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Introduction: Giant cell (temporal) arteritis (GCA) is a cell-mediated vasculitis that damages the major blood vessels such as an aorta with its major branches and mainly extracranial branches of the carotid artery. Vision loss that can be caused by the anterior ischemic optic neuropathy (AION) or by the central retinal artery occlusion (CRAO) is considered to be one of the most terrible complications of the GCA. In the represented clinical case the complete vision loss was the cause of hospitalization of the patient and the basis for a diagnosis of GCA at the same time. The episodes of the reversible visual impairment that were observed 9 days before the hospitalization attract attention to themselves.Purpose. to pay attention to the main ophthalmological and general symptoms that let the doctor to suspect this disease during the primary reception and to carry out diagnostics promptly to start timely treatment.Conclusion. The main criteria for diagnosis of GCA in the practice of ophthalmologists are female gender, age over 50 years, intense headache with paresthesia, pain in the lower jaw during chewing and short-term episodes of vision loss. Clinical blood test including erythrocyte sedimentation rate, C-reactive protein level and platelet count are the necessary laboratory diagnostic methods.

Local injection therapy (LIT) is an important component of the complex treatment of musculoskeletal disorders (MSD), which is widely used in real clinical practice. Glucocorticoids, hyaluronic acid drugs (HA), autologous cell drugs, botulinum toxin type A, radioactive isotopes, etc. are used for LIT. LIT makes it possible to achieve a pronounced symptomatic effect, while in some cases, for example, repeated HA treatments in patients with osteoarthritis, the possibility of slowing the progression of the disease and reducing the need for surgical treatment is discussed.The performance of LIT requires special skills and abilities of the physician, careful compliance with the rules of asepsis and antisepsis, and instrumental visualization. LIT can be associated with serious complications and therefore must be performed according to strict indications.The Expert Council was devoted to defining the basic principles of LIT. The indications for the use of certain types of this therapies, the evidence base for its efficacy and safety, the order of application of different drugs, and the need to combine LIT with other drug and non-drug treatments of MSD were reviewed.

Objective: to describe a clinical case of polymorphic leukocytoclastic vasculitis (PLCV) associated with renal neoplasia.Materials and methods. Patient K., a man, 67 y. o., was admitted to the surgical department No. 2 of the N. I. Pirogov State Clinical Hospital No. 1 with cardiac complaints and heart failure decompensation symptoms, severe respiratory insufficiency associated right lower lobe pneumonia. Besides cardiac function evaluation and pneumonia managing there was a conducting of differential diagnostic search to clarify the genesis of ulcerative necrotic rashs among systemic vasculitis, paraneoplastic syndrome including hematologic problems and sepsis.Results. It was no data for systemic connective tissue diseases and systemic vasculitis during clinical examination and immunological diagnostics. On contrast-enhanced multispiral computed tomography of abdomen and retroperitoneal space there was latent malignant neoplasia of left kidney Т2аN1M0. PLCV was considered to paraneoplastic syndrome associated with malignancy. Due to the progression of vasculitis and the patient’s refusal of surgical treatment was prescribed GC 0.5 mg / kg / day as a result positive dynamics was noted.Conclusion. This clinical case demonstrates necessity of providing examination aimed at malignancy excluding for early neoplasm’s detecting for patients with vasculitis.

Currently, a large number of highly effective biologic disease modifying antirheumatic drugs (bDMARDs) and targeted synthetic DMARDs (tsDMARDs) are used for the treatment of rheumatoid arthritis (RA). However, in addition to effectiveness, it is necessary to evaluate the risk of adverse events (AEs) when using them.Objective: to determine the predictors of bDMARDs and tsDMARDs discontinuation due to AEs in patients with RA.Patients and methods. The study included 661 patients with RA who took bDMARDs and tsDMARDs. The search for predictors of targeted therapy discontinuation due to AEs was carried out in two stages. At the first stage, using the Kaplan-Meier method, we selected indicators that showed the greatest significant single-factor relationship with the duration of retention on therapy. At the second stage, significant independent indicators were obtained by iterative selection of variables within the multivariate proportional risk model according to Cox.Results and discussion. The presence of rheumatoid nodules (p

Wegener's granulomatosis (WG) is a systemic vasculitis characterized by necrotizing granulomatous inflammation of small and medium-sized blood vessels and upper respiratory tract, lungs and kidneys [1]. WG is traditionally considered to be a a rare disease the prevalence of which is 25-60 people per 1 million of population; however, the last 30 years have seen a 4-fold increase in the incidence of the disease [2]. 90% of patients die within the first 2 years of the onset of the disease without treatment. Timely diagnosis of WG is therefore important because the disease if often hard to diagnose in the beginning due to atypical oligosymptomatic flow.