BMC Rheumatology最新文献

{"title":"Prevalence of co-existing autoimmune and autoinflammatory diseases in vitiligo: a survey-based study from Egypt.","authors":"Samar Tharwat, Fatma Hamdy, Sara Hamdy, Mohammed Kamal Nassar","doi":"10.1186/s41927-024-00427-1","DOIUrl":"10.1186/s41927-024-00427-1","url":null,"abstract":"<p><strong>Background: </strong>The exact cause of vitiligo is still unknown. Genetic factors, self-destruction of melanocytes, the autoimmune process, and oxidative stress all can contribute to the pathogenesis of vitiligo.</p><p><strong>Objectives: </strong>The aim of this study was to figure out the frequency of coexisting autoimmune and autoinflammatory diseases (AIIDs) in Egyptian patients with vitiligo and identify the associated risk factors.</p><p><strong>Materials and methods: </strong>Egyptian children and adults with vitiligo and their parents were asked to answer a web-based survey. The survey consisted of multiple questions centered around demographic, clinical, and therapeutic data. The vitiligo disease activity (VIDA) score was evaluated for all the patients. Patients were also asked about the presence of co-existing AIIDs.</p><p><strong>Results: </strong>There was a total of 294 participants, mostly females (54.8%), with a median age of 35 years and a median disease duration of 9 years. Nearly 27% had at least one AIID. The most common associated AIIDs were autoimmune thyroid disease (47 patients, 16%), followed by alopecia areata (14 patients,4.8%), then psoriasis and rheumatoid arthritis (11 patients, 3.7%). Univariate regression analysis revealed that age (OR 1.02, P = 0.036), female gender (OR 2.2, P = 0.004), disease duration (OR 1.04, P < 0.001), affected body surface area (OR 1.7, P = 0.048), and family history of AIIDs (OR 2.7, P < 0.001) were predictors for the presence of AIIDs in patients with vitiligo.</p><p><strong>Conclusion: </strong>AIIDs are prevalent among vitiligo patients. Age, female gender, and family history of AIIDs are the main predictors of the presence of AIIDs in vitiligo patients.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"8 1","pages":"59"},"PeriodicalIF":2.1,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582067","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":"Norwegian society of rheumatology recommendations on diagnosis and treatment of patients with Polymyalgia Rheumatica: a narrative review.","authors":"Stig Tengesdal, Andreas P Diamantopoulos, Lene Kristin Brekke, Emilio Besada, Geirmund Myklebust","doi":"10.1186/s41927-024-00422-6","DOIUrl":"10.1186/s41927-024-00422-6","url":null,"abstract":"<p><strong>Background: </strong>To provide evidence-based, up-to-date recommendations for physicians in primary and specialist healthcare setting in diagnosing and treating patients with polymyalgia rheumatica (PMR).</p><p><strong>Methods: </strong>The PMR working group conducted a narrative review of the available evidence in the field and wrote the draft guidelines. These guidelines were discussed and revised according to the standard operating procedures within the Norwegian Society of Rheumatology. The European Alliance of Associations for Rheumatology (EULAR) and American College of Rheumatology (ACR) recommendations for the management of PMR, the British Society for Rheumatology (BSR) guidelines for the management for PMR, the treat-to-target recommendations in giant cell arteritis and PMR and the 2023 recommendations for early referral of individuals with suspected polymyalgia rheumatica were used in particular for purpose of harmonization.</p><p><strong>Results: </strong>A total of 10 recommendations have been formulated covering initial diagnostic investigations, comorbidity assessment, imaging, specialist referral criteria, treatment involving glucocorticoids and steroid-sparing agents and follow-up care.</p><p><strong>Conclusion: </strong>Norwegian recommendations for diagnostics and treatment to improve management and outcome in patients with PMR were developed.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"8 1","pages":"58"},"PeriodicalIF":2.1,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11533311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567077","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":"Headaches in SLE patients: a cross-sectional analysis of clinical, immunological, and Radiological Correlations.","authors":"Eman Samy, Enas S Zahran, Mona Sabry, Hosna Elshony","doi":"10.1186/s41927-024-00424-4","DOIUrl":"10.1186/s41927-024-00424-4","url":null,"abstract":"<p><strong>Background: </strong>Systemic Lupus Erythematosus (SLE) is a multifaceted autoimmune disorder characterized by diverse clinical manifestations, including a significant prevalence of headaches. This cross-sectional study aimed to thoroughly explore the relationship between SLE and headaches by analysing their prevalence, types, and associated clinical, immunological, and radiological factors.</p><p><strong>Method: </strong>A comparative analysis was conducted on 179 SLE patients, who were categorized into two groups: those with headaches and those without. Data collection encompassed demographic details, disease activity levels, neurological assessments, immunological profiles, and brain imaging results. Headaches were diagnosed and classified following the International Classification of Headache Disorders (ICHD-3). Disease activity was measured using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). Statistical analyses were performed to identify significant associations and correlations.</p><p><strong>Results: </strong>Headaches were observed in 55% of the SLE patients, predominantly presenting as tension-type headaches (65%) and migraines (27%). Notably, no patients met the criteria for a lupus-specific headache. The Headache Group exhibited significantly higher disease activity (SLEDAI scores). Tension-type and migraine headaches were particularly associated with increased muco-cutaneous manifestations. The presence of antiphospholipid (aPL) antibodies was significantly linked to migraines and cluster headaches. While neurological disorders such as ischemic stroke and venous sinus thrombosis were more prevalent in the Headache Group, these findings were not statistically significant. Brain MRI abnormalities were detected in 9.4% of patients with headaches, including venous sinus thrombosis (2.3%), ischemic stroke (5.8%), and white matter hyperintensities (1.1%).</p><p><strong>Conclusion: </strong>This study underscore es the complex relationship between SLE and headaches, suggesting that headaches may serve as an indicator of heightened SLE disease activity. Immunological factors, particularly aPL antibodies, show a strong association with specific headache types. MRI abnormalities further emphasize the intricate neurobiological aspects in SLE patients experiencing headaches. Continued research is essential to better understand biomarkers, genetic factors, and effective treatment strategies for managing headaches in SLE patients.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"8 1","pages":"57"},"PeriodicalIF":2.1,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11526631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543687","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":"What are the functional and clinical characteristics shared by fibromyalgia and low back pain? A scoping review.","authors":"Bastien Couëpel, Mathieu Tremblay, Marjorie Bernier, Jacques Abboud, Martin Descarreaux","doi":"10.1186/s41927-024-00430-6","DOIUrl":"10.1186/s41927-024-00430-6","url":null,"abstract":"<p><strong>Background: </strong>Fibromyalgia and chronic primary low back pain are two chronic pain conditions with a significant biopsychosocial burden. Recently, the International Association for the Study of Pain has grouped them under the term chronic primary pain. To further explore similarities and differences between these two conditions, the objective of this scoping review is to explore the pain-related, physiological and psychological outcomes in individuals with fibromyalgia and low back pain.</p><p><strong>Methods: </strong>The following databases were used to find relevant studies, using the PRISMA guidelines: Medline, Psycinfo, and CINAHL. Studies were included if they encompassed both participants with fibromyalgia or low back pain, with the objective to compare pain-related, physiological and/or psychological outcomes.</p><p><strong>Results: </strong>Nineteen studies were selected for extraction. Among the 2801 participants, 968 had fibromyalgia (mean age 48.56 ± 7.97 years, with 94% being female) and 896 had low back pain (mean age 47.48 ± 8.15 years, with 80% being female). Pain sensitivity, physical dysfunction, illness perception, psychological distress, alexithymia, depression, and anxiety were generally more severe in participants with fibromyalgia. Most studies found similar levels of pain intensity, kinesiophobia, quality of pain, quality of life, impact of pain, suicidal risk, anger, and social support comparing individuals with fibromyalgia and individuals with low back pain.</p><p><strong>Discussion: </strong>This scoping review highlights that although both conditions show similar pain intensity and impact on quality of life, fibromyalgia is associated with greater overall severity than low back pain, especially in sensitivity to pain and depression/anxiety.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"8 1","pages":"56"},"PeriodicalIF":2.1,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521037","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":"Correction: Patient-reported outcome measures for systemic lupus erythematosus: an expert Delphi consensus to guide implementation in routine care.","authors":"Isabel Castrejón, Laura Cano, María José Cuadrado, Joaquín Borrás, Maria Galindo, Tarek C Salman-Monte, Carlos Amorós, Carmen San Román, Isabel Cabezas, Marta Comellas, Alejandro Muñoz","doi":"10.1186/s41927-024-00432-4","DOIUrl":"10.1186/s41927-024-00432-4","url":null,"abstract":"","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"8 1","pages":"55"},"PeriodicalIF":2.1,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495100","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":"Correlations among quality of life, spinal mobility, and disease activity in early-treated axial spondyloarthritis: a single-center cross-sectional study.","authors":"Tinh Khampaen, Thanuchporn Kafaksom, Nichapa Dechapaphapitak, Nattakirana Tongdee, Parawee Chevaisrakul","doi":"10.1186/s41927-024-00426-2","DOIUrl":"https://doi.org/10.1186/s41927-024-00426-2","url":null,"abstract":"<p><strong>Background: </strong>Axial spondyloarthritis (axSpA) significantly impacts patients' lives. The ASAS-OMERACT guideline was formulated for the multidimensional evaluation of axSpA patients, employing a specific set of tools. Given the pivotal role of patient perception, comprehensive correlation among these tools, especially concerning quality of life, may provide a clinically relevant perspective and enhance treatment efficacy in the early stages of the disease. This study aims to investigate the correlation among disease activity, functional ability, and quality of life in early-treated axSpA patients. In addition, the association between high disease activity and clinical characteristics was explored.</p><p><strong>Methods: </strong>This cross-sectional study was conducted in a tertiary hospital in Thailand. Patients diagnosed with axSpA according to ASAS classification criteria and receiving treatment from rheumatologists within three years of onset of symptoms were included. Clinical and laboratory data were retrieved from a hospital database. Disease activity was assessed using the Ankylosing Spondylitis Disease Activity Score with ESR or CRP (ASDAS-ESR/CRP) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Spinal mobility was measured using the Bath Ankylosing Spondylitis Metrology Index (BASMI), while quality of life and function were evaluated using the ASAS Health Index (ASAS-HI) and Bath Ankylosing Spondylitis Functional Index (BASFI), respectively. The correlation between these measurements was analyzed using the Pearson correlation coefficient (r). Additionally, factors associated with high disease activity (ASDAS/CRP > 2.1) were explored using multivariate regression analysis.</p><p><strong>Results: </strong>Sixty-six patients (41 males; mean age 49.3 ± 13.3 years) were enrolled between April to December 2022. Disease activity (ASDAS-CRP) was significantly inversely correlated with spinal mobility (BASMI), function (BASFI), and quality of life (ASAS-HI). High disease activity was associated with obesity (BMI ≥ 30 kg/m^2) and a longer duration of symptoms before treatment (≥ 2 years).</p><p><strong>Conclusion: </strong>In early-treated axSpA patients, ASDAS-CRP showed significant correlations with functional ability, quality of life, and spinal mobility. High disease activity was associated with obesity and a longer pre-treatment symptom duration in our study. Early treatment may enhance patients' function, mobility, and quality of life, with weight reduction being possibly beneficial for obese axSpA patients.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"8 1","pages":"54"},"PeriodicalIF":2.1,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11481462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458044","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":"Reproductive health and rheumatoid arthritis.","authors":"Mohammad Erfan Ranjbaran, Maryam Kazemi","doi":"10.1186/s41927-024-00429-z","DOIUrl":"https://doi.org/10.1186/s41927-024-00429-z","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence of Rheumatoid Arthritis (RA) has been steadily increasing over the last thirty years, particularly among women. Due to the conflicting results of various studies on the link between rheumatoid arthritis and reproductive health, we have undertaken this study to explore their relationship.</p><p><strong>Methods: </strong>This cross-sectional study utilized primary data from5557 women involved in the Fasa Persian Cohort in the years 2013 to 2018. The study examined the frequency of RA and its association with various factors related to reproductive health, including age at first pregnancy, number of alive children, history of abortion, and infertility. SPSS software was utilized for data analysis, with the significance level set at p < 0.05.</p><p><strong>Results: </strong>5557 women with an average age of 48.6 ± 9.5 years participated. Of these women, 7.2% were diagnosed with rheumatoid disease, with an average onset age of 38.2 ± 15.2. The study did not find a significant correlation between RA and factors such as number of pregnancies, age at first pregnancy, duration of breastfeeding and number of children.</p><p><strong>Conclusion: </strong>The study suggests that the experience of RA is independent of gynecological, obstetric factors, or reproductive life. This finding may provide reassurance to women affected by RA.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"8 1","pages":"53"},"PeriodicalIF":2.1,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11475594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458045","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":"Survey self-report of rheumatoid arthritis and treatments versus specialist clinician confirmation.","authors":"Shamil Jugnundan, Gabriela Schmajuk, Laura Trupin, Paul D Blanc","doi":"10.1186/s41927-024-00425-3","DOIUrl":"10.1186/s41927-024-00425-3","url":null,"abstract":"<p><strong>Objective: </strong>To assess agreement between patient survey report and physician recorded arthritic conditions and medication use in order to validate population-based epidemiologic approaches to auto-immune arthritic conditions.</p><p><strong>Methods: </strong>Rheumatologists in the U.S. Appalachian region recruited men 50 years or older with a confirmed rheumatoid arthritis (RA) diagnosis. For each participating patient, the treating specialist completed a brief chart abstraction that included rheumatic diagnosis and corresponding treatment. Patients participated in a telephone interview using the same questionnaire as applied in a larger random digit dial survey that queried arthritis diagnosis and treatment. We assessed patient-clinician agreement with the Prevalence Adjusted and Biased Adjusted Kappa (PABAK) statistic.</p><p><strong>Results: </strong>We included 36 patient-clinician dyads in this analysis. All clinicians and patients concurred in the RA diagnosis (PABAK = 1). For concomitant systemic lupus and scleroderma, we observed generally concordant responses (PABAK 0.89 and 1, respectively). For medication use, for hydroxychloroquine or sulfasalazine was associated with the lowest PABAK (0.39), intermediate values for methotrexate and for the \"other conventional synthetic DMARDs\" category (0.67), and with the highest agreement PABAK value for the \"biologic DMARD or JAK 2 inhibitor\" category (0.89).</p><p><strong>Conclusion: </strong>Survey-based self-report of RA offers a useful approach in epidemiological investigation. This is particularly relevant to population-based approaches to autoimmune arthritis related to occupational and environmental factors.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"8 1","pages":"51"},"PeriodicalIF":2.1,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11462809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387974","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":"Disabling foot pain and its impact on daily living among people with psoriatic arthritis in Singapore: a cross-sectional observational investigation.","authors":"Vanessa H Y Teo, Kai Li Chia, Catherine Bowen, Manjari Lahiri, Peter P M Cheung, Deborah E Turner, Kate Carter","doi":"10.1186/s41927-024-00409-3","DOIUrl":"10.1186/s41927-024-00409-3","url":null,"abstract":"<p><strong>Background: </strong>Psoriatic Arthritis (PsA)-related foot involvement has been shown to have a profound impact on daily functioning, with most studies having focused on predominantly Caucasian populations. The aim was to describe disabling foot pain (DFP) and its impact on daily living in PsA in Singapore.</p><p><strong>Methods: </strong>A cross-sectional, retrospective study was conducted using clinical data collected during a single-visit to a rheumatology clinic in Singapore. Records for adults with physician-diagnosed PsA were reviewed for sociodemographic information, disease characteristics, global disease activity and burden. Foot-specific measures included clinical assessment and the Manchester Foot Pain and Disability Index used to define DFP and evaluate between-group differences.</p><p><strong>Results: </strong>Forty-two participants with PsA (83% female, 57% Chinese, 31% Malay, 9.5% Indian, mean (SD) age 54-years (16)) attended the rheumatology clinic over the study-period. The median (IQR) disease duration was 2-years (11) and all were taking current DMARDs. Global disease measures demonstrated mild-to-moderate global disease activity and mild functional impairment, and were significantly higher in those with DFP. Despite 90% reporting to be coping well with their condition, self-care and having emotional support (n = 38), this study sample demonstrated high levels of anxiety/depression (29%), sleep disturbance (34%) and fatigue (24%), and a lack of disease- and drug-specific knowledge (64%). Further management was indicated for medication adherence counselling (48%), occupational therapy (43%), physiotherapy (36%) and podiatry (30%). Nearly half had current foot pain with 40% reporting DFP (n = 17), which caused significantly greater difficulty walking 3 km than those without DFP (p < 0.05). Rearfoot enthesitis (plantar fasciitis, Achilles enthesitis) was the most common cause of DFP (67%) with pain lasting longer than 1-year. 72% were overweight or obese, with a high proportion not engaging in any cardiovascular exercise (70%). Three of 42 participants had previously seen a podiatrist.</p><p><strong>Conclusions: </strong>People with DFP in PsA experience more severe global disease activity, reduced mobility and higher levels of negative impact on their daily lives in Singapore. In the absence of working in a multidisciplinary-team, there is value in comprehensive assessments that have potential to capture a holistic view of personal impact and improve person-centred care in PsA.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"8 1","pages":"52"},"PeriodicalIF":2.1,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11462968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387972","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":"Environmental pollution impact on the severity of some rheumatic diseases: a comparative analytical study on inflammatory and non-inflammatory samples.","authors":"Adel Elbeialy, Soaad El Sawy, Hala Elzomor, Rana Haddad","doi":"10.1186/s41927-024-00420-8","DOIUrl":"https://doi.org/10.1186/s41927-024-00420-8","url":null,"abstract":"<p><strong>Objective: </strong>Environmental pollution of heavy metals is increasingly a problem and has become of great concern due to the adverse effects it causes worldwide. Heavy metal exposure has been implicated in health problems, including fibromyalgia and rheumatoid arthritis. We aim to evaluate the rule of chronic heavy metals toxicity on the induction of vitamin D3 (VD) deficiency and parathyroid hormone (PTH) disturbances in an inflammatory disease like rheumatoid arthritis (RA) and non-inflammatory disease like fibromyalgia syndrome (FMS).</p><p><strong>Methods: </strong>This comparative analytical study was conducted on sixty adults (age ≥ 18 years). Participants were divided into three groups. Group I: twenty patients diagnosed with RA according to the specific ACR/EULAR criteria for RA. Group II: twenty patients diagnosed with FMS according to the specific 2010 (ACR) criteria for FMS. Group III: twenty healthy adults. All patients and controls were subjected to routine laboratory tests as well as the measurement of PTH, VD and estimation of serum levels of lead, cadmium, and chromium.</p><p><strong>Results: </strong>VD was significantly inversely correlated to PTH, lead, cadmium, chromium, and activity scores in the RA and FMS groups. Lead, Cadmium and Chromium had a significant independent risk on the VD level in RA patients, while lead had a significant independent risk on the VD level in FMS patients.</p><p><strong>Conclusion: </strong>Heavy metals may affect VD synthesis, leading to hypovitaminosis D and secondary hyperparathyroidism in RA and FMS patients. Heavy metals play a key role in the pathogenesis of RA, FMS, and their disease activity.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"8 1","pages":"50"},"PeriodicalIF":2.1,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387973","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}