Rheumatology Research Journal
Volume:6 Issue: 3, Summer 2021

Rheumatoid arthritis (RA) is a polygenic autoimmune disease characterized by systemic inflammation and disability of  joints. Early diagnosis and treatment could prevent diseases in RA patients from becoming severe. miRNAs are small, non-coding RNA that regulate the post-transcriptional level of gene expression. miRNAs play important roles in gene expression and pathogenicity of autoimmune diseasesas well as RA. Properly using miRNAs regulation potential and detecting different expression patterns andtheir functions could facilitate and manage effective therapeuticinterventions in RA patients. Herein, we discuss miRNAs as a therapeutic agent in RA patients.

The usage of complementary and alternative medications (CAM) among rheumatologic patients has grown during re[1]cent years. The aim of this study was to determine the prevalence of CAM usage in rheumatologic patients in Kerman[1]shah, Iran, and to investigate its related factors. The study population comprised 500 patients with different rheumatic diseases, from whom data on age, gender, marital status, education level, whether they have regular visits by rheuma[1]tologist, type of rheumatic or musculoskeletal disease, disease duration, whether they use CAM and type of CAM, and source of information for using these medications was collectedand compared between patients who used CAM and  those who did not.The most common diseases were rheumatoid arthritis (32.8%) followed by systemic lupus erythematosus (18.8%) and osteoarthritis (14%). Of the 500 participants (mean age: 46.28, 426 female), 109 patients (21.8%) reported CAM usage,the most frequently reported of which were herbal supplements (42.67%) followed by bloodletting and cupping (29.05%),yoga and meditation (7.43%), and special dietary regimens (7.43%). This study identified a cor[1]relation between disease duration and usage of CAM, althoughother factors were not associated with CAM usage. The results showed that patients with longer disease duration had a greater tendency to use CAM. This result may be impor[1]tant for management of the increasing interest in CAM usage among rheumatologic patients.

A 56-year-old woman who had been coughing for 7 weeks was brought to the hospital on April 21, following the sensation of weakness in her lower extremities, then in her upper extremities, and a gradual increase in weakness. Reverse transcriptionpolymerase chain reaction (RT-PCR) testing of coronavirus disease 2019 (COVID-19) was found to be positive. COVID-19 IgG was also positive.Computed tomography (CT) scan of the chest showed patchy ground-glass opacities in the lungs. Muscle enzymes and aldolase were elevated. Muscle MRI showed defined hyperintensity and edema in proximal muscles. Immune mediated necrotizing myositis (IMNM) was recommended in this patient that may have developed following SARS-Cov-2. Treatment was begun with methylprednisolone pulse and intravenous immune globulin (IVIG). Following the start of treatment, the patient's dyspnea and muscle weakness improved. Although IMNM is a rare condition, especially in SARS-Cov-2, it is rapidly debilitating. Physicians need to be more aware of the clinical and paraclinical features and therapeutic approach of IMNM.

Behçet’s disease (BD) is a chronic multisystem disorder with the principal pathological finding of vasculitis, which may involve vessels of different sizes. The concurrence of small and large vessel involvement in BD patients is undetermined. The current study aims to evaluate small vessel involvement in BD patients with large vessel involvement. The study population comprised 35 BD patients with large vessel involvement (cases) and 35 BD patients without large vessel involvement (controls). Small vessel involvement was evaluated in all patients by capillaroscopy. Capillaroscopic findings were compared between the two groups. According to the capillaroscopic findings, all of our BD patients had small vessel involvement. The most prevalent abnormality was tortuosity (87.1%), followed by enlarged loops (58.6%) and avascular areas (51.4%). Capillaroscopy findings between the case and the control groups were not statistically different. There was a significant association between microbleeding and history of erythema nodosum (P-value = 0.015), tortuosity and a history of skin aphthosis (P-value = 0.015), architectural derangement and history of uveitis (P-Value = 0.029), the number of avascular areas and active oral aphthosis (P-value = 0.021), and architectural derangement and increased ESR (P-value = 0.011). There was no difference in nail fold folder involvement between BD patients with and without large vessel involvement; however, some capillaroscopic features were associated with some disease manifestations.

Cutaneous Leishmaniasis is the most prevalent type of leishmaniasis. Iran is among the first six countries in the world with the highest annual incidence of cutaneous Leishmaniasis. Non-caseating granulomatous inflammatory cutaneous reaction is the most common pattern of its skin lesions. The current article presents the case of a 36-year-old man with a history of polyarteritis nodosa vasculitis with extensive caseating granulomatous lesions who was diagnosed with cutaneous leishmaniasis. Caseating granulomatous can present in cutaneous Leishmaniasis; thus, it is recommended to consider leishmaniasis in the diagnosis of this histological pattern, especially in autoimmune patients before starting immunosuppressive treatment.