ARP Rheumatology

11/11/2025

📢 New study from the 🇵🇹 Portuguese national Reuma.pt cohort
🧾 Published Online First
🔬 Multicenter analysis of 1,532 patients with Sjögren’s disease:
🫁 9.5% had pulmonary involvement — mainly interstitial lung disease (ILD, 74%)
🚬 Smoking and 👵 older age were key risk factors for ILD
💊 Immunosuppressive therapy helped stabilize lung function (FVC & DLCO)

🌬️ A significant proportion of Sjögren’s patients develop progressive lung fibrosis, highlighting the importance of early recognition and timely treatment.
🔗 https://www.arprheumatology.com/article_abstract.php?id=1610

09/11/2025

🩺 Clinical Case Challenge | ARP Rheumatology (Online First)

👩‍⚕️ A 62-year-old woman presents with:
🫗 Bilateral parotid swelling
👁️ Dry eyes and mouth
🧠 Fatigue and unintentional weight loss

Her lab work shows cytopenia, low complement, elevated ACE and β₂-microglobulin, and imaging reveals enlarged parotid glands with lymphadenopathy.

💭 What’s your diagnosis?
A - Sjögren’s disease with glandular hyperplasia
B - IgG4-related disease
C- Lymphoproliferative disorder
D- Sarcoidosis flare

🔸Leave your answer in the comments!
👇 Read more to learn the answer:
🔗 https://www.arprheumatology.com/article_abstract.php?id=1611

Online firstARP Rheumatology - Online first: 2025-11-08Images in rheumatologyBilateral parotid gland swelling unveiling non-Hodgkin lymphomaAuthorsLucas Rocha M, Tenazinha CUnedited articleThis browser does not support PDFs. Please download the PDF to view it: View PDF. Share Facebook Twitter Gmail....

17/10/2025

🦴 Online first: Images in Rheumatology

We present the case of a 59-year-old woman diagnosed with alkaptonuria, a rare inherited metabolic disorder caused by homogentisic acid dioxygenase deficiency

🖤 The condition leads to ochronotic pigment deposition in connective tissues, resulting in progressive joint degeneration and secondary osteoarthritis. Despite medical management, she eventually required a total hip replacement — with the femoral head showing striking dark-bluish pigmentation, characteristic of ochronosis

✨ This case highlights the disabling musculoskeletal impact of alkaptonuria and the need for early recognition, multidisciplinary follow-up, and timely surgical intervention in advanced stages

📘 Read more here: https://www.arprheumatology.com/article_abstract.php?id=1606

08/10/2025

📢 New case series on immune-mediated diffuse alveolar hemorrhage (IM-DAH)

DAH is a life-threatening complication of immune-mediated diseases. This retrospective single-centre study (2005–2023) reviewed 12 episodes in 10 patients.

✅ Most were treated with glucocorticoids + cyclophosphamide.
✅ RTX, IVIg & PLEX were reserved for select/refractory or high-risk cases.
🏥 ICU admission was frequent, but 9/10 patients survived at 1 year.

This work highlights the complexity of IM-DAH management and the need for future prospective studies to clarify the role of IVIg and PLEX.

Read here 👉 https://www.arprheumatology.com/section.php?id=1780

06/10/2025

📢 New case report in EGPA (Eosinophilic Granulomatosis with Polyangiitis)

A 46-year-old man with ANCA-negative EGPA and multi-organ involvement (lungs, PNS, joints) required several therapeutic adjustments over the years.

✅ Mepolizumab successfully controlled respiratory disease but arthritis persisted.
✅ Addition of rituximab led to significant joint improvement and steroid tapering.

This case adds to the limited evidence (only six prior reports) supporting combined mepolizumab + rituximab in complex, treatment-resistant EGPA.

🤝 Highlights the need for tailored, multi-targeted approaches in refractory vasculitis.

Read here: https://www.arprheumatology.com/section.php?id=1779

02/10/2025

📢 Did you know? Rheumatoid arthritis (RA) doesn’t just affect the joints.

A new review highlights that otologic manifestations such as hearing loss, tinnitus, vertigo, and Ménière’s disease are relatively common in RA.
➡️ Hearing loss affects ~16% of RA patients, with a significantly higher risk than in the general population.

🤝 Collaboration between rheumatologists and ENT specialists is key.
✅ Early recognition can prevent complications and improve quality of life.

Read more here: https://www.arprheumatology.com/section.php?id=1775

30/09/2025

✨ Celebrating 5 years of progress at ARP Rheumatology (2020–2025) ✨

The new editorial in ARP Rheumatology looks back on a transformative five years for the official journal of the Portuguese Society of Rheumatology.

📖 From its origins as Acta Reumatológica Portuguesa to the successful transition to ARP Rheumatology in 2022, the journal has embraced change with a new name, website, submission system, and enhanced international visibility.

🌍 Key milestones:

309 articles published across 22 quarterly issues + annual congress supplements

Expansion from predominantly Portuguese authorship to nearly half of articles now from international colleagues

36% faster time from submission to online publication

Stronger integration with Reuma.pt, with 20 publications based on registry data

Increased presence on social media (X, Facebook, LinkedIn)

💡 ARP Rheumatology continues to be a trusted open-access platform — free for authors, rigorous in science, and growing in impact.

Congratulations to the editorial team, the Sociedade Portuguesa de Reumatologia and all contributors who shaped this journey. The next five years look even brighter!

Read the editorial here 👉https://www.arprheumatology.com/section.php?id=1769

23/09/2025

✨ Editor’s Choice – ARP Rheumatology ✨

Selected by Editor-in-Chief Professor Tânia Santiago, this month’s highlights bring forward important new insights:

🔹 PORTRESS – the first nationwide registry for Sjögren’s disease in Portugal 🇵🇹
🔹 Cervical CPPD – recognizing a diverse and often misdiagnosed spectrum with potential for severe complications
🔹 ASAS definition of difficult-to-manage & treatment-refractory axSpA – first real-world application and insights

📖 All articles are available FREE at 👉 https://www.arprheumatology.com

22/09/2025

📢Online first: “Vanishing hips” in an ultra-rare Gorham–Stout syndrome case

🔸A 54-year-old woman had 2 years of worsening hip pain and limited gait. 🔸X-ray, CT and MRI revealed resorption of both femoral heads with acetabular dysplasia
🔸 GSS remains a diagnosis of exclusion

🔗https://www.arprheumatology.com/article_abstract.php?id=1605

20/09/2025

📢Online first

🌿 What does “difficult-to-manage axial spondyloarthritis” mean?

A new definition from international experts (ASAS) helps doctors identify patients with difficult-to-manage (D2M) or treatment-refractory (TR) axial spondyloarthritis (axSpA).

👥 In a recent study including 207 people with axSpA:

Only 2.9% met the criteria for D2M axSpA
Only 1.4% met the criteria for TR axSpA

Why so few? Because the definition requires patients to have tried at least 2 different advanced treatments (biologics/targeted therapies) with different modes of action, in addition to having ongoing inflammation and symptoms that both the patient and doctor see as problematic.

👉 The good news: most people with axSpA respond to treatment and don’t fall into these categories.



🔗https://www.arprheumatology.com/article_abstract.php?id=1601

18/09/2025

🦴 Calcium pyrophosphate deposition (CPPD) disease is a common crystal arthritis in older adults. While it usually causes joint pain and inflammation, it can also affect the cervical spine — a presentation that is often overlooked.

👉 Cervical CPPD may appear in many ways:
• Incidental chondrocalcinosis on imaging
• Crowned dens syndrome
• Retro-odontoid pseudotumor
• Inflammatory discitis

⚠️ These conditions can mimic infection, cancer, or degenerative disease, leading to misdiagnosis and unnecessary treatments.

🔎 Diagnosis relies on clinical suspicion supported by imaging:

CT is best for detecting calcifications

MRI helps assess soft tissue masses, cord compression, or disc changes

💊 Treatment is mainly symptomatic (NSAIDs, colchicine, glucocorticoids), with surgery reserved for severe neurological complications.

🚨 Key message: Awareness of cervical CPPD is crucial to ensure timely, targeted care and to avoid unnecessary antibiotics or invasive procedures.

🔗https://www.arprheumatology.com/article_abstract.php?id=1603

15/09/2025

📢 Online first

🔎 Real-world evidence on guselkumab in psoriatic arthritis (PsA)

Clinical trials have shown guselkumab to be effective in PsA, but data from everyday practice are still limited. Our new retrospective study across three medical centers followed 70 PsA patients treated with guselkumab for at least 12 months.

✨ What we found:
✅ Significant improvement in disease activity scores (DAS28, DAPSA, MASES, ASDAS) after 12 months
🔒 Retention rate: 79% (most discontinuations were due to inefficacy)
⚠️ No major safety issues were observed
📊 Baseline characteristics did not predict who stopped treatment

👉 Conclusion: Guselkumab showed strong real-world effectiveness, safety, and good treatment persistence in PsA, supporting its role as a valuable therapeutic option. Longer prospective studies will help confirm these outcomes.



🔗 https://www.arprheumatology.com/article_abstract.php?id=1600