Search

A 45-year-old woman developed progressive multifocal leukoencephalopathy caused by JC virus infection while being treated for amyopathic dermatomyositis with prednisone, methotrexate, hydroxychloroquine, thalidomide, and methylprednisolone. She presented with neurological symptoms and was diagnosed through brain biopsy. Treatment involved discontinuing methylprednisolone and hydroxychloroquine, initiating immune-globulin therapy, and administering mirtazapine, resulting in complete resolution of the infection. [Extracted from the article]

A 51-year-old woman developed lymphoproliferative disorder while being treated with methotrexate and fibrin-associated diffuse large B-cell lymphoma (FA-DLBCL) while on ciclosporin for dermatomyositis. She had a history of dermatomyositis and had experienced two strokes prior to her presentation. After discontinuing methotrexate, her multiple aneurysms disappeared, and she underwent surgery for severe aortic regurgitation and non-infectious endocarditis. The woman was diagnosed with FA-DLBCL, attributed to ciclosporin use, and no recurrence was observed during a 2-year follow-up after surgery. [Extracted from the article]

A retrospective study in India involving 10 patients with sporadic inclusion body myositis (sIBM) reported a case of lack of efficacy in a patient receiving methotrexate, rituximab, and steroids for treatment. The patient, who also had rheumatoid arthritis, remained bed-bound despite the treatment, indicating the ineffectiveness of the medications. This case highlights the challenges in managing sIBM and the need for further research into more effective treatment options. [Extracted from the article]

A 51-year-old woman with a history of Ehlers-Danlos syndrome, type 2 diabetes mellitus, hypertension, and hypothyroidism developed myositis during treatment with docetaxel for uterine leiomyosarcoma. She experienced muscle pain, weakness, and swelling after her final cycle of chemotherapy, leading to a diagnosis of acute docetaxel-induced myositis. Treatment with opioid analgesics and high-dose prednisone resulted in gradual improvement of her symptoms, with her muscle enzyme levels returning to normal after three months. [Extracted from the article]

A 73-year-old man developed myositis while being treated with mogamulizumab for sezary syndrome. The onset of myositis occurred 7 weeks after starting mogamulizumab, with elevated creatine kinase levels and evidence of muscle membrane irritability. Discontinuation of mogamulizumab, treatment with steroids, and immune-globulin resulted in some improvement in symptoms, but dysphagia and elevated CK levels persisted. [Extracted from the article]

An 83-year-old man developed fulminant myositis while being treated with durvalumab for cholangiocarcinoma. After two cycles of durvalumab, he experienced myalgia, muscle weakness, and elevated serum creatine kinase levels. Diagnostic tests confirmed the diagnosis of fulminant myositis secondary to durvalumab, and the man was successfully treated with steroid pulse therapy, leading to the normalization of his serum CK levels and improvement in muscle weakness. [Extracted from the article]

A 69-year-old woman developed myositis and myasthenia gravis while being treated with cemiplimab for squamous cell carcinoma of the skin. Despite receiving immune-globulin therapy for these conditions, she experienced a lack of efficacy and her condition continued to deteriorate. After undergoing various treatments, including thymoma resection, plasma exchange, IV immune-globulin, and prednisone, she finally showed significant improvement with rituximab and was able to perform daily living activities independently after three months. [Extracted from the article]

A man in his 30s developed myositis while being treated with carbimazole for Graves disease. Initially diagnosed with thyrotoxic periodic paralysis, he later experienced severe muscle cramps and myalgia, leading to a diagnosis of carbimazole-induced myositis. Treatment with carbimazole was stopped, and propylthiouracil was initiated, resulting in symptom improvement and normal levels of creatine kinase. After 6 months, occasional muscle cramps persisted, but myalgia progressively improved over 24 months on propylthiouracil. [Extracted from the article]

A 60-year-old woman developed myasthenia gravis, myositis, hepatitis, and myocarditis while being treated with pembrolizumab for clear cell renal cell carcinoma stage-III. She experienced symptoms such as weakness, diplopia, ptosis, chest pain, and dyspnea one month after starting pembrolizumab. The woman received treatment with methylprednisolone and was monitored in the intensive care unit. Her symptoms and laboratory abnormalities gradually improved, and she was discharged from the hospital. Further evaluation showed positive anti-acetylcholine receptor antibodies and other positive test results. She was then started on treatment with pyridostigmine and efgartigimod. [Extracted from the article]

A 64-year-old man developed myasthenia gravis, myocarditis, and myositis while being treated with nivolumab for gastric adenocarcinoma. He experienced symptoms such as muscle weakness, dyspnea, and diplopia. The patient received plasma exchange, methylprednisolone, and IV immune-globulin as treatment. He did not require intubation and remained stable with normal pharyngeal function. [Extracted from the article]

A 72-year-old man developed myositis while being treated with pembrolizumab for prostate cancer and renal cell carcinoma. He also experienced lack of efficacy during treatment with immune-globulin, methylprednisolone, and prednisone for myositis-induced respiratory failure. The man had a history of prostate cancer, renal cell carcinoma, and nephrectomy. He was admitted to the hospital with symptoms including diarrhea, abdominal pain, nausea, vomiting, and weakness. His condition worsened, leading to respiratory distress and the need for intubation. Despite receiving various treatments, including plasmapheresis, his respiratory status remained poor. Some improvement was noted after long-term acute care. [Extracted from the article]

A 45-year-old woman with metastatic breast cancer developed orbital myositis while receiving treatment with pembrolizumab. She experienced cloudy vision and proptosis and was diagnosed with orbital myositis caused by pembrolizumab based on imaging and clinical findings. Despite treatment with steroids and plasma exchange therapy, her myositis progressed and she eventually developed bilateral optic neuropathy, leading to her death two weeks after presentation. [Extracted from the article]

A case report published in Reactions Weekly describes a 53-year-old woman with dysferlinopathy who exhibited lack of efficacy during treatment with methylprednisolone. The woman had a history of progressive muscle weakness and myalgia for 10 years and had recently become a wheelchair user. After starting treatment with methylprednisolone, she did not experience any improvement in symptoms. However, after being switched to immune-globulin treatment and mycophenolate-mofetil, her muscle strength gradually began to recover and her CK level returned to normal. [Extracted from the article]

A retrospective study was conducted on 76 patients between September 2018 and December 2023. The study described a patient who developed grade 2 myositis while being treated with IV camrelizumab for hepatocellular carcinoma (HCC). The patient also showed a lack of efficacy during treatment with epirubicin and gelatin. The age, sex, dosages, routes of administration, duration of treatment, and outcome were not provided in the study. [Extracted from the article]

A 50-year-old man developed orbital myositis after receiving botulinum-Toxin-A injections for wrinkles around his eyes. Three weeks after the injection, he experienced severe swelling and discomfort in his right eyelid. He was initially treated for orbital cellulitis but was later diagnosed with orbital myositis caused by the botulinum-Toxin-A. Treatment with methylprednisolone and prednisone resolved his symptoms, although he experienced a similar reaction after another injection of botulinum-Toxin-A. [Extracted from the article]

A study involving data from the European Medicine Agency's Eudravigilance database identified 10 patients who experienced various toxicities while being treated with cemiplimab, avelumab, or durvalumab. The toxicities included peripheral neuropathy, seizure, Guillain-Barre syndrome, encephalopathy, hypoaesthesia, myositis, polyneuropathy, autoimmune encephalitis, and memory impairment. The study did not provide specific information about the patients' ages, sexes, indications for treatment, routes of administration, dosages, duration of treatment, or outcomes. [Extracted from the article]

This article from Reactions Weekly describes two case reports of women aged 65-74 who developed anti-HMG-COA reductase antibody-associated immune-mediated necrotising myopathy while taking atorvastatin for hypercholesterolemia. Patient A experienced muscular symptoms and elevated creatine kinase levels after 5-6 years of atorvastatin use. Patient B also developed muscular symptoms after a similar duration of atorvastatin use. Both patients had strongly positive HMGCR antibodies. Atorvastatin was discontinued in both cases, and additional treatments such as glucocorticoids, immunoglobulins, and methotrexate were administered. The article suggests that the immune-mediated necrotising myopathy was a result of atorvastatin use. [Extracted from the article]

A 47-year-old woman with triple-negative breast cancer developed myasthenia-myositis-myocarditis overlap while receiving pembrolizumab treatment. She also experienced lack of efficacy with immune-globulin, neostigmine, and methylprednisolone for myasthenia gravis and myositis. The patient's condition worsened and she required parenteral feeding, but after starting treatment with eculizumab, her condition rapidly improved. She was discharged with a reduced medication dose and regained her ability to walk without support. The case was concluded as myasthenia-myositis-myocarditis overlap secondary to pembrolizumab. [Extracted from the article]

A 69-year-old woman with chronic lymphatic leukemia (CLL) experienced dermal side effects while being treated with ibrutinib. She also developed transient, self-limiting antibody-negative myositis during treatment with venetoclax. The woman had a history of various medical conditions and had previously received other treatments for CLL. The myositis resolved spontaneously, and it was suspected to be a result of venetoclax. [Extracted from the article]

This article presents two case reports of women aged 75 who developed immune-mediated neurological disorders while undergoing treatment for metastatic melanoma or non-small cell lung cancer. The first patient experienced symptoms such as double vision, fatigue, and weakness after receiving ipilimumab/nivolumab treatment. Despite receiving glucocorticoid and immune-globulin treatment, her condition worsened and she eventually died. The second patient developed ataxia and later experienced muscle weakness and difficulty walking after receiving pembrolizumab treatment. She was diagnosed with cerebellitis and longitudinal transverse myelitis, but her condition stabilized after receiving rituximab treatment. [Extracted from the article]

A case report published in Reactions Weekly describes a man who exhibited lack of efficacy during treatment with methotrexate and prednisolone for NXP-2 positive dermatomyositis. The man initially developed a rash and myalgias in his lower legs after being bitten by an unknown insect, which then spread to other areas of his body. Despite treatment with prednisolone and methotrexate, his dysphagia continued to progress. As a result, rituximab was initiated and a percutaneous endoscopic gastrostomy was implanted. [Extracted from the article]

A study conducted from September 2020 to December 2021 describes 41 patients, including 40 women and 1 man aged 30-84 years, who developed retinopathy while being treated with hydroxychloroquine for various conditions such as Sjogren syndrome, rheumatoid arthritis, and systemic lupus erythematosus. The patients started receiving doses of hydroxychloroquine ranging from 3.64-19.05 mg/kg. Visual tests showed low vision, and imaging tests revealed retinal pigment epithelium changes. The study confirms that retinopathy secondary to hydroxychloroquine occurred in all patients. [Extracted from the article]

A 59-year-old man with lung adenocarcinoma and multiple brain metastases developed cholangitis and myositis while being treated with pembrolizumab. He also experienced lack of efficacy with azathioprine, cisplatin, and pemetrexed. The patient initially presented with visual field loss and received pembrolizumab, cisplatin, and pemetrexed. He later developed pain in his thigh and lumbar region, which was diagnosed as pembrolizumab-related myositis. Treatment with prednisolone improved his symptoms, but he subsequently developed epigastric pain and was diagnosed with pembrolizumab-related cholangitis. Despite treatment modifications, his condition did not improve, and he eventually died due to lung cancer progression. Autopsy findings confirmed the presence of myositis and sclerosing cholangitis. [Extracted from the article]

A 26-year-old woman with a history of depression experienced a lack of efficacy during treatment with methylprednisolone for hypoxic ischaemic encephalopathy. She had been found unconscious due to carbon monoxide exposure and received hyperbaric oxygen treatment, resulting in neurological recovery. However, she later developed neurological disturbances and was diagnosed with hypoxic ischaemic encephalopathy. Treatment with methylprednisolone did not improve her condition, but after undergoing twenty sessions of hyperbaric oxygen treatment, she experienced progressive improvement in her symptoms and was able to mobilize independently. [Extracted from the article]

A 72-year-old man with renal cell carcinoma developed immune-mediated myositis and respiratory failure while being treated with pembrolizumab. He also experienced lack of efficacy with immune globulin and prednisone. The patient presented with abdominal pain and diarrhea, followed by vocal cord paralysis, muscle weakness, and acute respiratory failure. After receiving plasmapheresis and steroids, he showed significant improvement and was successfully weaned off the ventilator. This case highlights the potential side effects and treatment challenges associated with pembrolizumab therapy. [Extracted from the article]

A 71-year-old woman with a history of Sjogren syndrome and oral lichen planus developed drug-induced subacute cutaneous lupus erythematosus (SCLE) and experienced poorly tolerated side effects, such as nausea and hair loss, while being treated with methotrexate, prednisolone, and terbinafine. She also did not respond well to hydroxychloroquine and prednisolone for SCLE. After discontinuing these medications, she was treated with off-label oral upadacitinib, which resulted in a significant improvement in her symptoms. She discontinued upadacitinib after 5 months without relapse and remained stable. [Extracted from the article]

This article from Reactions Weekly describes two case studies of girls aged 9-16 who experienced lack of efficacy with various drugs while being treated for orbital myositis. In the first case, a 16-year-old girl had refractory symptoms despite receiving unspecified corticosteroids and methotrexate. She eventually found relief with infliximab, but experienced a flare when switched to mycophenolate mofetil. In the second case, a 9-year-old girl had recurrent symptoms despite treatment with triamcinolone, methotrexate, and unspecified corticosteroids. She achieved disease-free status after starting infliximab treatment. [Extracted from the article]

A 73-year-old man developed myasthenia gravis (MG) and myositis while being treated with pembrolizumab for high-grade undifferentiated pleiomorphic sarcoma. He was hospitalized after experiencing worsening ptosis and was found to be seronegative for MG. The man received treatment for his symptoms and his pembrolizumab treatment was stopped. His neurologic symptoms improved significantly. [Extracted from the article]

A 41-year-old man with antisynthetase syndrome experienced cytokine release syndrome while being treated with MB-CART19.1. He also showed a lack of efficacy with prednisolone, rituximab, and cyclophosphamide. The man had various symptoms of antisynthetase syndrome, including muscle inflammation, interstitial lung disease, and raynaud's syndrome. Despite receiving multiple treatments, his condition did not improve until he was treated with paracetamol and tocilizumab for cytokine release syndrome. [Extracted from the article]

In a retrospective chart review study, a 9-year-old boy with Anti-HMG Coenzyme A reductase antibody myopathy was found to have a lack of efficacy during treatment with immune-globulin. The boy had a history of muscle weakness and high levels of anti-HMGCR antibodies. He initially showed improvement with immune-globulin treatment, but after 2 years, his creatine kinase levels remained elevated. He then started receiving treatment with methotrexate and showed improvement in muscle strength. After 11 years, his condition had improved, and he was able to participate in soccer with mild fatigue. [Extracted from the article]

A 76-year-old man developed myasthenia gravis, myocarditis, and myositis while being treated with ipilimumab and nivolumab for melanoma. He later experienced a lack of efficacy with heparin, adenosine, amiodarone, lidocaine, and procainamide for his myocarditis and myositis. The man had a history of coronary artery disease and other medical conditions. Despite receiving various treatments, his condition worsened, and he ultimately passed away. This case highlights the potential toxicities associated with certain medications and the importance of monitoring patients closely during treatment. [Extracted from the article]

A 79-year-old man developed myositis, myasthenia gravis (MG), and myocarditis (triple M syndrome) while being treated with pembrolizumab for stage IV nonsmall cell lung cancer. He experienced worsening dyspnea and physical examination revealed right ptosis. Further tests showed elevated troponin-I and creatine kinase levels, as well as ECG abnormalities. The patient was admitted to the ICU and received treatment for myocarditis and MG. He was discharged on a methylprednisolone taper and remained stable. The case was reported as an instance of pembrolizumab-induced triple M syndrome, which resulted in third-degree atrioventricular block, left bundle branch block, and complete heart block. [Extracted from the article]

A 43-year-old man with anti-MDA5-dermatomyositis associated rapidly progressive interstitial lung disease (RP-ILD) and Pneumocystis jirovecii infection exhibited lack of efficacy during treatment with immune-globulin, methotrexate, methylprednisolone, and prednisone. Despite being on treatment, his respiratory condition rapidly deteriorated, and he ultimately required a lung transplant, but unfortunately died before the transplant could take place. This case highlights the challenges in managing RP-ILD and the need for further research to improve treatment outcomes. [Extracted from the article]

A 68-year-old man developed myasthenia gravis, myositis, and multi-organ failure while being treated with avelumab for urothelial carcinoma of the renal pelvis. The man had undergone surgery and chemotherapy prior to starting maintenance therapy with avelumab. He experienced symptoms such as dysphagia, bilateral ptosis, dysarthria, and general weakness. Laboratory tests and imaging confirmed the diagnosis, and the man was transferred to the intensive care unit for respiratory failure. Treatment with immune-globulin, methylprednisolone, and pyridostigmine resulted in clinical improvement. [Extracted from the article]

A 68-year-old man developed myasthenia gravis, myositis, and multi-organ failure while being treated with avelumab for urothelial carcinoma of the renal pelvis. The man had undergone surgery and chemotherapy prior to starting maintenance therapy with avelumab. He experienced symptoms such as dysphagia, bilateral ptosis, dysarthria, and general weakness. Laboratory tests and imaging confirmed the diagnosis, and the man was transferred to the intensive care unit for respiratory failure. Treatment with immune-globulin, methylprednisolone, and pyridostigmine resulted in clinical improvement. [Extracted from the article]

A 67-year-old man developed immune-related myositis while being treated with pembrolizumab for non-small cell lung cancer. He had a history of smoking and was diagnosed with locally advanced pulmonary sarcomatoid carcinoma. After receiving three cycles of chemotherapy and immunotherapy, his tumor size and lymph nodes significantly reduced. However, he developed grade 3 immune-related myositis after one cycle of adjuvant pembrolizumab therapy. The treatment was discontinued, and the patient experienced muscle weakness but eventually made a full recovery without specific treatment. He is currently in excellent health with no signs of recurrence. [Extracted from the article]

A 67-year-old man developed immune-related myositis while being treated with pembrolizumab for non-small cell lung cancer. He had a history of smoking and was diagnosed with locally advanced pulmonary sarcomatoid carcinoma. After receiving chemotherapy and immunotherapy, his tumor size and lymph nodes significantly reduced. However, he developed grade 3 immune-related myositis after one cycle of adjuvant pembrolizumab therapy. The treatment was discontinued, and the patient experienced muscle weakness but eventually made a full recovery without specific treatment. He is currently in excellent health with no signs of recurrence. [Extracted from the article]

A 78-year-old woman developed diffuse myositis while being treated with pembrolizumab for metastatic colon cancer. She had a history of various medical conditions and was on multiple medications. She presented to the hospital with weakness in her lower limbs and tests showed increased levels of certain enzymes. Imaging and nerve conduction studies confirmed the diagnosis of pembrolizumab-induced diffuse myositis. Treatment with pembrolizumab was stopped and she was given corticosteroids, which resulted in a good response. She was eventually discharged from the hospital for rehabilitation. [Extracted from the article]

An 18-year-old man developed myositis, a condition characterized by muscle inflammation, while undergoing treatment with isotretinoin for nodulocystic acne. The patient had a history of ulcerative colitis and primary sclerosing cholangitis, and presented with acute pain in his calf and buttock. Blood tests revealed elevated levels of certain markers, confirming the diagnosis of myositis. Treatment included discontinuing isotretinoin, administering analgesia and fluids, and starting a course of antibiotics. Prednisolone was also prescribed, leading to significant improvement and resolution of the myositis within two months. [Extracted from the article]

A 62-year-old woman developed myocarditis with myositis/myasthenia gravis overlap syndrome while receiving treatment with pembrolizumab for endometrial adenocarcinoma. After her latest infusion, she experienced dyspnea, fatigue, and lower extremity edema. Laboratory tests indicated myocarditis, and she also exhibited neurological symptoms such as ptosis, dysarthria, and leg weakness. Treatment with steroids, plasma-exchange, and immune-globulin improved her neurological symptoms, but she later developed severe respiratory distress and required a tracheostomy and ventilation. [Extracted from the article]

A 65-year-old man with sarcoidosis experienced a lack of efficacy during treatment with methotrexate. He initially presented with muscle weakness and myalgias, and was diagnosed with sarcoidosis. He was started on high-dose steroids followed by methotrexate, but despite maximal dosing, his CK levels continued to increase. His treatment was switched to azathioprine with minimal effect, and he was subsequently started on anti-tumour necrosis factor therapy in combination with azathioprine, which resulted in normalization of his CK levels and minor improvement in muscle strength. [Extracted from the article]

In a retrospective study, three patients with preexisting type 1 diabetes mellitus and cancer were described. They were treated with immune checkpoint inhibitors for metastatic lung cancer or renal cell carcinoma. The patients developed grade 3 immune-related adverse events, including hepatitis, myositis, and myasthenia gravis, as a result of their treatment with durvalumab, pembrolizumab, or nivolumab. The therapies were discontinued, and the patients were subsequently treated with mycophenolate, immune-globulin, or steroids. [Extracted from the article]

Two patients with acute myeloid leukemia developed skin rash and myositis after receiving treatment with cytarabine/daunorubicin. The symptoms of myositis, including myalgia and immobility, appeared one week after starting the treatment. One patient experienced myalgia after two cycles of treatment, while the other patient experienced it after one cycle. Histological examination revealed leucopenia and thrombopenia. The myositis and skin rash were attributed to cytarabine/daunorubicin. Both patients received opioid therapy for the myalgia, and the myositis resolved after two weeks. [Extracted from the article]

A 58-year-old woman developed anti-MDA5 antibody-positive dermatomyositis with severe necrosis on her limbs after receiving the tozinameran (Pfizer-mRNA-COVID-19 vaccine) for COVID-19. She initially presented with chilblains on her fingers, followed by joint pain and the development of ulcers with necrosis and chilblains. Despite treatment with vasodilators, antiplatelet medications, steroids, and immunosuppressants, her condition did not improve. She was diagnosed with anti-MDA5 antibody-positive dermatomyositis and is currently receiving prednisolone and tacrolimus therapy. [Extracted from the article]

A 64-year-old man developed anti-melanoma differentiation-associated gene 5 (MDA5)-positive pauci-myopathic dermatomyositis, hypothyroidism, and severe diarrhea after receiving pembrolizumab for squamous cell lung cancer. The patient had a history of arterial hypertension and chronic allergic contact dermatitis. He experienced hypothyroidism, dyspnea, exacerbation of eczema, myalgia, and muscle weakness. The diagnosis of anti-MDA5-positive pauci-myopathic dermatomyositis was made, and treatment with pembrolizumab was discontinued. The patient later developed severe diarrhea and hypokalemia, leading to the discontinuation of pembrolizumab again. Overall, the patient's condition improved with treatment. [Extracted from the article]

A 33-year-old man developed a rare condition called myositis-myocarditis-myasthenia gravis overlap syndrome while being treated with nivolumab for stage 4 thymoma. He also experienced steroid-induced acne while taking prednisolone for the syndrome. The man did not respond to pyridostigmine for myasthenic crisis, but his symptoms improved with immune-globulin treatment. However, he had to discontinue prednisolone due to skin lesions, and his treatment was switched to azathioprine for myasthenia gravis. Despite these complications, he continued to receive nivolumab treatment under close monitoring. [Extracted from the article]

A 65-year-old man developed myositis with myocarditis while being treated for metastatic renal cell carcinoma with ipilimumab and nivolumab. He also experienced lack of efficacy during treatment with immune-globulin and unspecified steroids for his condition. Despite receiving hydration, steroids, and IV immune-globulin, his symptoms worsened and he developed respiratory muscle weakness, tachyarrhythmias, and bradyarrhythmias. Unfortunately, he ultimately died due to myositis with myocarditis. [Extracted from the article]

A 36-year-old man developed myositis, a condition characterized by inflammation of the muscles, while being treated with tretinoin for acute promyelocytic leukemia. The patient experienced symptoms such as fever, necrotic ulcers in the oral cavity, and severe pain in his right calf. After discontinuing tretinoin and receiving treatment with dexamethasone, the patient's condition improved and the myositis resolved. Tretinoin was later restarted without any recurrence of myositis. This case report provides details of the patient's medical history, treatment, and outcome. [Extracted from the article]

A 65-year-old man developed myocarditis and myositis while being treated with ipilimumab and nivolumab for metastatic renal cell carcinoma. Despite receiving treatment with immune-globulin, methylprednisolone, and mycophenolate, he experienced a lack of efficacy and his condition worsened. The man initially presented with weakness and was misdiagnosed with rhabdomyolysis. Laboratory tests revealed elevated levels of potassium, creatinine, and creatine phosphokinase. He was later diagnosed with myocarditis and myositis secondary to the medications. [Extracted from the article]

A retrospective case series of four patients, three men and one woman aged 45-51 years, were described who experienced various toxicities and lack of efficacy during treatment with immunosuppressants and antirheumatics. The patients developed conditions such as histoplasma tenosynovitis, dermatomyositis, and undifferentiated connective tissue disease. Despite receiving medications such as prednisone, mycophenolate, methotrexate, hydroxychloroquine, and adalimumab, the patients did not experience improvement or had adverse reactions. The cases highlight the complexities and challenges of treating these conditions and the need for further research and alternative treatment options. [Extracted from the article]