International Journal of Rheumatic Diseases最新文献

{"title":"Ubiquitin Ligase MDM2 Regulates Chondrocyte Damage, Ferroptosis, and Oxidative Stress by Modulating the Ubiquitination Level of CDKN1A","authors":"Kaihong Gui,&nbsp;Xiaosong Li,&nbsp;Junlai Song,&nbsp;Ao Li,&nbsp;Jun Fan,&nbsp;Lin Huang","doi":"10.1111/1756-185x.70384","DOIUrl":"https://doi.org/10.1111/1756-185x.70384","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Osteoarthritis (OA) is a common degenerative disease involving pathological changes in joint tissues, which seriously affects the quality of life of patients. It was reported that both Cyclin dependent kinase inhibitor 1A (CDKN1A) and ubiquitinating enzyme MDM2 exhibited abnormal expression in OA. However, it is currently unclear whether there is a specific regulatory mechanism between the two.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Firstly, C28/I2 cells were treated with IL-1β to construct an in vitro cell model of OA, while qRT-PCR and western blot were used to detect the mRNA and protein levels of CDKN1A and MDM2. C28/I2 cell viability, apoptosis, and the release of inflammatory factors were measured by CCK-8, flow cytometry, and ELISA kits. In addition, the levels of Fe²⁺, glutathione (GSH), reactive oxygen species (ROS), and Malondialdehyde (MDA) were evaluated by corresponding kits. Subsequently, the relationship between MDM2 and CDKN1A was predicted by the UbiBrowser website, and the ubiquitination level of CDKN1A and the interaction between them were verified by western blot and Co-IP technology. Cycloheximide (CHX) exposure was used to assess mRNA stability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>CDKN1A was downregulated in OA cartilage tissues and IL-1β induced C28/I2 cells, while overexpression of CDKN1A enhanced C28/I2 cell activity and inhibited cell apoptosis. Meanwhile, the release of IL-6 and TNF-α as well as ferroptosis and oxidative stress, were also hindered by CDKN1A overexpression. MDM2 was highly expressed in OA patients and in IL-1β induced C28/I2 cells and mediated the ubiquitination modification of CDKN1A. Most importantly, MDM2 knockdown alleviated IL-1β-induced chondrocyte damage via upregulating CDKN1A.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>MDM2 downregulated the level of CDKN1A in chondrocytes by mediating the ubiquitination modification of CDKN1A, leading to impaired chondrocyte viability and inducing ferroptosis and oxidative stress.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 8","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144858596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toward Identifying a Multivariate Correlation of Septic Arthritis With a Machine Learning Approach: Time to Reset the Current Australasian Guidelines?","authors":"Sourav Bhattacharjee,&nbsp;Imal C. Hemachandra,&nbsp;Sudharsan Venkatesan,&nbsp;Robert W. Baird,&nbsp;Sachin Khetan","doi":"10.1111/1756-185x.70386","DOIUrl":"https://doi.org/10.1111/1756-185x.70386","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To understand the complexity of disease pathology through the prism of septic arthritis, especially the reliability of popular and, yet, arbitrary thresholds like synovial leucocyte counts of ≥ 100,000/μL suggestive of it, with the help of statistical analysis and logistic regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An anonymized patient dataset comprising 360 swollen joint episodes was collated along with a range of patient attributes, including age, gender, comorbidity (e.g., diabetes, gout, pseudogout, immunosuppression), prior administration of antibiotics and washout of the affected joint, isolation of crystals from synovial aspirate, blood/synovial fluid culture growth, and synovial aspirate cell count. The dataset was subjected to statistical analysis (e.g., sensitivity, specificity, predictive and likelihood ratios) and logistic regression modeling, with results compared to the synovial leucocyte count thresholds of ≥ 100,000/μL and ≥ 50,000/μL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The logistic regression model (sensitivity 50%, specificity 97.04%) outperformed the models based on arbitrary thresholds like a synovial leucocyte count of ≥ 100,000/μL (sensitivity 48.21%, specificity 88.16%) or ≥ 50,000/μL (sensitivity 64.29%, specificity 69.74%) in predicting septic arthritis. Independent variables like age, presence of gout, and autoimmune arthritis as comorbidities, hip joint involvement, synovial aspirate leucocyte count, and crystals in aspirated fluid demonstrated a significant (<i>p</i> &lt; 0.05) correlation to septic arthritis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Septic arthritis presents a multivariate correlation that deserves a holistic oversight rather than singling out individual factors. Data mining platforms like logistic regression can investigate the complex interplay among these individual variables while making a diagnosis not only in septic arthritis but also in other diseases with multisystem involvement, infective or non-infective alike.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 8","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1756-185x.70386","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144853790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of Genetic Causality Between Epstein–Barr Virus Infection and Risk of Autoimmune Diseases","authors":"Xiao Hu,&nbsp;Mei Fang,&nbsp;Ping-Ting Zhou,&nbsp;Yu-Chen Liu,&nbsp;Yue-Can Gao,&nbsp;Li Gu,&nbsp;Wen-Wen Ding,&nbsp;Ye-Hai Liu,&nbsp;Hai-Feng Pan,&nbsp;Peng Wang","doi":"10.1111/1756-185x.70389","DOIUrl":"https://doi.org/10.1111/1756-185x.70389","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 8","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144832928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Value of Rheumatoid Arthritis Citrullinated Peptides (RACP) System in the Diagnosis of Rheumatoid Arthritis: A Retrospective Analysis of 2632 Patients","authors":"Kun Yang,&nbsp;Sixing Li,&nbsp;Leting Zheng,&nbsp;Fei Dong,&nbsp;Jing Wen,&nbsp;Zhendong He,&nbsp;Jiale Wen,&nbsp;Fang Qin","doi":"10.1111/1756-185x.70393","DOIUrl":"https://doi.org/10.1111/1756-185x.70393","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives and Aim</h3>\u0000 \u0000 <p>This study aimed to evaluate the diagnostic accuracy and prognostic value of the Rheumatoid Arthritis Citrullinated Peptides (RACP) assay in a real-world cohort, assessing its performance both independently and in combination with established biomarkers such as anti-cyclic citrullinated peptide (anti-CCP), rheumatoid factor (RF), and anti-keratin antibodies (AKA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A single-center retrospective analysis included 2632 patients who underwent serological testing between September 2022 and September 2023. Of these, 644 patients met ACR/EULAR classification criteria for rheumatoid arthritis (RA), while 1988 patients served as non-RA controls, including an osteoarthritis (OA) subgroup. RACP, anti-CCP, RF, and AKA levels were measured by enzyme-linked immunosorbent assay (ELISA). Diagnostic sensitivity, specificity, and combination strategies were assessed using chi-square and <i>t</i>-tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>RACP alone demonstrated a sensitivity of 76.86% and a specificity of 89.94%, closely comparable to anti-CCP (70.87% sensitivity and 89.92% specificity). Area under the curve (AUC) values were 0.805 for RACP, 0.783 for RF, 0.799 for anti-CCP, and 0.623 for AKA. Combining RACP with RF improved sensitivity (85.36%), while dual positivity (RACP + AKA) optimized specificity (96.61%). In the OA subgroup, biomarker positivity remained minimal, confirming strong discriminatory capacity. Patients positive for RACP or anti-CCP exhibited significantly higher tender joint counts, correlating biomarker positivity with clinical disease severity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>RACP is a robust biomarker for RA diagnosis, offering sensitivity and specificity comparable to or exceeding traditional assays. Combinations with RF or anti-CCP enhance diagnostic accuracy, supporting its utility in early RA detection, differential diagnosis from OA, and potentially reflecting disease activity. Prospective studies are warranted to confirm these findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 8","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Potential CD8+ T-Cell-Related Biomarker IFIT3 for Rheumatoid Arthritis","authors":"Kangsong Tian,&nbsp;Jie Guo,&nbsp;Qian Yan,&nbsp;Ning Wang","doi":"10.1111/1756-185x.70385","DOIUrl":"https://doi.org/10.1111/1756-185x.70385","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The aim is to pinpoint crucial genes linked to CD8⁺ T cells in rheumatoid arthritis (RA) for aiding in diagnosis, predicting disease progression, and ultimately discovering potential drug targets.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study utilized datasets from the Gene Expression Omnibus (GEO) database to analyze gene expression profiles in RA patients. Weighted Gene Coexpression Network Analysis (WGCNA) was conducted to identify gene modules associated with the diseases, followed by differential gene expression analysis. Functional enrichment and protein–protein interaction (PPI) network analysis were employed. Gene Set Enrichment Analysis (GSEA) and Disease Ontology (DO) analysis were applied to understand their potential pathways. Transcription factors (TFs) correlated with target gene expression were screened, and TF binding sites were predicted. The proportion of immune cell infiltration was calculated using CIBERSORT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study identified 58 candidate genes associated with CD8⁺ T cells in RA. The top five genes, <i>RSAD2, IFIT3, OAS1, IFIT2</i>, and <i>SAMD9L</i>, were found to be upregulated in RA and other autoimmune diseases. <i>IFIT3</i> showed potential diagnostic value in RA, with significant expression differences in RA vs. OA samples. TF <i>BCL11B</i> bound to the <i>IFIT3</i> promoter. GSEA analysis indicated <i>IFIT3</i>'s influence on pathways like the cell cycle and TNF signaling. Immune landscape analysis showed <i>IFIT3</i>'s correlation with immune cell infiltration such as B cells and plasma cells. Drug prediction analysis suggested naringin's treatment potential for RA via targeting <i>IFIT3</i>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study identifies key CD8⁺ T-cell genes in RA, with <i>IFIT3</i> as a potential diagnostic and therapeutic target, revealing <i>BCL11B</i>'s regulatory role.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 8","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Pigmented Villonodular Synovitis in a Patient With Sjögren's Syndrome","authors":"Ting-Yu Chang,&nbsp;Chun-Cheng Liao,&nbsp;Tao-An Chen,&nbsp;Deng-Ho Yang,&nbsp;Chia-Wen Kuo","doi":"10.1111/1756-185x.70392","DOIUrl":"https://doi.org/10.1111/1756-185x.70392","url":null,"abstract":"&lt;p&gt;Pigmented villonodular synovitis (PVNS) is a rare but locally aggressive proliferative lesion that arises in the synovium, tendon sheaths, and bursae. According to the 2020 WHO Classification of Tumours of Soft Tissue and Bone, PVNS is now classified as diffuse-type tenosynovial giant cell tumor (diffuse-TGCT) [&lt;span&gt;1&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;PVNS primarily affects large joints, most commonly the knee, followed by the hip, ankle, and shoulder. It is characterized by nonspecific symptoms, such as joint pain, swelling, stiffness, and limited range of motion, which often leads to misdiagnosis as other inflammatory or degenerative joint disorders [&lt;span&gt;1&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;While the exact etiology of PVNS remains unclear, it is believed to involve neoplastic and inflammatory components. Recent studies suggest that a neoplastic process driven by a translocation involving colony-stimulating factor 1 (CSF1) and its receptor (CSF1R) leads to abnormal macrophage recruitment and infiltration of other inflammatory cells, thereby contributing to disease progression. This process leads to chronic inflammation, synovial proliferation, and cartilage destruction. The deposition of hemosiderin resulting from recurrent intra-articular bleeding contributes to increased tissue damage and fibrosis. Risk factors for progression include delayed diagnosis, incomplete surgical resection, recurrent synovial inflammation, and disease recurrence [&lt;span&gt;2, 3&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Hemarthrosis detected through joint aspiration can be a crucial diagnostic clue for PVNS. Magnetic resonance imaging (MRI) is essential, typically revealing a well-defined lesion with hemosiderin deposition, characterized by low signal intensity on T2-weighted sequences. Histopathologically, PVNS is characterized by mononuclear cells, multinucleated giant cells, and hemosiderin-laden macrophages [&lt;span&gt;4, 5&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;The treatment primarily involves surgical resection, often through arthroscopic synovectomy; however, the recurrence rate remains high. In some cases, adjuvant therapies—such as radiotherapy or targeted molecular treatments such as tyrosine kinase inhibitors (e.g., pexidartinib)—may be considered to reduce the risk of recurrence [&lt;span&gt;2, 6&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;This case report describes a patient with an underlying diagnosis of Sjögren's syndrome who was diagnosed with PVNS based on pathological findings from a total knee replacement (TKR). We aim to highlight the key considerations in its diagnosis and management.&lt;/p&gt;&lt;p&gt;A 62-year-old Taiwanese woman presented with a 5-year history of persistent right knee pain and limited range of motion. She is a chronic hepatitis B carrier under regular monitoring. She does not smoke or drink. She has no significant family history. Initially, she was diagnosed with a knee effusion in her right knee and underwent arthroscopy in 2017. However, her symptoms gradually worsened, significantly impairing daily life. In 2022, she sought medical care at our orthopedic outpat","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 8","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1756-185x.70392","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144832927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Anifrolumab for Successful Treatment of Refractory Ulcers due to Cutaneous Lupus Vasculitis","authors":"Shunichiro Hanai,&nbsp;Yoshiaki Kobayashi,&nbsp;Moe Watanabe,&nbsp;Kojiro Ikeda,&nbsp;Soichiro Kubota,&nbsp;Daiki Nakagomi","doi":"10.1111/1756-185x.70387","DOIUrl":"https://doi.org/10.1111/1756-185x.70387","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 8","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144832929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Daratumumab for a Patient With Refractory Systemic Lupus Erythematosus and Antiphospholipid Syndrome Presenting as Thrombocytopenia","authors":"Xinyu Li,&nbsp;Xuesong Liu,&nbsp;Hanlin Yin,&nbsp;Liangjing Lu","doi":"10.1111/1756-185x.70395","DOIUrl":"https://doi.org/10.1111/1756-185x.70395","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 8","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144814909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes After SARS-CoV-2 Infection and Vaccination in Patients With Pediatric Rheumatic Diseases","authors":"Yuko Hayashi,&nbsp;Maho Hatano,&nbsp;Shuya Kaneko,&nbsp;Asami Shimbo,&nbsp;Hitoshi Irabu,&nbsp;Yuko Akutsu,&nbsp;Masaaki Mori,&nbsp;Masaki Shimizu","doi":"10.1111/1756-185x.70394","DOIUrl":"https://doi.org/10.1111/1756-185x.70394","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 8","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144814908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bleed and Blister: A Case Report of a 40-Year-Old Woman With Hemorrhagic Bullous Henoch-Schonlein Purpura","authors":"Brylle Domerson Turalba,&nbsp;Hannah Urbanozo-Corpuz,&nbsp;Allan Corpuz","doi":"10.1111/1756-185x.70388","DOIUrl":"https://doi.org/10.1111/1756-185x.70388","url":null,"abstract":"<div>\u0000 \u0000 <p>Henoch-Schonlein Purpura (HSP) is a rare immune vasculitis affecting small blood vessels. Hemorrhagic-bullous conversion of HSP is even rarer, especially in adults, and remains poorly characterized. We present a unique case of a 40-year-old female with hemorrhagic-bullous HSP. The patient presented with maculopapular and vesicular rashes, progressing to bullae predominantly on the bilateral legs. Past history included a similar episode at 17 years old. Laboratory findings showed elevated inflammatory markers, microscopic hematuria, and fecal occult blood. Skin biopsy confirmed leukocytoclastic vasculitis. Immunosuppression with hydrocortisone, colchicine, and azathioprine was initiated. Methylprednisolone pulse therapy was given; transitioning to prednisone. Concurrent urinary tract infection and nephrolithiasis were addressed. Lesions regressed, and the patient was discharged on a tapering prednisone regimen. HSP, particularly the hemorrhagic-bullous variant, is a diagnostic challenge; management remains varied. This case contributes to understanding this rare manifestation and emphasizes the importance of a multidisciplinary approach for optimal patient outcomes.</p>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 8","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144811061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}