosis factor inhibitors (TNFi) is extensively used in psoriatic arthritis (PsA), although the additive benefit remains unclear. We aimed to compare treatment outcomes in patients with PsA treated with TNFi and csDMARD...

Eosinophilic fasciitis is a rare disorder of unknown etiology and poorly understood pathogenesis. It may be triggered by excessive exercise, physical factors such as radiation therapy, exposure to certain medications, infections, the initiation of hemodialysis and some other medical conditions. Skin modifications appear with collagenous thickening...

Rheumatoid arthritis (RA) is the most encountered chronic inflammatory rheumatic condition with a predominance in middle-aged women. If inadequately controlled and in the presence of risk factors, RA can lead to complications such as septic arthritis. The case presentation displays a 55-year-old female patient with a long history of RA that develop...

Objectives. The purpose of this paper is to assess the frequency of ultrasonography detected enthesitis in spondyloarthritis (SpA) patients as well as it’s correlation to reported pain and disease activity. Methods. 80 SpA patients were evaluated clinically (medical history, clinical examination, inflammatory markers, clinical and composite indices...

Objective. To evaluate sexual function in a cohort of men with rheumatic disease compared to healthy controls. Patients and methods. The study included 60 patients (ankylosing spondylitis, rheumatoid arthritis, systemic sclerosis, gout, psoriatic arthritis) and 60 healthy age-matched controls. Sexual function of patients and controls was evaluated...

Objective. In this study, we aim to evaluate the frequency of enthesitis in psoriatic arthritis (PsA), using musculoskeletal ultrasonography (MSUS) and to determine to what extent it is correlated to clinical spontanous or provoked pain, disease activity and biologic inflammatory markers. Methods. 320 entheses, belonging to 20 PsA patients, were ev...

SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) is responsible for the current pandemic, causing so far over 100.000 cases and more than 4500 deaths in Romania. Clinical manifestations are variable, ranging from mild forms (fever, dry cough, dyspnea, tachypnea, asthenia, myalgia) to severe bilateral pneumonia (COVID-19). Generally, pat...

Primary Sjögren’s syndrome (pSS) includes a rarer subtype with positive anti-centromere antibodies, which appears to be linked with scleroderma features and at higher risk of developing lymphoma. Two female patients were evaluated in our department for severe dryness of the mouth and eyes. The younger history of recurrent corneal ulcers. They both...

Objectives: To explore 6-month and 12-month secukinumab effectiveness in patients with axial spondyloarthritis (axSpA) overall, as well as across (1) number of previous biologic/targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs), (2) time since diagnosis and (3) different European registries. Methods: Real-life data from 13 Eu...

The Romanian Register of Rheumatic Diseases (RRBR, in Romanian) is an electronic database which includes data regarding all patients with immune-mediated rheumatic diseases who receive biologic therapies. These real-life data include: demographics, clinical disease forms, comorbidities, treatment regimens with biologic disease-modifying anti-rheuma...

Introduction. Rheumatoid arthritis (RA) patients have poor quality of life due to inflammation and joint destruction that characterizes the disease. Osteoporosis, through the fragile osteoporotic fractures as a complication, also associates an important decrease in the quality of life. Knowledge of the impact of osteoporosis on quality of life in p...

Availability of biosimilar medicines is rapidly increasing, potentially leading to a wider prescription and a support for healthcare system costs. Despite efforts of patient and physician educational initiatives there still remains a reluctance in prescribing or administering this type of products. A multi-centric survey was conducted on 336 patien...

Systemic lupus erythematosus (SLE) is one of the most heterogeneous autoimmune disease that can virtually affect any organ, characterized by different course of evolution and being associated with increased morbidity due to activity, that can also contribute to chronic damage. It is imperative to have a good monitoring schedule according to differe...

The Romanian Registry of Rheumatic Diseases (RRBR, in Romanian) is an electronic application that includesdata of all patients with inflammatory rheumatic diseases treated with biologics in Romania. First patients with axial spondyloarthritis (axSpA) were included in 2015 and the registry collected multiple variables like demographics,axSpA therapi...

Objectives: To assess the impact of 'patient's minus evaluator's global assessment of disease activity' (ΔPEG) at treatment initiation on retention and remission rates of TNF inhibitors (TNFi) in psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) patients across Europe. Methods: Real-life data from PsA and axSpA patients starting thei...

"Introduction. Primary Sjogren's syndrome (pSSj) is a chronic, autoimmune disease that predominantly affects the lacrimal and salivary glands but is also responsible for extra-glandular disturbances. Although rare, optic neuritis (ON) may appear as initial manifestation and may be responsible for visual loss if diagnosis is delayed. The aim of the...

Background In this work, we aimed to establish a clinical target in the management of knee osteoarthritis (KOA) and to propose good clinical practice (GCP) statements for carrying out a treat-to-target strategy. Methods A steering committee of seven experts had formulated a provisional set of recommendations that were exposed for discussion and mo...

Total joint arthroplasty (TJA) including total hip arthroplasty (THA) and total knee arthroplasty (TKA) are performed for patients with primary osteoarthritis (OA). Also, there are patients who undergo TJA for management of inflammatory arthritis (IA), including patients with rheumatoid arthritis (RA), Spondyloarthritis (SPA) including ankylosing s...

Objective: To investigate TNF inhibitor (TNFi) retention and response rates in European biologic-naïve patients with PsA. Methods: Prospectively collected data on PsA patients in routine care from 12 European registries were pooled. Heterogeneity in baseline characteristics between registries were explored (analysis of variance and pairwise comp...

Objective: The study aims to compare the efficacy and safety of biosimilar etanercept (SB4) to original etanercept (ETN) in a real-life national cohort of rheumatoid arthritis (RA). Methods: Data from RA patients were retrieved electronically from the Romanian Registry of Rheumatic Diseases (RRBR), which contains all patients receiving biologics...

We present the case of a 34-year-old male who suddenly experienced upper right quadrant abdominal pain of medium-high intensity that radiated towards his right lumbar area and right testicle, accompanied by nausea and vomiting. His personal history was significant for having an eye prosthesis implanted when he was three years old, due to structural...

Systemic lupus erythematosus is a chronic and multi­sys­te­mic autoimmune disease that can occur in members of the same family. Genetic factors are still unidentified and not all relatives with these risk factors are predestined to develop the disease, but are more likely (1) . Relatives of sys­temic lupus erythematosus (SLE) patients appear to be...

Objective To study drug retention and response rates in patients with axial spondyloarthritis (axSpA) initiating a first tumour necrosis factor inhibitor (TNFi). Methods Data from 12 European registries, prospectively collected in routine care, were pooled. TNFi retention rates (Kaplan-Meier statistics), Ankylosing Spondylitis Disease Activity Sco...

Background Tumour necrosis factor inhibitors (TNFi) are efficacious in patients with axial spondyloarthritis (axSpA), but some patients switch to a different TNFi because of adverse effects (AE) or lack of effect (LOE). The EuroSpA Collaboration has previously demonstrated a 1-year retention rate of 79% and 6 months LUNDEX adjusted BASDAI<4 of 59%¹...

Background Accompanying the increased use of biological and non-biological antirheumatic drugs, a greater number of cases of hepatitis B virus (HBV) reactivation have been reported in inactive hepatitis B surface antigen (HBsAg) carriers and also in HBsAg-negative patients (pts) who have resolved HBV infection (1). Romania has a high prevalence for...

Background There is a lack of data on exposure, treatment outcomes and retention rates of secukinumab in patients with psoriatic arthritis (PsA) treated in routine care. Objectives Primary objective: To assess the proportion of PsA patients in remission after 6 months of secukinumab treatment across Europe. Secondary objectives: To compare baselin...

Background There is a lack of real-life data on secukinumab exposure, treatment outcomes and retention rates in axial spondyloarthritis (axSpA) patients. Objectives Primary objective: To assess the proportion of axSpA patients in BASDAI low disease activity (<4) and ASDAS inactive disease (<1.3) after 6 months of secukinumab treatment across Europ...

Background Discordance between baseline patient’s and evaluator’s global assessment of disease activity is common¹ and may reduce the likelihood of remission following tumor necrosis factor inhibitor (TNFi) treatment in patients with psoriatic arthritis (PsA).² However, the impact of such discordance on retention rates of TNFi in PsA patients remai...

Background Currently there is no fully validated index for assessing overall disease activity in patients with systemic sclerosis (SSc). Objectives To estimate the effect of disease activity as measured by 4 disease activity indices on the risk of subsequent organ damage in a EUSTAR center cohort. Methods Longitudinal observational study; Europea...

Background Discordance between baseline patient’s and evaluator’s global assessment of disease activity is common.¹ However, the impact of such discordance on retention and remission rates of TNF inhibitor (TNFi) therapy in axial spondyloarthritis (axSpA) patients remains unexplored. Objectives To assess the impact of baseline discordance, defined...

Background The efficacy of Tumour Necrosis Factor inhibitor (TNFi) in patients with psoriatic arthritis (PsA) has been investigated in randomized controlled trials (RCTs) with strict inclusion and exclusion criteria. Patients treated in routine care are more heterogeneous and only ≈20-30% of patients receiving TNFi in routine care would have been e...

Background The usefulness of capillaroscopy in the follow-up of scleroderma (SSc) patients and the possible prognostic role for the appearance of visceral involvement is suggested by many authors but still under debate. Objectives The aim of this study was to assess the role of monitoring capillaroscopic abnormalities (qualitative and semiquantita...

Background The efficacy of Tumour Necrosis Factor Inhibitor (TNFi) in patients with axial spondyloarthritis (axSpA) has been investigated in randomized controlled trials (RCTs) with strict inclusion and exclusion criteria. Patients treated in routine care are more heterogeneous and only ≈20-30% of patients receiving TNFi in routine care would have...

Background Rheumatoid arthritis (RA) is associated with increased mortality, with longitudinal studies averaging a standardised mortality ratio of 1.5 (95%CI 1.2 to 1.8) for RA patients compared to the general population [1]. In contrast, information on mortality in ankylosing spondylitis (AS) is scarce, whereas there are conflicting reports of the...

Background Biosimilars are highly similar to original biological medicines¹.Worldwide prescription of biosimilars is still low because of the lack of understanding in manufacturing and approval process together with mistrust in the extrapolation of indication in clinical use².Lack of biosimilar awareness throughout rheumatic patients results in an...

Background Tumour necrosis factor inhibitors (TNFi) are efficacious in patients with psoriatic arthritis (PsA), but some patients switch to a different TNFi because of adverse events (AE) or lack of effect (LOE). The EuroSpA Collaboration has previously demonstrated a 1-year retention rate of 77% and 6 months LUNDEX adjusted 28-joint count Disease...

Cardiovascular risk assessment in patients with rheumatoid arthritis (RA) is challenging. Not all risk calculators adjust for RA status, yielding discording results. A 56-year-old woman with RA presented for bilateral pain and swelling in the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints. She was diagnosed with RA 10 years ago...

Spondyloarthritis (SpA) is a group of associated chronic systemic inflammatory immune-mediated rheumatic diseases affecting axial and peripheral joints and entheses. The aim of the present study was to identify what parameters are useful to determine in order to better understand the correlation between the disease activity/severity and the microbi...

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by the production of autoantibodies, which deposit within tissues and fix complement leading to systemic inflammation (1). Is a heterogeneous disease with a continuum of disease activity. Some patients can have predominant skin and joint involvement, whereas others can...

Immune checkpoint inhibitors are used with increasing regularity in metastatic disease. Anti-CTLA4 (ipilimumab) anti-PD1 (pembrolizumab, nivolumab) or anti-PD-L1(avelumab, atezolizumab) are approved for use in metastatic melanoma, non-small cell lung cancer, renal cell carcinoma and other malignancies. Despite their advantages, their immune adverse...

Objective. The objective of this initial phase of the study is to retrospectively screen rheumatoid arthritis (RA) phenotype characteristics associated with osteoporosis. Methods. The study included all RA patients who randomly came to the university rheumatology department between January and July 2018. Demographic data, anthropometric data, RA-sp...

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by the production of autoantibodies, which deposit within tissues and fix complement leading to systemic inflammation (1). Is a heterogeneous disease with a continuum of disease activity. Some patients can have predominant skin and joint involvement, whereas others can...

B cell hyper-reactivity implied in the pathogenesis of Sjö gren’s syndrome (SS) justifies the therapy that involves B cell depletion. Ultrasound of salivary glands demonstrated alterations during disease progression. Objective. To evaluate changes in salivary gland parenchyma with ultrasound after rituximab treatment in patients’ with secondary SS...

Autoimmune rheumatic disorders have a multifactorial determinism, caused by various environmental factors acting on the individual’s genetic susceptibility, desta­bi­lizing the systems which regulate the immune response. Epi­de­miological and genetic investigations are very im­portant to demonstrate the contribution of genetic fac­tors to the devel...

More than 600.000 people in Romania (3% of the total population), out of which 2000 are children, suffer from inflammatory rheumatic diseases, such as rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis and juvenile idiopathic arthritis. To prevent functional deficits, inflammatory rheumatic diseases must be recognized and correctly t...

Rationale. Clinicians need to have evidence-based information regarding the feasibility of tapering biologics in ankylosing spondylitis (AS). Objective. The study aims to identify significant predictors of tapering in clinical practice. Methods and results. AS patients on their first tumor necrosis factor alpha inhibitor (iTNFα) were enrolled betwe...

We present the case of a 24 year old male who was admitted to Sf. Maria Clinical Hospital’s Internal Medicine and Rheumatology Department having an impressive soft palate destruction and necrotic ulcers of the posterior oropharynx wall and left palatine tonsil, as well as a gigantic skin ulcer on the left calf. His disease started in 2010, at age 1...

Autoimmune rheumatic disorders have a multifactorial determinism, caused by various environmental factors acting on the individual’s genetic susceptibility, destabilizing the systems which regulate the immune response. Epidemiological and genetic investigations are very important to demonstrate the contribution of genetic factors to the development...

Aim: Patients describe rheumatoid arthritis (RA) remission as the absence of any symptoms or return to normality. Residual ultrasound (US) synovitis was frequently described in remission cohorts in previous studies. US tenosynovitis evaluation and scoring seems to better follow clinical remission scores compared with synovitis in RA. Our objective...

Hyperuricemia is frequent in psoriatic arthritis (PsA) and it seems to be related to metabolic syndrome rather than extensive psoriatic skin disease. The objectives of this study were to evaluate the prevalence of hyperuricemia in PsA patients and to identify the associ-ated factors. Design: cross-sectional study, including consecutive, unselected,...

Introduction. Antineutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV) represent a group of conditions evolving with necrotizing inflammation in small and medium-sized blood vessels. AAV are composed of GPA (granulomatosis with polyangiitis, former Wegener’s granulomatosis), MPA (microscopic polyangiitis) and EGPA (eosinophilic granul...

We are presenting the case of a 48 years old female diagnosed at the age of 28 with diffuse cutaneous systemic sclerosis. During the course of disease, despite the vasodilatator treatments and immunosuppresion for visceral involvement, the patient developed multiple infected digital ulcers both in the upper limbs and in the lower limbs, which compl...

Lupus nephritis is one of the most important organ involvement in patients diagnosed with Systemic Lupus Erythematosus (SLE). It requires aggressive and prolonged immunosuppression in order to induce and maintain remission. There is always a risk of adverse events. It is presented the case of a young woman diagnosed with SLE and active lupus nephri...

Background. Behçet’s disease is a rare type of vasculitis. Validated activity and damage scores were developed for vasculitis patients in order to allow a better way to evaluate disease activity and decide treatment plans. Objective. The main objective was to compare two vasculitis activity scores applied to a group of patients diagnosed with Behç...

The aim of this study was to establish consensus for potential early symptomatic knee osteoarthritis (ESKOA) clinical definition and referral criteria from primary care to rheumatologists, based on available data from literature and a qualitative approach, in order to perform studies on patients fulfilling such criteria and to validate the obtained...

The lung is a common site of complications in systemic connective tissue diseases (CTD), and its involvement can present in several ways. Although it is generally thought that interstitial lung disease develops later on in CTD, it is often the initial presentation (“lung dominant” CTD). Interstitial lung disease (ILD) can be present in most types o...