Mediterranean Journal of Rheumatology最新文献

{"title":"The Hidden Enemy: A Case Report of Early-Onset Rheumatoid Vasculitis Masquerading as Peripheral Artery Disease.","authors":"Shrreya Agarawal, Gorantla Sai Susmitha, Joydeep Samanta, Jhasaketan Meher, Vinay R Pandit","doi":"10.31138/mjr.230625.erv","DOIUrl":"10.31138/mjr.230625.erv","url":null,"abstract":"<p><p>Rheumatoid vasculitis (RV) is a rare, severe extra-articular manifestation of rheumatoid arthritis (RA), typically occurring after long-standing erosive disease. Advances in RA therapy have reduced its incidence; however, RV can occasionally present early in high-risk patients. We report a man in his thirties from Central India with a 3-year history of inadequately treated seropositive RA, who presented with progressive polyarthritis, neuropathy, and distal ischemic changes. Over five months, he developed worsening joint pain and swelling, followed by tingling, numbness, and subsequently dry gangrene of the 2^nd-5^th toes of the left foot. Examination revealed palpable peripheral pulses, normal ankle-brachial index, active synovitis in 24/28 joints, and sensorimotor deficits with weakness and absent ankle reflex. Laboratory evaluation showed anaemia, thrombocytosis, markedly elevated ESR and CRP, and high RF (288 U/mL) and ACPA (>300 U/mL). ANA and ANCA were negative. CT angiogram ruled out peripheral arterial occlusion, and echocardiography excluded cardiac emboli. Nerve conduction study demonstrated sensorimotor axonal neuropathy. Sural nerve biopsy confirmed vasculitis with axonal damage and perivascular inflammation. A diagnosis of rheumatoid vasculitis was made. Treatment with high-dose intravenous methylprednisolone, followed by oral prednisolone, rituximab, and methotrexate, led to rapid control of joint inflammation and halting of gangrene progression. At 6-month follow-up, the patient was asymptomatic on methotrexate 25 mg/week with steroids tapered off, and no further vascular events. This case highlights that RV may rarely occur early in seropositive RA with poorly controlled disease. Prompt recognition, biopsy confirmation, and aggressive immunosuppression are crucial for favourable outcomes.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"37 1","pages":"243-246"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vision-Threatening Juvenile Lupus Retinopathy: A Report of Two Cases and Review of the Literature.","authors":"Kaustav Bhowmick, Somnath Chakraborty, Sonali Dey, Saptadeep Misra, Juber Khan, Arghya Chattopadhyay, Pasang Lhamu Sherpa","doi":"10.31138/mjr.220625.rra","DOIUrl":"10.31138/mjr.220625.rra","url":null,"abstract":"<p><strong>Aim: </strong>The present case-based review aims to highlight two successfully treated cases of juvenile lupus retinopathy in a 15-year-old and a 17-year-old female with a review of literature highlighting the clinical profile and the treatment modalities used in those cases.</p><p><strong>Methods: </strong>A comprehensive literature search for vision-threatening juvenile lupus retinopathy on Medline/PubMed, Scopus, Web of Science, and Directory of Open Access Journals (DOAJ) revealed 27 cases from 25 case reports.</p><p><strong>Results: </strong>The interval between visual loss and treatment initiation was three days (range: 0- 2 months). The most prevalent fundoscopic findings were cotton-wool spots in 18 (66.7%). IV Cyclophosphamide (CYC) was the most commonly used immunosuppressive agent in 12 cases (44.4%). Retinal photocoagulation was the principal intraocular treatment modality employed in 11 cases (40.7%). The majority of JLR cases (17; 63%) showed excellent vision recovery.</p><p><strong>Conclusion: </strong>Juvenile lupus retinopathy is a rare yet severe manifestation of juvenile lupus and can have excellent outcomes if addressed early and aggressively.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"37 1","pages":"220-235"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pan-Immune-Inflammation Value Predicts Disease Activity and Ocular Involvement in Behçet's Disease: A Case-Control Study.","authors":"Eman M Shawky, Maha S I Abdelrahman, Sara Farrag","doi":"10.31138/mjr.200625.era","DOIUrl":"10.31138/mjr.200625.era","url":null,"abstract":"<p><strong>Objective/aim: </strong>Behçet's disease (BD) lacks distinctive laboratory findings, so this study aimed at evaluating the pan-immune-inflammation value (PIV), neutrophil to lymphocyte ratio (NLR), platelets to lymphocytes ratio (PLR), and monocytes to lymphocytes ratio (MLR) in BD in addition to investigating their relationship with disease activity.</p><p><strong>Methods: </strong>This case control study included 40 BD patients and 40 age and sex matched healthy volunteers. Complete clinical evaluation and disease activity scoring were conducted. Complete blood count was done for all participants with calculation of PIV, NLR, PLR and MLR.</p><p><strong>Results: </strong>BD patients showed significantly higher PIV, NLR, PLR and MLR level than healthy participants (p=0.04, 0.04, < 0.001 and 0.007, respectively). PIV showed significant positive correlation with BDCAF and erythrocyte sedimentation rate (p= 0.025 and 0.039, respectively). We detected a significantly greater PIV in patients with active ocular and musculoskeletal disease (p=0.001 and 0.037 respectively). At a cutoff of 238.26, PIV yielded an AUC of 0.81 (95% CI, p=0.001), with 83% sensitivity and 82% specificity for detecting active ocular involvement.</p><p><strong>Conclusion: </strong>PIV showed positive correlation with disease activity. PIV is superior to other studied blood cells derived ratios in detecting active ocular involvement in BD patients.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"37 1","pages":"193-198"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Giant Cell Myocarditis: Is It Time to Redeploy Cytokine Inhibitors?","authors":"Deepak Nagra, Iyantha Sarindhi Kuruppurachchi, Kaiyang Song, Mark Russell, Katie Bechman, Maryam Adas, Zijing Yang, Chamith Rosa, Siwalik Banerjee, Olivia Flowers, Chris Wincup, Arti Mahto, Daniel Bromage, Nicola Gullick, James Galloway","doi":"10.31138/mjr.240725.eca","DOIUrl":"10.31138/mjr.240725.eca","url":null,"abstract":"<p><p>Giant cell myocarditis (GCM) is a rare, aggressive T-lymphocyte-mediated inflammatory cardiac disorder associated with high mortality. Diagnosis relies on endomyocardial biopsy, revealing lymphocytic infiltrates, granulomas, and myocyte necrosis, with cardiac MRI serving as a valuable non-invasive adjunct. Due to its rarity and coding limitations, GCM remains poorly captured in epidemiological data, hindering robust clinical trials. Current treatment strategies are largely based on case reports and off-label immunosuppressive use, with limited success using conventional DMARDs. Emerging evidence supports targeting T-cell-mediated and cytokine-driven pathways, including TNF inhibitors, JAK inhibitors (e.g., tofacitinib, ruxolitinib), and IL-2-targeted therapies (e.g., basiliximab). Tofacitinib, in particular, offers rapid, broad-spectrum immunomodulation and favourable pharmacokinetics. Although high-quality evidence is lacking, real-world data and coordinated international efforts (e.g., multicentre case series, registries) may help define optimal therapeutic strategies. With increasing availability of biosimilars and off-patent biologics, early cytokine inhibition could represent a paradigm shift in the management of this life-threatening condition.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"37 1","pages":"247-250"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-Related Microbiota Signatures in Inflammatory Diseases: Comparative Insights into Paediatric and Adult Crohn's Disease, Ulcerative Colitis, and Spondyloarthritis.","authors":"Giancarlo Gimignani, Alessandro Borello, Cristina Panetta, Linda Lucchetti, Roberta Caorsi, Marco Gattorno, Alessandro Conforti","doi":"10.31138/mjr.290825.mid","DOIUrl":"10.31138/mjr.290825.mid","url":null,"abstract":"<p><strong>Objectives: </strong>The study investigated the relationship among the human microbiota in the development and progression of inflammatory bowel diseases (IBD), specifically Crohn's Disease (CD) and Ulcerative Colitis (UC), as well as Spondyloarthritis (SpA), comparing paediatric and adult populations.</p><p><strong>Methods: </strong>The research elaborated the distinct characteristics and impacts of CD, UC, and SpA across age groups. It further explored the developmental stages of the paediatric microbiota, identifying factors like delivery method, feeding, and antibiotics as critical influencers. It examined specific dysbiosis patterns in paediatric IBD and SpA associated to disease activity. Subsequently, it addressed the adult microbiota's stability and variations due to diet, lifestyle, and medications, detailing microbial alterations in adult CD, UC, and SpA.</p><p><strong>Results: </strong>A comparative analysis underscores age-related differences in microbiota composition, clinical manifestations, and treatment responses, indicating greater yet weaker microbial populations in adults. In paediatric patients, there was a marked decrease in <i>Faecalibacterium prausnitzii</i> and other bacteria responsible for producing short-chain fatty acids. In contrast, adults tended to show a more persistent form of dysbiosis and lower microbiome resilience. These disparities in microbial and metabolic phenotypes were strongly associated with the activity of the disease and the response to the treatment, which suggests the potential of microbiota-based biomarkers to create age-specific diagnostic and therapeutic approaches.</p><p><strong>Conclusion: </strong>This research found that microbiota play a great role in the inflammatory diseases and they can be of great use in the current treatments as well as serve as a biomarker. The new targeted therapies underscored the necessity of patient specific microbiome studies to enhance diagnostics and therapies of these disorders throughout the lifespan.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"37 1","pages":"146-155"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal Manifestations in VEXAS Syndrome: A Systematic Review of Clinical Features, Pathology, and Outcomes.","authors":"Akhila Arya, Vishnu Mulavini, Rasiya Hashim, Madhumita Rondla, Jia Wei Tan, Dileep Unnikrishnan","doi":"10.31138/mjr.280525.apq","DOIUrl":"10.31138/mjr.280525.apq","url":null,"abstract":"<p><strong>Objective: </strong>This review aimed to synthesise current literature on the clinical presentation, renal pathology, treatment, and outcomes of kidney involvement in VEXAS syndrome.</p><p><strong>Methods: </strong>We conducted a systematic review in accordance with PRISMA guidelines, including all original English-language publications from 2020 to May 14, 2025, that described any form of renal involvement in VEXAS syndrome. Data extracted included patient demographics, clinical presentation, renal biopsy findings, treatment strategies (including dialysis), clinical outcomes, and cause of death.</p><p><strong>Results: </strong>We included nine studies (five case series, three case reports, and one retrospective cohort), providing a total of 39 individual patient records. The reported frequency of renal involvement in VEXAS syndrome ranged from 3.6% to as high as 39% at 10-year follow-up. All documented cases involved male patients. The most common clinical presentations included acute kidney injury (AKI), chronic kidney disease (CKD), proteinuria, and haematuria. Among biopsy findings, interstitial nephritis was most frequently reported, followed by glomerulonephritis, minimal change disease, acute tubular injury, and IgA nephropathy. Less frequently, membranous nephropathy, peritubular capillaritis, glomerulosclerosis, and light chain cast nephropathy were also observed. Treatment primarily involved glucocorticoids, with steroid-sparing agents added based on the presence of coexisting non-renal manifestations. Renal outcomes were generally favourable, with most patients achieving recovery and only rare instances of dialysis dependence. The contribution of renal involvement to overall mortality remains unclear.</p><p><strong>Conclusion: </strong>Renal manifestations in VEXAS syndrome are varied but remain underexplored due to the rarity of the disease. Focused studies on kidney involvement are crucial to improve our understanding of the underlying pathophysiology and its clinical implications.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"37 1","pages":"110-116"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Translation and Validation of the Greek Version of the Revised Fibromyalgia Impact Questionnaire (FIQR).","authors":"Arriana Gkouvi, Eleni C Pardali, Katerina Maria Kontouli, Eleni Patrikiou, Dimitrios P Bogdanos, Dimitrios G Goulis, Maria G Grammatikopoulou","doi":"10.31138/mjr.190525.ria","DOIUrl":"10.31138/mjr.190525.ria","url":null,"abstract":"<p><strong>Objective: </strong>Increasing awareness of chronic pain conditions, such as fibromyalgia, requires validated tools to monitor the impact of the disease and response to treatment. This study aimed to translate and validate the Revised Fibromyalgia Impact Questionnaire (FIQR) in Greek patients with fibromyalgia.</p><p><strong>Methods: </strong>The FIQR was translated into Greek (FIQR-GR) using the forward-backward-forward method. A total of 311 adults participated in this validation study by completing questionnaires and reporting their demographic characteristics (age, gender, weight, height, education, profession, and number of children). Internal consistency was evaluated using Cronbach's alpha, and confirmatory factor analysis (CFA) was conducted to assess the structural validity of the tool. Regression models were used to test the association between FIQR and demographic characteristics.</p><p><strong>Results: </strong>The FIQR-GR demonstrated excellent internal consistency (Cronbach's alpha=0.94, function domain 0.92, Overall Impact domain 0.85, symptoms domain 0.85). CFA revealed goodness of fit (CFI=0.900, RMSEA=0.080, SRMR=0.056) and confirmed the original three-factor model. Most items had high standardised factor loadings (0.51 to 0.86), providing strong evidence for validity, although two items had lower values than expected (0.40 for energy levels, 0.48 for depression). There was a significant positive association between FIQR and body mass index (BMI) (p<0.001), suggesting that patients with a higher BMI experienced more severe fibromyalgia symptoms.</p><p><strong>Conclusion: </strong>The FIQR-GR is a valid and reliable tool for Greek patients with fibromyalgia and a valuable tool in clinical and research settings.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"37 1","pages":"156-163"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimising Conventional Therapy in Rheumatoid Arthritis.","authors":"Alexandros A Drosos, Paraskevi V Voulgari","doi":"10.31138/mjr.311025.eti","DOIUrl":"10.31138/mjr.311025.eti","url":null,"abstract":"<p><p>In the decades of the 1980s and 1990s, before the onset of biologic therapies for rheumatoid arthritis (RA) management, there was a significant number of patients who did not achieve remission or low disease activity (LDA), due to limited therapeutic choices. At that time, only some conventional synthetic disease modifying anti-rheumatic drugs (csDMARDs), along with steroids, were used. Nowadays, despite the progress of RA management with the introduction of biologic (b) and targeted synthetic (ts) DMARDs, which showed significant clinical improvement and retardation of radiological damage, unmet needs of RA treatment still exist. On the other hand, the concept of treat-to-target (T2T) approach and tight control monitoring of disease activity, are considered now the cornerstone for achieving remission or LDA in RA patients. Several clinical trials confirmed the efficacy and safety of csDMARDs using the tight control and T2T strategies. Methotrexate is the fundamental drug for RA management and in combination with other csDMARDs, with or without steroids, it has proven to be efficacious and safe and less expensive in comparison to newer biologic therapies. Furthermore, MTX demonstrated cardioprotective effects and reduced the risk of cardiovascular events in RA patients Therefore, there is a potential for improving treatment strategies with conventional therapies in the management of early RA. Optimal and early use of csDMARDs controls disease activity similarly to biologic therapies and is less expensive.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"37 1","pages":"117-125"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impairment of Diverse Patient-Reported Outcome Measures in Patients with Takayasu Arteritis: A Cohort Study.","authors":"Darpan R Thakare, Upendra Rathore, Kritika Singh, Tooba Qamar, Vikas Agarwal, Manas Ranjan Behera, Neeraj Jain, Manish Ora, Durga Prasanna Misra","doi":"10.31138/mjr.050625.qtr","DOIUrl":"10.31138/mjr.050625.qtr","url":null,"abstract":"<p><strong>Aim: </strong>To comprehensively evaluate patient-reported outcome measures (PROMs) and fibromyalgia in patients with Takayasu arteritis (TAK) compared with healthy controls.</p><p><strong>Methods: </strong>Quality of life (QoL) using EuroQol-5D-3L (EQ-5D), disability using Health Assessment Questionnaire (HAQ), physical activity - Metabolic Equivalents of Task (METs) using International Physical Activity Questionnaire - Short Form (IPAQ-SF), work impairment using Work Productivity and Activity Impairment - General Health (WPAIGH), anxiety using Generalised Anxiety Disorder seven items (GAD-7), depression using Patient Health Questionnaire nine items (PHQ-9), fatigue using Multidisciplinary Fatigue Inventory (MFI) and Functional Assessment of Chronic Illness Therapy (FACIT) scales and fibromyalgia were assessed in patients with TAK. Comparisons were performed between PROMs in patients with TAK and age- and sex-similar healthy controls, TAK with active or inactive disease by physician global assessment (adjusted for Large Vessel Vasculitis Index of Damage scores), or the same patients with TAK over time.</p><p><strong>Results: </strong>Eighty-four patients with TAK (mean age 35.61 years, 61 females) were compared with 61 healthy controls (mean age 33.62 years, 45 females). Patients with TAK had worse QoL, disability, activity impairment due to health, anxiety, depression and fatigue than controls (p<0.01); similar proportions had fibromyalgia. After adjustment for damage scores, patients with active TAK had worse impairment of physical activity due to health and fatigue. PROMs remained stable on follow-up in the patients with TAK (mean follow-up interval 7.53 months).</p><p><strong>Conclusion: </strong>QoL, disability, anxiety, depression, and fatigue are impaired in patients with TAK and remain stable over time. Fatigue is associated with active TAK.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"37 1","pages":"164-178"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Methotrexate-Induced Accelerated Nodulosis: A Case Series\".","authors":"Pavlos Stamatis","doi":"10.31138/mjr.171125.voc","DOIUrl":"10.31138/mjr.171125.voc","url":null,"abstract":"<p><p>Comment on \"Methotrexate-Induced Accelerated Nodulosis: A Case Series\" [Subramanian R et al, Mediterr J Rheumatol 2024;35(4):680-683].</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"37 1","pages":"273-274"},"PeriodicalIF":2.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}