Reumatismo最新文献

{"title":"Factors associated with life quality, sleep quality, and depression in systemic sclerosis patients: a cross-sectional study from Iran.","authors":"Dena Mohamadzadeh, Shirin Assar, Zhovan Fatahi, Faraneh Farsad","doi":"10.4081/reumatismo.2025.1790","DOIUrl":"https://doi.org/10.4081/reumatismo.2025.1790","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to determine the prevalence and associated factors of depressive symptoms, poor sleep, and life quality among patients with systemic sclerosis (SSc).</p><p><strong>Methods: </strong>This was a cross-sectional study including 120 SSc patients. Demographic and clinical data were obtained. The Short Form Health Survey 36 (SF-36), Pittsburgh Sleep Quality Index (PSQI), and short form of the Beck Depression Questionnaire were used to evaluate life quality, sleep quality, and self-reported depressive symptoms, respectively. The obtained data were analyzed to identify the demographic and clinical risk associations for depressive symptoms, poor sleep, and life quality.</p><p><strong>Results: </strong>Of 120 participants, 108 patients (90%) were female. The mean age was 42.23 years, and the mean disease duration was 13.58 years. Most of the patients were married, unemployed, or housekeepers. Most of them had moderate economic conditions and tertiary education. The total scores of the SF-36 and PSQI questionnaires were 93.25±3.7 and 9.02±4.51, respectively, which showed good life quality but poor sleep quality. The prevalence of depressive symptoms was 44.16% (n=53), and most of them had mild to moderate depressive symptoms. The factors that correlated with life quality were occupational status and cough. The factors that negatively correlated with sleep quality were the presence of digital ulcers, cough, and dysphasia. The presence of cough, dyspnea, and gastroesophageal reflux disease was associated with depressive symptoms.</p><p><strong>Conclusions: </strong>Our study showed a high prevalence of poor sleep quality and depressive symptoms among SSc patients. We found that gastrointestinal symptoms, respiratory symptoms, and digital ulcers affected patients' life quality, sleep quality, and mental status. Our results also demonstrated that depression was correlated with poor sleep quality, and they were both risk factors for diminished life quality. Identification of these factors would help to make pharmacological and non-pharmacological interventions to improve the quality of life and sleep in SSc patients.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of tramadol/paracetamol 75 mg/650 mg combination therapy for early-stage knee osteoarthritis: a retrospective observational study.","authors":"Alessandro Conforti, Cosimo Ruggiero, Nastasja Palombi, Filippo Messina, Marco Bonifacio, Linda Lucchetti, Marco Ruggiero, Giuseppe La Cava, Roberto Piazza, Mario Mangrella","doi":"10.4081/reumatismo.2025.1872","DOIUrl":"https://doi.org/10.4081/reumatismo.2025.1872","url":null,"abstract":"<p><strong>Objective: </strong>Knee osteoarthritis (KOA) is a progressive joint disorder that significantly impairs patients' quality of life. Effective long-term management of KOA remains challenging due to limited pharmacological options and associated adverse effects. This monocentric, retrospective observational study evaluated the efficacy and safety of a fixed-dose tramadol/paracetamol combination (75/650 mg) in alleviating pain in patients with grade I-II KOA according to the Kellgren-Lawrence classification.</p><p><strong>Methods: </strong>A total of 30 patients treated for 15 days were assessed using the Numerical Rating Scale for pain, the Western Ontario and McMaster Universities Osteoarthritis Index for functional impairment, and the Pittsburgh Sleep Quality Index for sleep quality.</p><p><strong>Results: </strong>Results showed a 30% and 50% pain reduction in 86% and 43% of patients, respectively, alongside significant improvements in functional mobility and sleep quality. Adverse events, including nausea, itching, and sleepiness, occurred in 10% of patients and did not necessitate treatment discontinuation. Efficacy was consistent across demographic and clinical subgroups, possibly suggesting broad treatment applicability.</p><p><strong>Conclusions: </strong>While the findings could support tramadol/paracetamol as a safe and effective first-line therapy for KOA, reinforcing its role in optimizing KOA management strategies, limitations such as the small sample size and lack of a control group highlight the need for further research.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of anifrolumab in reshaping the treatment landscape of extra-renal systemic lupus erythematosus.","authors":"Fulvia Ceccarelli, Matteo Piga, Alessandra Bortoluzzi, Laura Coladonato, Micaela Fredi, Daniele Mauro, Chiara Tani, Luca Iaccarino","doi":"10.4081/reumatismo.2025.1830","DOIUrl":"https://doi.org/10.4081/reumatismo.2025.1830","url":null,"abstract":"<p><strong>Objective: </strong>Systemic lupus erythematosus (SLE) is a multifaceted autoimmune disorder that typically requires management with immunosuppressive and anti-inflammatory treatments. The 2023 guidelines of the European Alliance of Associations for Rheumatology now recommend lowering maintenance glucocorticoid doses to ≤5 mg/day to reduce long-term health risks, a decrease from the previous 7.5 mg/day threshold set in 2019. To help achieve these reduced doses, early initiation of biologic therapies is suggested, even before conventional immunosuppressants. Belimumab and anifrolumab, the biologics currently approved for SLE treatment, have shown greater efficacy than placebo in clinical trials and similar safety profiles, supporting their use in achieving remission and enabling glucocorticoid tapering or discontinuation. This review evaluates the role of biologics, especially anifrolumab, in treating extra-renal SLE in Italy, using clinical scenarios to illustrate situations where early anifrolumab therapy could be beneficial.</p><p><strong>Methods: </strong>Hypothetical scenarios derived from clinical practice were examined to identify real-life contexts suitable for the early initiation of anifrolumab treatment.</p><p><strong>Results: </strong>Anifrolumab represents an effective therapeutic option for various extra-renal SLE patients. These include those who have failed to achieve or maintain remission with standard care, have contraindications to conventional immunosuppressants, are glucocorticoid-dependent, or experience mucocutaneous and musculoskeletal manifestations. Anifrolumab also offers potential benefits for patients planning pregnancy by promoting remission or low disease activity.</p><p><strong>Conclusions: </strong>Despite its recent approval and limited real-world evidence, anifrolumab has emerged as a promising therapeutic option for non-renal lupus. We hope this review will encourage further studies on the efficacy and safety of anifrolumab in real-life SLE patient cohorts.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lucio phenomenon and antiphospholipid antibodies in leprosy mimicking rheumatologic disorders: a case report.","authors":"Rudy Hidayat, Johanda Damanik, Abirianty Priandani Araminta, Melani Marissa, Maria Angela Putri Maharani","doi":"10.4081/reumatismo.2025.1834","DOIUrl":"https://doi.org/10.4081/reumatismo.2025.1834","url":null,"abstract":"<p><p>Hansen's disease, also known as leprosy, is often termed \"the great imitator\" due to its diverse clinical presentations that can mimic various rheumatologic disorders. We present the case of a 34-year-old female who developed extensive purpuric rashes, initially raising suspicion of vasculitis. Laboratory investigations revealed triple-positive antiphospholipid antibodies. However, skin smears and histopathological examination confirmed a diagnosis of diffuse lepromatous leprosy complicated by Lucio phenomenon. This case highlights the importance of considering infectious etiologies, such as leprosy, in the differential diagnosis of vasculitis and rheumatologic diseases. Given the overlapping clinical features, a comprehensive patient history and careful interpretation of autoantibody tests are essential for achieving an accurate diagnosis.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How the ultrasound protocol may improve the timely diagnosis of cerebrovascular complications in giant cell arteritis.","authors":"Beatrice Maranini, Maura Pugliatti, Marcello Govoni","doi":"10.4081/reumatismo.2025.1831","DOIUrl":"10.4081/reumatismo.2025.1831","url":null,"abstract":"<p><p>Giant cell arteritis (GCA) is a granulomatous inflammatory vasculitis of medium and large vessels, with a predilection for the external carotid and ophthalmic arteries and, to a lesser extent, for the vertebral arteries. In early phases of the disease, symptoms may be nonspecific, such as malaise, fever, and weight loss. Overt typical GCA symptoms are temporal headache, scalp tenderness, jaw claudication, and sudden vision loss. Inflammatory vessel involvement in GCA results in partial or complete occlusion of the arterial lumen, leading to complications such as acute ischemic optic neuropathy, transient ischemic attack, and ischemic stroke. The latter is a rare but severe complication of GCA, and it has been reported in 2.8-7% of patients diagnosed with GCA. The majority of ischemic strokes are related to inflammation of vertebral and, less frequently, basilar and internal carotid arteries. Stroke in GCA patients affects vertebrobasilar circulation in 50 to 100% of cases, compared to only 20% observed in cerebrovascular accidents in the general population. Prompt diagnosis of GCA cranial involvement is pivotal, since early start of high-dose corticosteroid treatment and/or immunosuppressive drugs (e.g., tocilizumab and methotrexate) is highly effective in preventing further evolution and recurrence of such complications. In this viewpoint, we have briefly pinpointed the current possible value of vertebral ultrasound from both the rheumatologist's and neurologist's point of view.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retention rate and predictor factors of drug discontinuation in axial spondyloarthritis: a focus on certolizumab and secukinumab.","authors":"Ebru Atalar, Hatice Ecem Konak, Pınar Akyüz Dağlı, Bahar Özdemir Ulusoy, Özlem Karakaş, Kevser Orhan, Rezan Koçak Ulucaköy, Esra Kayacan Erdoğan, Serdar Can Güven, Orhan Küçükşahin, İsmail Doğan, Hakan Babaoğlu, Yüksel Maraş, Şükran Erten, Ahmet Omma, Berkan Armağan","doi":"10.4081/reumatismo.2025.1792","DOIUrl":"10.4081/reumatismo.2025.1792","url":null,"abstract":"<p><strong>Objective: </strong>Drug survival rate and time are important to demonstrate the effectiveness of treatment in patients with axial spondyloarthritis (axSpA) in real life. Therefore, we aimed to evaluate drug survival rate and predictors of discontinuation of certolizumab and secukinumab in axSpA patients.</p><p><strong>Methods: </strong>This single-center retrospective cohort study included patients treated with certolizumab (n=239) and secukinumab (n=64) among axSpA patients followed up at the rheumatology clinic. Clinical, laboratory, and imaging findings, treatment duration, and reasons for discontinuation were evaluated between April 2019 and December 2022. Drug survival rate and time were analyzed using Kaplan-Meier analysis, and predictive factors associated with drug discontinuation were analyzed using multivariable Cox regression analysis.</p><p><strong>Results: </strong>At 12 months, drug retention rates were 76% in the secukinumab group and 73% in the certolizumab group. The overall retention rate was similar in both groups (p=0.641). The median survival time was 66.0 months in the secukinumab group versus 62.8 months in the certolizumab group. A comparison of the patients who discontinued certolizumab treatment with those who continued showed that patients who discontinued certolizumab treatment had a higher frequency of female sex, peripheral arthritis, and inflammatory bowel disease. Comparison of the patients who discontinued secukinumab treatment with those who continued revealed that patients who discontinued secukinumab treatment only had a higher frequency of male sex. Multivariable Cox regression showed that male sex was independently associated with a lower risk of certolizumab discontinuation [hazard ratio (HR): 0.634, 95% confidence interval (CI): 0.41-0.97, p=0.036] and with a higher risk of secukinumab discontinuation (HR: 2.77, 95% CI: 1.18-6.49, p=0.018).</p><p><strong>Conclusions: </strong>Our data showed that the drug survival rate of certolizumab and secukinumab was similar in patients with AxSpA. There was a lower risk of certolizumab discontinuation and a higher risk of secukinumab discontinuation in males.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of an algorithm for optimizing the implementation of ultrasound in the diagnostic workflow in clinical practice: preliminary phase of the RADIAL study, a project of the US Study Group of the Italian Society for Rheumatology.","authors":"Garifallia Sakellariou, Antonella Adinolfi, Joao Madruga Dias, Arianna Damiani, Greta Carrara, Carlo Alberto Scirè, Alberto Batticciotto, Manuela Costa, Emilio Filippucci, Francesco Porta, Marco Canzoni, Annamaria Iagnocco, Georgios Filippou","doi":"10.4081/reumatismo.2025.1787","DOIUrl":"10.4081/reumatismo.2025.1787","url":null,"abstract":"<p><strong>Objective: </strong>To develop and test an algorithm with the aim of optimizing the implementation of ultrasound in the diagnostic workflow in clinical practice.</p><p><strong>Methods: </strong>Through a consensus among the Musculoskeletal Ultrasound (MSUS) Study Group of the Italian Society for Rheumatology, we identified clinical and laboratory variables to be included in 1000minds surveys to develop an algorithm driving clinical diagnostic suspicion. The algorithm would identify potential differential diagnoses where MSUS protocols targeted for specific diseases (rheumatoid arthritis, psoriatic arthritis, gout, calcium pyrophosphate deposition disease, polymyalgia rheumatica, and osteoarthritis) could be applied. The joint sites and elementary lesions for each disease were selected based on a previously performed systematic literature review (SLR) and consensus. Finally, we conducted a pilot study on patients with new-onset arthritis to assess the performance of the algorithm, comparing the algorithm-based diagnosis with the final clinical diagnosis.</p><p><strong>Results: </strong>Based on the consensus and the surveys, age, the number of involved joints, anti-citrullinated protein antibody, rheumatoid factor, C-reactive protein, and erythrocyte sedimentation rate were included in the algorithm. The pilot study included 59 patients: median (interquartile range) age 62.2 (54.1-72.6) years, 78% female. The agreement between the diagnosis selected by the algorithm and the final diagnosis by the rheumatologist was 88.1%. The elementary lesions and joint sites included in the different MSUS protocols were selected based on the best diagnostic accuracy, as shown by the SLR and defined by the working group.</p><p><strong>Conclusions: </strong>The developed algorithm was accurate in identifying the correct diagnosis. Thus, it could reliably drive the decision on the MSUS assessment to perform. The RADIAL study will further investigate the feasibility and added value of MSUS in the diagnostic workflow according to this newly developed clinical suspicion-driven algorithm.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intimate partner violence in reproductive-age and pregnant-postpartum women with autoimmune rheumatic diseases: a comparative cross-sectional study.","authors":"Mara Alejandra Ponce-Santillán, Anahí Carrazco-Chapa, Andres Manuel Ortiz-Rios, Maria Eugenia Corral-Trujillo, Jesus Alberto Cardenas-de la Garza, Cassandra Michele Skinner-Taylor, Dionicio Angel Galarza-Delgado, Lorena Perez-Barbosa","doi":"10.4081/reumatismo.2025.1850","DOIUrl":"https://doi.org/10.4081/reumatismo.2025.1850","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to describe the frequency of intimate partner violence (IPV) in reproductive-age women and pregnant-postpartum women with autoimmune rheumatic diseases (ARDs) and compare it with those without ARDs (controls).</p><p><strong>Methods: </strong>A descriptive, cross-sectional, and comparative study was conducted among pregnant-postpartum patients and reproductive-age women (18-45 years) with and without ARDs who attended the Hospital Universitario in Monterrey, Mexico, and answered the survey Hurt-Insult-Threaten-Scream (HITS) scale in the validated Spanish version, from June 2023 to May 2024.</p><p><strong>Results: </strong>A total of 120 women were included: 60 with ARDs and 60 controls. In both groups, 30 patients were reproductive-age women and 30 were pregnant-postpartum women. A total of 44 (36%) women reported being victims of IPV. No significant differences were found in reported IPV between the control group and the group of women with ARDs (n=21, 35% vs. n=23, 38%, p=0.85). There was no statistically significant difference between the ARD group compared to the control group in the HITS score (p=0.537), nor between the pregnant-postpartum subgroups (p=0.356) or the reproductive-age subgroups (p=0.972). These findings indicate that IPV rates did not significantly differ by ARD status or reproductive stage in this sample.</p><p><strong>Conclusions: </strong>Nearly one in every three women experienced IPV, but our research showed that there was no difference in the frequency of IPV between the ARD group and the control group. Pregnant and postpartum women were more likely to report IPV than women of reproductive age. These findings highlight that IPV is a significant concern for all women in Mexico and the need for increased attention and support for them.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coexisting rheumatoid arthritis and sickle cell disease: case series and literature review.","authors":"Abdallah Alqethami, Sabri Alsaeedi, Samera Felemban, Abdulelah Qadi","doi":"10.4081/reumatismo.2025.1682","DOIUrl":"10.4081/reumatismo.2025.1682","url":null,"abstract":"<p><p>Rheumatoid arthritis (RA) is rarely reported among patients with sickle cell disease (SCD). RA treatment in these patients is believed to be more challenging due to the fear of increasing the risk of infection and complications of SCD. We are reporting 7 patients with concurrent SCD and RA. The average age at the time of the diagnosis of RA was 33.3±12.6 years (ranging from 16 to 53 years), and most were women (5/7). Most of the patients were positive for rheumatoid factor (6/7) or anticyclic citrullinated peptide (6/7). Four patients were treated with hydroxyurea. The most used antirheumatic drugs were methotrexate (7/7), biologic agents (5/7), and prednisone (4/7). Two patients were in remission, four had low and one had high disease activity. Four patients (4/7) had avascular necrosis, two in the shoulders and two in the hip joints. Four patients had emergency visits or hospitalizations within one year of the diagnosis of RA, but none had blood transfusions, infections, or death. The start of antirheumatic medications was not associated with an increased risk of infection, blood transfusions, emergency visits, or hospitalizations, nor with a worsening of laboratory measures. The findings suggest that the treatment of RA in patients with SCD should follow the same strategy as in patients without SCD. However, treatment should be individualized according to the individual patient's risk of infection and SCD complications.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142954111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tuberculosis infection in patients with dermatomyositis.","authors":"Luis Carlos Palomino Romero, Alfredo Vargas Caselles, Natalia Soledad Rius, Enrique Soriano, Javier Rosa, Marina Scolnik","doi":"10.4081/reumatismo.2025.1631","DOIUrl":"10.4081/reumatismo.2025.1631","url":null,"abstract":"<p><p>Patients with dermatomyositis (DM) are particularly susceptible to opportunistic infections due to immunosuppression induced by the disease itself and its treatment. We describe three patients who met the diagnostic criteria for DM and developed tuberculous myositis. The first case, a 54-year-old woman, had a positive polymerase chain reaction (PCR) for Mycobacterium tuberculosis detected in a post-mortem muscle biopsy. A second patient was diagnosed with a positive Ziehl-Neelsen stain in bronchoalveolar lavage, and a third patient, with multiple collections in the thorax and lower limbs, had positive Ziehl-Neelsen stain and PCR for Mycobacterium tuberculosis. In inflammatory myopathies, muscle and soft tissue infection by tuberculosis may produce symptoms similar to the underlying disease. The differential diagnosis of tuberculosis superinfection can be difficult.</p>","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}