Coenzyme Q10 supplementation in rheumatic diseases: A systematic review.

Coenzyme Q10 (CoQ10) is a potent antioxidant and anti-inflammatory substance used to treat some rheumatic diseases. Our objective was to review the use of CoQ10 in rheumatic diseases. PubMed/Medline, Embase, Scopus, and Web of Science databases were searched for articles on CoQ10 and rheumatic diseases between 1966 and April 2023. Twenty articles were found, including 483 patients. The investigated conditions were Fibromyalgia (FM) with 15 studies, Rheumatoid Arthritis (RA) with 3 studies, and Antiphospholipid Syndrome (APS) with 2 studies. After CoQ10 supplementation, RA patients observed improvements in disease activity index, inflammatory biomarkers (erythrocyte sedimentation rate), cytokine levels, and a decrease in malondialdehyde. In APS, CoQ10 improved endothelial function and decreased prothrombotic and proinflammatory mediators. Regarding FM, in most of the studies, the patients observed improvements in pain, fatigue, sleep, tender points count, mood disorders, and scores on the Fibromyalgia Impact Questionnaire (FIQ). The drug was well tolerated, with reports of minor side effects in two studies. CoQ10 supplementation seems to be efficacious as a complementary treatment for RA and FM. Upcoming studies with larger samples and including other rheumatic diseases are welcome.

Successful treatment of ankylosing spondylitis with alternative and complementary medicine withdrawal of adalimumab treatment.

BACKGROUND AND PURPOSE: Current treatment strategies for ankylosing spondylitis (AS) include adalimumab and other biological drugs. However, treatment failures and side effects are commonly observed. This report documents the successful use of supplements and dietary changes to treat a patient with AS after cessation of adalimumab therapy. PATIENT PRESENTATION: A 38-year-old human leukocyte antigen B27 positive female patient with AS showed no improvement when treated with a non-steroidal anti-inflammatory drug. The patient then began adalimumab therapy with some success; however, after nine months, she developed a disseminated and refractory Molluscum contagiosum infection. Adalimumab was withdrawn, and the patient started taking supplements, while adopting an anti-inflammatory diet (dairy-free, gluten-free, and sugar-free). Normalization of inflammatory markers was achieved after two months, and magnetic resonance imaging of the sacroiliac revealed a notable physical improvement.

Essential oil therapy in rheumatic diseases: A systematic review.

OBJECTIVES: This paper aims to review articles that have evaluated the role of essential oil therapy in patients with rheumatic diseases. METHODOLOGY: Systematic review. No study design or language limitation was applied. RESULTS: We have identified 13 articles, most of them were used in osteoarthritis (n = 4), rheumatoid arthritis (n = 3) and fibromyalgia (n = 3). Two studies included patients with RA and OA (n = 2). The number of people involved in the study varied from 9 to 162, where female sex was observed in 60-100%. The age of the patients ranged from 36 to 78.3 years old and disease duration 1-11.67 years. The lavender essential oil was the most used, and then Ginger oil, Rosemary oil, and Rosmarinus officinalis. Time of oil use varied from 2 to 12 weeks. Importantly, all studies but one (91.6%) have demonstrated the efficacy of aromatherapy. CONCLUSION: There are few reports on essential oils in rheumatic disease, mainly osteoarthritis, rheumatoid arthritis, and fibromyalgia. All but one study have showed the efficacy of this complementary therapy.

Coronary aneurysms in a child: an unusual presentation of pseudovasculitis.

Abnormalities of the coronary arteries in children are rare and Kawasaki disease is the most common cause of acquired coronary disease in a paediatric population. We report a case of a female child with coronary artery aneurysms and convulsions, who was diagnosed with Kawasaki disease. Due to systemic arterial hypertension and persistence of high inflammatory markers after treatment with high dose glucocorticoid and intravenous immunoglobulin, further investigation was performed and revealed a pheochromocytoma. Surgical removal led to normalization of blood pressure and laboratory parameters. Periodic echocardiography studies revealed progressive reduction of coronary aneurysms, with complete normalisation after 8 months. This is the first case described of coronary aneurysms presenting as a pseudovasculitis syndrome associated with pheochromocytoma.

The role of environmental factors in the pathogenesis of non-organ-specific autoimmune diseases.

The immune system must be able to discriminate between self and non-self. However, mechanisms of doing so sometimes fail, causing the activation and clonal expansion of autoreactive lymphocytes and the development of autoimmune conditions. Although some autoimmune diseases have heritable components, these components are not sufficient to develop an autoimmune condition. A variety of environmental factors have been described as possible triggers of autoimmune diseases, including drugs, infectious agents, smoking, vaccination and adjuvants. The aim of this chapter is to review the most common environmental factors associated with autoimmune diseases.

Psoriatic arthritis.

Psoriatic arthritis (PsA) is a chronic inflammatory spondyloarthritis that occurs in combination with psoriasis. The exact prevalence of PsA is unknown, and its pathogenesis has not yet been fully elucidated. Genetic, environmental, and immunologic factors have all been implicated. The appearance of arthritis might precede, succeed or occur concomitant with skin lesions. PsA is sometimes considered a benign form of arthritis, but it affects patient quality of life and also causes functional impairment. Up to 20% of affected patients exhibit extremely destructive and disfiguring forms of the disease, and PsA is associated with increased mortality. The treatment of PsA aims to provide relief from signs and symptoms of the disease, prevent structural damage to joints, improve patient quality of life and decrease mortality. The choice of treatment depends on the severity of clinical presentation. The use of immunobiological agents is restricted to cases that do not respond to conservative treatment.