Laura Trives-Folguera, Ana Melissa Anzola, Indalecio Monteagudo-Saéz, Juan Carlos Nieto-González
{"title":"Real life treatment in juvenile idiopathic arthritis: Is remission long lasting?","authors":"Laura Trives-Folguera, Ana Melissa Anzola, Indalecio Monteagudo-Saéz, Juan Carlos Nieto-González","doi":"10.1016/j.reuma.2025.501949","DOIUrl":"10.1016/j.reuma.2025.501949","url":null,"abstract":"<div><h3>Objectives</h3><div>Juvenile idiopathic arthritis (JIA) is a chronic inflammatory disease that can cause pediatric disability. Achieving stable remission is the main objective to avoid disability. We evaluated remission survival in a cohort of patients with JIA and analyzed factors that might influence long lasting remission.</div></div><div><h3>Methods</h3><div>We designed an observational, retrospective and longitudinal study of JIA patients. Remission survival was determined from the first visit in clinical remission to the first flare after remission or the last visit recorded at the end of the study. Stable remission was defined as patients fulfilling the Wallace criteria during 18 months of the Covid pandemic. To compare the role of treatment on stable remission, we divided patients into three groups: without systemic treatment, treated with methotrexate only and treated with biologics.</div></div><div><h3>Results</h3><div>We included 82 JIA patients, 68.3% of whom were female and the median age of disease onset was 4.49 years old. There were no differences in the remission survival rates between JIA subgroups. Nearly 80% had maintained remission at 3 years and a high proportion of patients (68.3%) were still in remission after 5 years. Fifty-seven patients (69.5%) reached stable remission throughout 18 months of the Covid-19 pandemic. Stable remission was more likely in patients without systemic treatment (47.4%) (<em>p</em> <!-->=<!--> <!-->0.015).</div></div><div><h3>Conclusions</h3><div>Remission survival was long-term in real life conditions, with nearly 80% of our patients maintaining stable remission after 3 years. Flares were more frequent in patients treated with methotrexate in monotherapy.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 8","pages":"Article 501949"},"PeriodicalIF":1.3,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145120396","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}
José Édgar Ferrández-Gómez , Mariano Gacto-Sánchez , Aitor Baño-Alcaraz
{"title":"Spanish cross-cultural adaptation and psychometric validation of the graded chronic pain scale revised for fibromyalgia","authors":"José Édgar Ferrández-Gómez , Mariano Gacto-Sánchez , Aitor Baño-Alcaraz","doi":"10.1016/j.reuma.2025.501965","DOIUrl":"10.1016/j.reuma.2025.501965","url":null,"abstract":"<div><h3>Background</h3><div>Chronic widespread pain represents one of the cornerstones in the definition of fibromyalgia. Pain severity can be measured through different instruments, among which the Graded Chronic Pain Scale represents an outstanding framework to assess pain. Its revised version (GCPS-R) has been recently created to adhere to the new paradigmatic definition of chronic pain. Despite the relevance and clinical impact of the GCPS-R, its validation into Spanish has not been performed yet.</div></div><div><h3>Objectives</h3><div>To develop a cross-cultural Spanish-language adaptation of the GCPS-R in a sample of patients diagnosed with fibromyalgia. Besides, we aimed to carry out an initial psychometric analysis of the questionnaire in this population.</div></div><div><h3>Methods</h3><div>An observational, prospective, longitudinal study was conducted among a sample of subjects with fibromyalgia. The translation and cross-cultural adaptation of the GCPS-R was performed, and the new version of the instrument was administered to patients with fibromyalgia. Construct validity was assessed by means of factor analysis, whilst internal consistency, convergent validity, and test–retest reliability were also performed.</div></div><div><h3>Results</h3><div>The sample analyzed consisted of 224 subjects overall. Factor 1 displayed a Cronbach's alpha of 0.711, whilst Factor 2 had an alpha value of 0.890. The convergent validity analysis performed on the pain-intensity subscale of the instrument yielded statistically significant and strong correlation coefficients (Pearson's <em>r</em> <!-->=<!--> <!-->0.713; <em>p</em>-value<!--> <!--><<!--> <!-->0.001). Test–retest reliability yielded weighted Cohen's Kappa scores of 0.537 (<em>p</em>-value<!--> <!--><<!--> <!-->0.001).</div></div><div><h3>Conclusion</h3><div>The GCPS-R-SP represents a simple, easy to administrate, and clinically efficient measure with favorable psychometric properties, covering the level and the impact of chronic pain in subjects with fibromyalgia.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 8","pages":"Article 501965"},"PeriodicalIF":1.3,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145120261","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}
Carmen Gomez-Vaquero, Maribel Mora, Xavier González-Giménez, Carla Marco-Pascual, Pilar Medina, Maria Marta Bianchi, Pilar Santo, Joan M. Nolla
{"title":"Improving fracture risk classification in Spain: A 10-year evaluation of a modified FRAX-based algorithm","authors":"Carmen Gomez-Vaquero, Maribel Mora, Xavier González-Giménez, Carla Marco-Pascual, Pilar Medina, Maria Marta Bianchi, Pilar Santo, Joan M. Nolla","doi":"10.1016/j.reuma.2025.501950","DOIUrl":"10.1016/j.reuma.2025.501950","url":null,"abstract":"<div><h3>Objective</h3><div>Osteoporotic fractures represent a significant clinical and public health burden. Although FRAX is widely used to estimate 10-year fracture risk, its Spanish version underestimates the probability of major osteoporotic fractures (MOF). This study assessed the performance of a modified FRAX-based algorithm, calibrated for the Spanish population, to stratify postmenopausal women into clinically meaningful risk categories.</div></div><div><h3>Methods</h3><div>We retrospectively followed 837 women (mean age 62<!--> <!-->±<!--> <!-->9 years in 2008) referred for bone densitometry. All MOF over a 10-year period were recorded. Women were initially categorized as low risk (MOFR<!--> <!--><<!--> <!-->3.5%) or high risk (≥10%). Those with MOFR between 3.5% and 10% were reclassified as high risk if they had osteoporosis or if the recalculated MOFR including BMD was ≥7%.</div></div><div><h3>Results</h3><div>A total of 124 women experienced a MOF (66 vertebral, 39 distal forearm, 10 hip, 9 humerus). Initial risk classification identified 40% of women as low risk (fracture incidence: 9.4%, 95% CI: 6.2–12.5), 42% as intermediate (16.3%, 95% CI: 12.4–20.1), and 18% as high risk (23.5%, 95% CI: 16.7–30.3). After reclassification, 69% were considered low risk (11.0%, 95% CI: 8.4–13.5) and 31% high risk (23.2%, 95% CI: 18.1–28.3).</div></div><div><h3>Conclusions</h3><div>The proposed FRAX-based algorithm improves fracture risk classification in Spanish women and supports more rational use of bone densitometry and therapeutic interventions.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 8","pages":"Article 501950"},"PeriodicalIF":1.3,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145120334","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}
Hilary Miranda-Mendoza , Daniel Paulino-González , Julio Sesma-Soto , Stephany Segura-García , Gerardo Tirado-Ojeda , Abraham Romero-Beltrán , Fernando Ortiz-Sanchez , Michele Enríquez-Luna , Brandon Fisher-Bautista , Guadalupe O. Gutiérrez-Esparza , Mireya Martínez-García , Luis M. Amezcua-Guerra
{"title":"Establishing reference values for serum urate in healthy adults from Mexico City: Data from the Tlalpan 2020 cohort","authors":"Hilary Miranda-Mendoza , Daniel Paulino-González , Julio Sesma-Soto , Stephany Segura-García , Gerardo Tirado-Ojeda , Abraham Romero-Beltrán , Fernando Ortiz-Sanchez , Michele Enríquez-Luna , Brandon Fisher-Bautista , Guadalupe O. Gutiérrez-Esparza , Mireya Martínez-García , Luis M. Amezcua-Guerra","doi":"10.1016/j.reuma.2025.501943","DOIUrl":"10.1016/j.reuma.2025.501943","url":null,"abstract":"<div><h3>Background</h3><div>Urate is the final product of purine catabolism, and its levels have been linked to various cardiometabolic disorders. In Mexico, most epidemiological data on urate levels derive from populations with existing comorbidities, limiting the establishment of normative reference values.</div></div><div><h3>Objective</h3><div>To characterize the distribution of serum urate concentrations in a healthy adult population residing in Mexico City.</div></div><div><h3>Methods</h3><div>A cross-sectional analysis was conducted using data from 3099 healthy adults (64.6% women) enrolled in the Tlalpan 2020 cohort. Participants with chronic diseases, abnormal blood pressure or glucose levels, or exposure to urate-altering medications were excluded. Clinical, anthropometric, and biochemical parameters were recorded, and serum urate concentrations were analyzed overall and stratified by sex.</div></div><div><h3>Results</h3><div>The median serum urate level in the overall cohort was 5.16<!--> <!-->mg/dL (interquartile range, 4.32–6.15), with a central 95% reference interval ranging from 3.05 to 7.98<!--> <!-->mg/dL. Median urate levels differed significantly by sex: 4.60<!--> <!-->mg/dL (3.99–5.28) in women and 6.39<!--> <!-->mg/dL (5.61–7.09) in men. The prevalence of hyperuricemia in the total cohort was 16.5%, notably higher in men (28.4%) compared to women (10.0%).</div></div><div><h3>Conclusion</h3><div>This study establishes sex-specific reference values for serum urate in a healthy Mexican adult population. The findings may inform clinical decision-making and future research on urate-related risk stratification.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 8","pages":"Article 501943"},"PeriodicalIF":1.3,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145120395","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}
Paul J. Tejada-Llacsa , Vidia Lumbe Diaz , Carlos Diaz-Arocutipa
{"title":"Association between hypothyroidism and elderly-onset rheumatoid arthritis: A cross-sectional study at national hospital in Peru","authors":"Paul J. Tejada-Llacsa , Vidia Lumbe Diaz , Carlos Diaz-Arocutipa","doi":"10.1016/j.reuma.2025.501948","DOIUrl":"10.1016/j.reuma.2025.501948","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the association between hypothyroidism and elderly-onset rheumatoid arthritis (EORA).</div></div><div><h3>Methods</h3><div>A cross-sectional study was performed including patients with rheumatoid arthritis at the Adolfo Guevara Velasco National Hospital, Cusco, Peru in 2024. The outcome was EORA, defined as disease onset after 60 years old. The exposure was a history of hypothyroidism, and the following covariates were considered: sex, smoking, family history of autoimmune disease in first-degree relatives, rheumatoid factor and anti-CCP levels. The association between hypothyroidism and EORA was assessed using prevalence ratios (PR) with their 95% confidence interval (CI), estimated by generalized linear models with a Poisson family, log link, and robust variance. A <em>p</em>-value <0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>A total of 133 patients were included, 14 (10.5%) of whom had EORA. The mean age was 55<!--> <!-->±<!--> <!-->12.6 years and 90% were female. Only 8.3% of patients reported a history of hypothyroidism. Hypothyroidism was significantly associated with EORA (adjusted PR 9.03, 95% CI 3.17–26.68). Other factors associated with EORA were disease duration, smoking, the history of autoimmune disease in a first-degree relative, and rheumatoid factor.</div></div><div><h3>Conclusions</h3><div>A history of hypothyroidism was independently associated with EORA in patients with rheumatoid arthritis from Peru. Screening for hypothyroidism in EORA patients may enhance management and address autoimmune comorbidities.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 8","pages":"Article 501948"},"PeriodicalIF":1.3,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145120394","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}
Marcos Cruces Olivar , Allan D. Burboa , Yolanda M. Gómez
{"title":"Survival of first line biological and targeted synthetic disease-modifying anti-rheumatic drugs in patients with rheumatoid arthritis in Chile","authors":"Marcos Cruces Olivar , Allan D. Burboa , Yolanda M. Gómez","doi":"10.1016/j.reuma.2025.501946","DOIUrl":"10.1016/j.reuma.2025.501946","url":null,"abstract":"<div><h3>Introduction</h3><div>In Chile, patients with refractory rheumatoid arthritis (RA) are candidates for treatment with biologic and targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs). Due to the cost and diversity of drugs currently available to treat RA, there is a greater need to evaluate their survival in the real world and mainly to provide local and national data.</div></div><div><h3>Objectives</h3><div>To describe the survival and cause of discontinuation/change of first line b/tsDMARDs in patients with active refractory RA at the rheumatology clinic of the Regional Hospital of Copiapó.</div></div><div><h3>Materials and methods</h3><div>Patients with refractory RA on first-line treatment with b/tsDMARDs were included. Data were obtained from the RA registry of patients from January 01, 2018, until July 31, 2023, and by reviewing medical records. Demographic and clinical characteristics of the patients, survival of b/tsDMARDs, and cause of discontinuation/change of therapy are described. Kaplan–Meier plots and log-rank tests were performed. Cox model was used to identify factors that affected treatment discontinuation.</div></div><div><h3>Results</h3><div>One hundred thirty patients met the selection criteria. Survival of the different treatments was calculated, excluding rituximab and tocilizumab due to <em>n</em> <10. There were no significant differences between the survival of the groups (anti-TNF, abatacept, tofacitinib), with <em>p</em> <!-->><!--> <!-->0.05. The mean survival time for b/tsDMARDs was 194 weeks. In this cohort, 34.62% (<em>n</em> <!-->=<!--> <!-->45) of the patients had treatment discontinuation/change, with lack of efficacy representing 80%.</div></div><div><h3>Conclusion</h3><div>In this cohort of patients with RA, there were no statistically significant differences in survival after first-line treatment with b/tsDMARDs. The choice of initial therapy will depend on multiple clinical, demographic, economic and regulatory factors.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 8","pages":"Article 501946"},"PeriodicalIF":1.3,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145120333","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}
Jorge Medina-Castillo , Rodrigo J. Castillo-de la Garza , David Vega-Morales , Jorge A. Esquivel-Valerio , Axel A. De León-Pérez , Lorenia De La Cruz-Becerra , Alondra Elizabeth Montoya-Montes , Lourdes Gil-Flores , Dionicio Ángel Galarza-Delgado
{"title":"Rotator cuff tendinopathy is associated with increased activity score in rheumatoid arthritis","authors":"Jorge Medina-Castillo , Rodrigo J. Castillo-de la Garza , David Vega-Morales , Jorge A. Esquivel-Valerio , Axel A. De León-Pérez , Lorenia De La Cruz-Becerra , Alondra Elizabeth Montoya-Montes , Lourdes Gil-Flores , Dionicio Ángel Galarza-Delgado","doi":"10.1016/j.reuma.2025.501947","DOIUrl":"10.1016/j.reuma.2025.501947","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>Rheumatoid arthritis (RA) is often accompanied by musculoskeletal (MS) symptoms, which can hinder the diagnosis of concurrent conditions like rotator cuff tendinopathy (RCT), the most common cause of shoulder pain. Undiagnosed RCT in patients with RA may be associated with higher disease activity scores. This study aimed to assess the difference in these scores between RA patients with and without RCT, considering ultrasound pathological findings.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional, observational, comparative study in patients with shoulder pain who met the 2010 ACR-EULAR classification criteria for RA between January 2022 and January 2023. The measurements of Disease Activity Score based on 28 joints using C-Reactive Protein (DAS28-CRP), Erythrocyte Sedimentation Rate (DAS28-ESR), and the Clinical Disease Activity Index (CDAI) were used to evaluate RA activity, while functional capacity was assessed using the Health Assessment Questionnaire Disability Index (HAQ-DI). The Disabilities of the Arm, Shoulder, and Hand questionnaire (DASHe) and shoulder ultrasound examination was performed to detect the presence or absence of RCT.</div></div><div><h3>Results</h3><div>Patients with RCT had greater mean scores on DAS28-CRP (5.23, 1.28 vs. 3.08, <em>p</em> <!--><<!--> <!-->0.001), and DAS 28-ESR (5.43, SD<!--> <!-->=<!--> <!-->1.28 vs. 3.66, <em>p</em> <!--><<!--> <!-->0.001). VAS median scores were higher in the RCT group (70.00 vs. 2.00, <em>p</em> <!--><<!--> <!-->0.001). By ultrasound 12 patients (21%) had acromioclavicular synovitis. Glenohumeral and acromioclavicular arthrosis was found in both groups. No patients had arthritis in the glenohumeral joint.</div></div><div><h3>Conclusion</h3><div>RA patients with RCT have higher composite index and disease activity scores than those without RCT. An intentional RCT screening should be recommended for those with shoulder pain and elevated disease activity.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 8","pages":"Article 501947"},"PeriodicalIF":1.3,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145120332","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}
Allison Milagros Figueroa-Sánchez , Leonor Stefani León-Yaurimucha , Manuel F. Ugarte-Gil , Victor R. Pimentel-Quiroz
{"title":"Factores asociados a la calidad de vida relacionada con la salud en pacientes con vasculitis asociada a anticuerpos anticitoplasma de neutrófilos: datos de la Almenara Vasculitis Cohort","authors":"Allison Milagros Figueroa-Sánchez , Leonor Stefani León-Yaurimucha , Manuel F. Ugarte-Gil , Victor R. Pimentel-Quiroz","doi":"10.1016/j.reuma.2025.501942","DOIUrl":"10.1016/j.reuma.2025.501942","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the factors associated with health-related quality of life (HRQoL) in adult patients with ANCA-associated vasculitis.</div></div><div><h3>Methodology</h3><div>An observational, analytical, retrospective study was conducted using a convenience sampling technique. Data were obtained from the Almenara Vasculitis Cohort during the period from December 2022 to December 2023. Sociodemographic and disease-related features were obtained using a data collection form. Disease activity, damage accrual, and HRQoL were assessed using the BVASv3, VDI, and SF-36 questionnaires, respectively. Cross-sectional univariable and multivariable linear regression models were performed. Multivariate models were generated using a backward selection procedure with an alpha to stay in the model of 0.05.</div></div><div><h3>Results</h3><div>Fifty-five patients were evaluated; 41 (74.6%) of them were female. Their mean age and disease duration were 58.7 (13.5) and 5.8 (5.2) years, respectively. In the multivariate analysis, low socioeconomic status, older age, and higher erythrocyte sedimentation rate were associated with worse HRQoL. Conversely, male sex, have a diagnosis of eosinophilic granulomatosis with polyangiitis, have an employment, and the use of immunosuppressive drugs other than cyclophosphamide or rituximab were associated with better HRQoL.</div></div><div><h3>Conclusions</h3><div>In our study, male sex, have an employment, the eosinophilic granulomatosis with polyangiitis subtype, and treatment with immunosuppressive drugs other than rituximab and cyclophosphamide were associated with better HRQoL. Meanwhile, older age, low socioeconomic status, and high erythrocyte sedimentation rate levels were associated with worse HRQoL.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 7","pages":"Article 501942"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144831514","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}
Pablo González del Pozo, Paula Álvarez Peñalba, Stefanie Burger, Norma Alejandra Callejas Pineda, Rubén Queiro Silva, Sara Alonso Castro
{"title":"Algas aclorofílicas y bursitis crónica: una asociación excepcional","authors":"Pablo González del Pozo, Paula Álvarez Peñalba, Stefanie Burger, Norma Alejandra Callejas Pineda, Rubén Queiro Silva, Sara Alonso Castro","doi":"10.1016/j.reuma.2025.501920","DOIUrl":"10.1016/j.reuma.2025.501920","url":null,"abstract":"<div><div>We describe a case about a 79-year-old woman with rheumatoid arthritis with chronic left olecranon bursitis refractory to conventional therapy. Following appropriate diagnostic workup, <em>Prototheca</em> spp. alga was identified as the causative agent. The exceptional nature of the case is emphasized.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 7","pages":"Article 501920"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144831417","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}