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Antiphospholipid antibodies syndrome (APS) is an acquired prothrombotic status, that is due to the occurrence of a certain type of autoantibodies directed against negatively charged phospholipid structures – hence the name. Neoplasia is also characterized by a systemic procoagulant status, through various mechanisms. Obviously, both conditions may occur in the same patient, raising the question of a possible causal relation. Regardless of the potential liaison between the two events, clinicians caring for neoplastic patients as well as for APS patients, should be aware of the presence of both conditions in the same patient, as this has important therapeutic consequences. [ABSTRACT FROM AUTHOR]

Spondylatrhritis is a multifaceted disease, primary involving the axial skeleton. But sometimes, the patient present either with articular involvement plus other organ invelovement, or with only extraarticular involvement. As the most frequent, uveitis is the main extraarticular manifestation (EAM) of spondylarthritis. This EAM is very important because it can be the first manifestation of SpA, so it may bring the patient to the doctor, be it an ophthalmologist or a rheumatologist. Diagnosing uveitis in the context of SpA, is of paramount importance also because anterior uveitis is an emergency, because it can lead to blindness. So, knowing the clinical appearance and the treatment of uveitis in the context of SpA is crucial for providing the best care for SpA patients. [ABSTRACT FROM AUTHOR]

Psoriasis is a chronic, immune-mediated inflammatory disease of unknown etiology that may be associated with abnormal T-lymphocyte function. Ocular manifestations associated with psoriasis, particularly artropathic or pustular psoriasis, usually affect men, often during exacerbations of the disease. It has been reported that eye damage tends to occur later compared with cutaneous or joint manifestations, blindness being the most disabling complication. Previous studies have focused on ophthalmic manifestations and identified several etiopathogenic mechanisms. Psoriasis may be associated with eye complications such as lesions of the eyelids, conjunctiva and others, with systemic inflammation being the main contributor. In addition, the treatment used for psoriasis may cause ocular changes. The main ophthalmic manifestations associated with psoriasis are keratoconjunctivitis sicca, blepharitis, conjunctivitis and uveitis. The treatment of uveitis, perceived as one of the most serious eye conditions, is controversial and has yet to be clearly determined. Thus, the aim of the present review was to emphasize the importance of regular eye examination for patients with psoriasis, either those receiving biological treatment or those not receiving treatment, in order to diagnose and manage the disease appropriately. [ABSTRACT FROM AUTHOR]

Rheumatoid arthritis (RA) is a chronic, systemic inflammatory autoimmune disease with unclear etiology that involves the peripheral joints symmetrically, causing synovial hypertrophy, inflammation and, consequently, erosions of the bone and cartilage. We hereby present the case of a 51-year-old female patient diagnosed with RA in 2009 for which she received treatment with Methotrexate and TNF alpha treatment (Infliximab). Prior to the first dose of Infliximab Quantiferon-TB Gold was performed with a negative result. In 2016 the patient presented with ascites and pleural effusion with a positive repeated test for Quantiferon-TB Gold, the treatment with Infliximab and Methotrexate was stopped and she was started on anti TB standard treatment regimen for 9 months with the remission of the polyserositis. After the completion of the anti TB treatment we reinitiated Methotrexate therapy given a high disease activity (DAS28-CRP of 6.59) which improved the patients complaints; however, 3 months later, given an increase in the patients inflammatory markers we performed a computed tomography (CT) scan that revealed peritoneal thickening, and several omental nodules, the histological examination confirming the diagnosis of peritoneal TB. The patient was reinitiated on the anti-TB treatment. [ABSTRACT FROM AUTHOR]

Objective. The study aimed at determining whether RA patients starting or stopping biosimilars differ in any regard from those starting or stopping originals. Methods. Data on RA patients was obtained from the Romanian Registry of Rheumatic Diseases (RRBR) database between January 1st, 2022, and December 31st, 2022, encompassing all Romanian RA patients fulfilling the national criteria for bo/ bsDMARD initiation, continuation or switching. Results. Etanercept and adalimumab predominated for initiations of biosimilars. Most entries on biosimilars originated from originals (including non-medical switches) and from bDMARDs without biosimilars. A historical effect of accumulation of patients was observed, manifested in the fact that originals still dominated the group of patients continuing their treatment, with the exception of infliximab, while biosimilars tended to be continued in younger patients and in patients with shorter disease duration. Cases categorized more severe by both patients, their doctors and their disease activity were preferably reserved for originals. In patients continuing their previous bDMARD, biosimilars exhibited higher DAS28 and SDAI remission rates. Conclusion. RRBR data from 2022 confirm the market rise of biosimilars in RA, but also physicians’ prudence in prescribing them to highly active cases. In the Romanian RA cohort, biosimilars are overall more effective in holding remission than originals. [ABSTRACT FROM AUTHOR]

Hyperferritinemic syndrome represents a common nosological classification for systemic inflammatory syndromes, including Catastrophic antiphospholipid syndrome, in which hyperferritinemia (> 500 ng/mL) is present. Recent studies suggest that in this syndrome, ferritin is more than a passive marker of inflammation, playing an active role in the process. We present the case of a 74-year-old female patient with elevated serum ferritin levels (above 1000 ng/mL), along with an intense inflammatory syndrome, non-immune thrombotic microangiopathy, and multisystem involvement (pulmonary, cardiac, hepatic, pancreatic, neurological and renal changes), outlining the picture of a hyperferritinemic syndrome that is hard to classify otherwise. This underlines the necessity for diagnostic and classification criteria for this pathology. [ABSTRACT FROM AUTHOR]

Vasculitides are inflammatory disorders which affect the blood vessels. There are three major categories of vasculitides depending on the size of the injured vessels. Although each category can affect any size artery, usually large vessel vasculitis affects large arteries. Takayasu arteritis and Giant Cell arteritis are known to be the two main types of large vessel arteritis. We present the case of a patient with a delayed diagnosis of Takayasu disease who sequentially develops a series of complications. The atypical evolution of the disease confirms once again the complexity of the vasculitic disorders and raises questions about the understanding of their pathophysiologic mechanisms. [ABSTRACT FROM AUTHOR]