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Background. Rheumatoid arthritis (RA) is a systemic inflammatory disease, associated with a number of extra-articular organ manifestations. Pulmonary involvement is a frequent and severe extraarticular manifestations of rheumatoid arthritis. RA can affect lung parenchyma, airways and pleura. Objectives. To identify RA-related lung disease on chest computed tomography (CT). Material and methods. We performed high-resolution computed tomography (HRCT) on a total of 92 patients with longstanding RA. Results. The subjects were predominantely female (79.3%), the age at entry was 63.77 ±11.56 years, and 42.9% had a history of smoking. Disease duration was 15.00±11.55 years. Pulmonary CT abnormalities were found in 71 of the 92 patients (77.2%). The most common HRCT anomalies were: linear attenuation (reticulation) (52.11%), bronchiectasis andbronchial wall thickening (45%), nodular attenuation (39.43%) and pleural involvement (pleural effusion or thickening) (39.43%). Conclusions. We conclude that RA-related lung disease was commonly detected on chest CT imaging in longstanding RA patients. [ABSTRACT FROM AUTHOR]

Scleroderma renal crisis is an important cause of morbidity and mortality in systemic sclerosis patients, occurring in about 5-10% of the cases. It is seen mostly early in the progression of the disease, about 75% of the scleroderma renal crises affecting the patients in their first 4 years since the onset of the disease. We present the case of a 62 year old woman who was admitted in our clinic for oliguria, edema, an important elevation of the kidney function tests, arterial hypertension and severe anemia. Immunological tests showed intensely positive antinuclear antibodies with positive anti RNA polymerase III antibodies. She was diagnosed with systemic sclerosis according to ACR/EULAR 2013 criteria and scleroderma renal crisis. Specific therapy was started along with hemodialysis imposed by the progression of the kidney failure. [ABSTRACT FROM AUTHOR]

The cause of rheumatoid arthritis, which is the most frequent inflammatory rheumatic disease, affecting between 0.5 and 1% of the general population, still remains unknown. However, as with all autoimmune disorders, it is assumed that rheumatoid arthritis is the consequence of the influence of environmental factors on a genetically predisposed host. Regional variations in disease prevalence support the environmental influence theory: geographical and climatic conditions, industrialization and pollution, socioeconomic status or lifestyle. For the time being, with a few exceptions, such as smoking, the vast majority of factors that can influence the onset of the disease remain unclear, although their contribution is most probably significant. [ABSTRACT FROM AUTHOR]

Background. Rheumatoid arthritis (RA) epidemiology is characterised by the preference of the disease for women under age of 50, a sex ratio female:male of ≤ 3:1 being classically described, along with a peak for age onset between 50 and 75 years old. The relationship between female sexual hormons and susceptibility of rheumatoid arthritis is not completely understood and regional differences in the prevalence of the disease support the idea of environmental factors influence. Aim. To evaluate demographic features of patients with rheumatoid arthritis from South-East Romania, living in the climatic, economic and ethnic profile of Constanta county. Material and method. We included 447 patients (age≥18) with RA (ACR 1987 or ACR/EULAR 2010 diagnosis criteria) admitted in our Rheumatology Department - IInd Internal Medicine Clinic, Sf. Apostol Andrei Emergency Clinical County Hospital Constanta from January 2013 to December 2014. All patients agreed to participate in the study through an informed consent (approved by local ethical comittee) signed at admittion time. All patients underwent a careful clinical, biological and imagistic evaluation. Results. Our group of patients was a rheumatoid arthritis cohort with 88.4% Caucasian, 380 women (85%) and 67 men (15%), with a female-male ratio (F:M) of more than 5:1 (5.7:1), mean age of our patients was 62.13 ± 11.44 years and a mean age at onset of RA of 51.71±13.67 years, statistically different between men and women (p < 0.001). Sex distribution of rheumatoid arthritis varies with actual age of the patients, significant differences being observed in extreme age categories: < 40 years (F:M = 17:1) and > 70 years (F:M = 4.25:1), age at onset, with smoking status (F:M = 2:1), in early disease (F:M = 3.6:1). Conclusions. Female:Male ratio increases impresively in RA cases with early onset (<45 years), young man's hormon constellation being probably a protective factor for the disease. Patients' age, especially age at onset, seems to be the most important factor that influences sex distribution of rheumatoid arthritis. [ABSTRACT FROM AUTHOR]

Rowell syndrome is considered to be an unusual association between systemic lupus erythematous (SLE), erythema multiforme-like lesions and an immunological pattern consisting of speckled ANA, positive rheumatoid factor and positive anti-La (SSB) antibodies. We present the case of an 81 year old woman with late-onset SLE who developed an erythema multiforme-like rash, with a speckled antinuclear antibodies (ANA) immunofluorescence pattern and a positive rheumatoid factor. The key in establishing the diagnosis was the biopsy of the lesion, which set the diagnosis of Rowell syndrome. [ABSTRACT FROM AUTHOR]

Rheumatoid arthritis (RA) is a common autoimmune systemic inflammatory disease with still unknown cause. A robust hypothesis for the occurence of the disease is the result of an environmental exposure in a genetically susceptible individual. The risk of RA varies by ethnicity: the majority of the Caucasian populations reported a prevalence of 0.5 to 1% for this disease; higher prevalences were observed in American Indian tribes and lower ones, in countries of Africa and Asia. This regional variation in the prevalence of RA sustains the involvement of both genetic and enviromental factors in the occurence of this condition. [ABSTRACT FROM AUTHOR]