Background: Jaccoud’s arthropathy is a non-erosive deforming arthropathy characterized by reducible joint deformities. It is classically associated with rheumatic fever and, more recently, with systemic lupus erythematosus. Rare cases have also been described in association with ulcerative colitis and with primary or secondary hyperparathyroidism. Case Report: We describe a rare case of Jaccoud’s arthropathy in a patient with Crohn’s disease and secondary hyperparathyroidism due to chronic kidney disease. The patient presented characteristic reducible to joint deformities in the absence of bone erosions, consistent with the diagnosis. Conclusions: To the best of our knowledge, this is the only reported case of Jaccoud’s arthropathy occurring in the context of both Crohn’s disease and secondary hyperparathyroidism. This case adds to the spectrum of systemic conditions in which this arthropathy may manifest.
Background: Pericardial disease is an uncommon early manifestation of autoimmune diseases, particularly in limited systemic sclerosis (CREST syndrome). Recognizing it as a presenting feature is essential, as it may precede hallmark features of systemic manifestations and require prompt immunosuppressive therapy. Furthermore, serum mucin biomarkers like CA-125, traditionally used in oncology, have emerged as potential indicators of autoimmune serositis; however, their role remains under investigation. Case Presentation: We describe the case of a 60-year-old woman who presented with dyspnea, peripheral edema, and imaging-confirmed pericardial effusion. Further work-up revealed clinical and immunological features of limited systemic sclerosis (CREST), including positive antinuclear antibodies with a centromere pattern and high titers of anti-centromere antibodies. During hospitalization, she developed cardiac tamponade requiring pericardiocentesis. Notably, CA-125 levels were markedly elevated during active pericardial inflammation. The patient responded favorably to immunosuppressive therapy, which included glucocorticoids and cyclophosphamide. We additionally conducted a narrative review on pericardial involvement in autoimmune diseases, with particular emphasis on systemic sclerosis (SSc). The review includes an epidemiological perspective from the Colombian population, highlighting the local prevalence and clinical implications of these presentations in low-prevalence settings. In addition, we discuss the potential role of mucin-derived biomarkers, especially CA-125, as indicators of active serosal inflammation in systemic autoimmune diseases. Conclusions: Pericardial effusion can be a heralding sign of systemic sclerosis and may precede classic cutaneous and vascular features. This case underscores the importance of early recognition of autoimmune pericarditis and suggests that CA-125 may serve as a surrogate marker of serosal activity in autoimmune disorders. Clinicians should maintain a high index of suspicion for autoimmune causes in unexplained pericardial disease, and further studies are needed to validate mucin-based biomarkers as diagnostic and prognostic tools.
Patients with autoimmune rheumatic diseases have an increased cardiovascular risk driven by chronic systemic inflammation and frequent dyslipidemia. Niacin (nicotinic acid or vitamin B3) is a classic lipid-lowering agent with pleiotropic effects, including anti-inflammatory properties mediated by the G protein-coupled receptor GPR109A. Despite consistent biological rationale, direct clinical evidence on the use of niacin in rheumatic diseases remains scarce. This narrative review synthesizes the available data covering biological mechanisms, observational studies, clinical data, and current gaps in literature. Few studies were found, including observational analyses associating higher dietary niacin intake with lower prevalence of rheumatoid arthritis and better function in osteoarthritis, as well as a small clinical study demonstrating the benefit of topical nicotinamide in cutaneous discoid lupus lesions. To date, no completed clinical trials have evaluated the use of oral niacin for inflammation modulation or cardiovascular prevention in patients with rheumatoid arthritis, systemic lupus erythematosus, or other autoimmune diseases. Future clinical trials are needed to clarify whether niacin could play a relevant role in rheumatology practice.
Objectives: The aim of this study was to evaluate the efficacy of a therapeutic education program on the knowledge and safety skills of rheumatoid arthritis patients regarding biotherapy, as well as its impact on disease activity and quality of life. Using biosecure questionnaire on Moroccan form. Patients and Methods: This was an open parallel group randomized controlled trial with two arms, each containing 60 PR-patients. At M6 sixty patients received individual or group ETP sessions. The primary outcome was the assessment of the security and safety skills using biosecure questionnaire on Moroccan form. The secondary outcome was the DAS28-ESR assessment of disease activity, the HAQ and HAD scores. The comparison between the ETP and non-ETP groups was conducted using statistical comparison tests with a significance threshold of p = 0.05. Results: At M6 (6 months), the mean age of the ETP group was 49±11 y. The mean disease duration was 8±4.52y. The analyses between groups show that the ETP group had a statistically better biosecure score [13.60; 95% CI (24-3.20), p = 0.011], better quality of life [0.35; 95% CI (0.10-0.60), p = 0.006] and psychological score [3; 95% CI (2.40-3.63), p = 0.04] compared to the control group. There were lower DAS28-3 scores in the ETP-group [1.18; 95% CI (0.85-1.51), p<0.001]. The use of corticosteroid and DMARDS drugs was more significant in group control mean change score 53; 95% CI (36.21-65.50) p<0.0001). Conclusions: We were able to demonstrate, with a validated tool, that therapeutic educational programs seem to improve safety knowledge and skills of RA patients treated by biologics.
Objective: Available in both oral and intravenous formulations, bisphosphonates are the most frequently prescribed medications for the treatment of osteoporosis. Their side effect profile is well-established, with gastrointestinal involvement being the most common reason for bisphosphonate cessation by patients. Though ocular side effects can occur, episodes of ocular inflammation are rarely reported. However, the current case describes a patient who experienced two episodes of ocular inflammation after separate exposures to bisphosphonates. Case presentation: A case of a 64-year-old female with osteoporosis who experienced episcleritis and uveitis after receiving oral and intravenous bisphosphonates is reported. Her initial occurrence of episcleritis was originally thought to be related to viral exposure. However, she then developed uveitis two days after receiving intravenous zoledronate. Conclusions: This case, therefore, highlights the importance of discussions with patients around less common side effects of oral and intravenous bisphosphonates to allow for earlier identification and treatment of episodes of ocular inflammation.
