Introduction:Ankylosing spondylitis (AS) is a chronic inflammatory disease that can be managed with tumor necrosis factor (TNF) inhibitors. This study evaluated the effects of adalimumab, a TNF inhibitor, on inflammatory markers, including C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Monitoring disease activity during therapy is important for assessing treatment response. Material and methods:We analyzed the medical history of 28 patients with confirmed AS, treated with adalimumab. The inflammatory markers neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), CRP, ESR, and the Bath Ankylosing Spondylitis Disease Activity Index were assessed at the beginning of the observation (month 0) and after 3, 6, and 12 months of therapy. Results:The mean NLR value after 3 months of treatment was 1.48 (95% confidence interval, CI: 0.92-2.03, p < 0.001), after 6 months was 1.48 (95% CI: 0.92-2.12, p < 0.001), and after 12 months was 1.67 (95% CI: 1.08-2.30, p < 0.001). Mean MLR value after 3 months of treatment was 0.07 (95% CI: 0.03-0.13, p = 0.005), after 6 months was 0.05 (95% CI: 0.00-0.11, p = 0.101), and after 12 months was 0.06 (95% CI: 0.01-0.11, p = 0.047), showing statistical significance only after 3 and 12 months. The mean PLR value after 3 months of treatment was 52.8 (95% CI: 30.1-79.60, p < 0.001), after 6 months was 65.50 (95% CI: 31.60-83.90, p < 0.001), and after 12 months was 68.80 (95% CI: 42.70-93.70, p < 0.001). Conclusions:Neutrophil-lymphocyte ratio may be a useful marker of inflammation in patients with AS. Monocyte-lymphocyte ratio and PLR require further investigation. Peripheral blood tests are simple and inexpensive to perform, making hematological markers promising tools for monitoring inflammatory diseases.
Spondyloarthritis (SpA) is characterized by inflammation of joints and entheses, leading to structural damage and loss of bone mineral density. The goal of this narrative review was to analyse the impact of physical activity on bone remodelling in patients with SpA. Two investigators searched the PubMed, Scopus, Directory of Open Access Journals, and Web of Science bibliographic databases (May 20, 2024; October 4, 2024; and May 19, 2025), then screened the articles for compliance with the inclusion criteria. Six related articles were included. No studies directly assessed the impact of physical activity on bone density in SpA. Prior research showed that short-term exercise does not affect ultrasound or magnetic resonance imaging findings, while repeated activities, such as certain job types, may worsen structural damage. Data regarding the effect of physical activity on bone remodelling are scarce, and results are divergent. More research regarding biomechanical stress and bone remodelling is needed.
Granulomatosis with polyangiitis (GPA) is a vasculitis affecting small and medium-sized blood vessels. It typically presents with upper respiratory tract, lung, and kidney involvement. However, the disease may involve multiple other organs, and not all cases present with these classic manifestations. Periocular lesions are described in the GPA and, especially in the case of isolated, single-site disease, require extensive differentiation from other diseases, such as IgG4-related disease or myofibroblastic tumor. However, periocular lesions and coexisting symptoms suggesting changes in the central nervous system without other organ changes are undoubtedly a diagnostic challenge. Such situations are described in the literature mainly as case reports, not as a rule in connection with GPA. The impetus for writing this article and analyzing the literature was a case of GPA manifesting as infiltration of the skull base presenting as multiple cranial nerve palsies. A review of atypical cases of GPA in the literature suggests that skull-based involvement is an important yet easily overlooked presentation. Through this case-based review, we aim to raise awareness that GPA may present with isolated cranial nerve palsies.
Introduction:This study aimed to identify research trends and thematic structures in case reports related to rheumatoid arthritis (RA) and complications published between 1995 and September 2025. By applying unsupervised machine learning (ML), the study sought to uncover longitudinal patterns and cross-domain relationships that may not be fully captured in traditional reviews or large-scale epidemiological studies. Material and methods:Bibliographic data were collected from the Web of Science Core Collection using the search term "rheumatoid arthritis and complications," limited to case reports published between 1995 and 2025. Titles, key words, and abstracts were combined into unified text documents and processed with natural language processing (NLP) techniques. Term Frequency-Inverse Document Frequency was applied for text vectorization. Topic extraction employed non-negative matrix factorization, and clustering was performed using K-means. The optimal number of clusters was determined based on the highest Silhouette Score (0.636). Analyses were conducted in Python (Version 3.10.5) within the PyCharm environment (Version 2022.1.3). Results:The unsupervised ML framework identified two major and stable clusters among 1,200 case reports: a pharmacological and immunological management cluster and a surgical and postoperative complications cluster. Cluster 1 included 890 reports characterized by pharmacological and immunological terms such as "TNF," "therapy," and "anti," while cluster 2 contained 310 reports dominated by orthopedic terms such as "arthroplasty," "knee," and "revision." Reproducibility tests across five runs demonstrated consistent clustering patterns, supporting methodological reliability. Conclusions:This NLP and ML-based analysis revealed a dual structure in RA complication literature, reflecting immunological treatment-related complications and surgical outcomes. Beyond confirming known domains, the study provides a data-driven characterization of their evolution and overlap, offering insights into the evolution of research themes in RA management. This approach demonstrates the potential of unsupervised ML for longitudinal mapping of clinical research domains.
Metastatic Crohn's disease (MCD) is the rarest and one of the most disfiguring cutaneous manifestations of inflammatory bowel disease (IBD): non-caseating granulomatous inflammation at skin or mucosal sites not contiguous with the gut. Only about 500 cases have been reported since 1965, placing patients at the crossroads of gastroenterology, dermatology, and rheumatology. Because its course can run independently of bowel activity and may precede the underlying disease, MCD belongs in the differential of any chronic, treatment-resistant rash. A rare disease like this cannot be solved within a single specialty: this editorial introduces an interdisciplinary ECCO CONFER (Round 12) project that unites dermatologists and gastroenterologists across centres worldwide to assemble the largest MCD case series and validate the 2025 Delphi diagnostic criteria for these patients.
