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Background: Aortic stiffness is an independent predictor of cardiovascular events which is increased in rheumatoid arthritis (RA). It can be measured by carotid-femoral pulse wave velocity (cfPWV). Phase angle (PhA) is lower in patients with cardiovascular disease and may be informative in assessing the clinical course of RA. Materials and Methods: In this observational and cross-sectional study, all RA patients referred to the Imam Khomeini Hospital rheumatology clinic between September 2022 and March 2023 were included in the study. RA activity was assessed using the DAS28 criteria. In the patients, PhA and cfPWV were measured using Inbody-s10 and PulsePen tonometer instruments. The relationships between PhA, cfPWV, clinical course of RA, and CRP were evaluated using regression analysis. Results: 53 patients were included in the study (83% female, mean age 46.5 years). Significant inverse relationships existed between PhA, CRP, and age (P value = 0.003, 0.0001, R: 0.69, respectively). People with aortic stiffness had a lower mean PhA (P value = 0.05). In patients with RA duration of less than 10 years, the cfPWV percentile and the prevalence of rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) positive cases were higher than in patients with RA duration >10 years (P values = 0.02, 0.01, respectively). Conclusions: With increasing duration of RA, aortic stiffness and positive serology cases decreased. PhA and cfPWV may be useful in assessing the clinical course of RA to prevent cardiovascular events.

It has been proved that rheumatoid arthritis (RA) is linked to dyslipidemia and the risk of cardiovascular complications is higher in these patients. The aim of this study was to evaluate dyslipidemia in RA patients. In this study, RA patients were enrolled regarding the inclusion and exclusion criteria. Their demographic information and medication profiles were evaluated. Clinical assessments were performed by evaluation of disease activity score (DAS28) and visual analogue scale. Moreover, laboratory investigations of lipid profile including triglycerides (TG), total cholesterol (Chol), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) were performed. From a total of 150 patients with the mean age of 54.9±16.8 years, 65.3% were diagnosed with dyslipidemia. Females in menopausal ages had a higher prevalence of dyslipidemia as well as patients with longer disease duration. Mean serum HDL, LDL, Chol, and TG were 52.76±13.8, 96.65±21.6, 177.26±38.9, and 128.04±33.9, respectively. Considering DAS28, 100% of the patients with high disease activity were diagnosed with dyslipidemia. In the moderate and low disease activity groups and also patients in remission the ratio was 77.02%, 66.66%, and 43.75%, respectively. According to the results, patients under treatment with prednisolone and methotrexate were more affected by dyslipidemia than those with prednisolone, methotrexate, and hydroxychloroquine. Moreover, in the patients under prednisolone, methotrexate, and leflunomide treatment, the prevalence of dyslipidemia was significantly lower than those used only prednisolone and methotrexate. Altogether, it is necessary to have more clinical suspicion towards dyslipidemia and its complications in the patients with greater number of affecting factors.

Systemic lupus erythematosus (SLE) is a chronic inflammatory disorderwith unknown etiology which can involve various organs in the body. The most common symptoms of this disease are constitutional symptoms along with skin rashes, arthritis, nephrologic, and hematologic manifestations. Acute pancreatitis is an unusual presentation of SLE. Here, we report an interesting case SLE who suffered from fever, weakness, abdominal pain, and weight loss. Finally, lupuspancreatitis was diagnosed based on her symptoms, laboratory, and imaging findings.

Sarcoidosis is an inflammatory disorder characterized by the presence of noncaseating granulomas. Sarcoidosis can affect any organ in the body. As we know lung is most commonly affected but other organs such as liver, skin, eye and spleen could be involved. Here we report an interesting case of hepatic and splenic sarcoidosis in 55 year old woman suffered from epigastric pain, weight loss and constipation due to hypercalcemia.