Macrophage activation syndrome (MAS) is one of the few entities in rheumatology with the potential to quickly cause multiple organ failure and loss of life, and as such, requires urgent clinical intervention. It has a broad symptomatology, depending on the organs it affects. One especially dangerous aspect of MAS’s course of illness is myocarditis leading to acute heart failure and possibly death. Research in recent years has proved that macrophages settled in different organs are not a homogenous group, with particular populations differing in both structure and function. Within the heart, we can determine two major groups, based on the presence of the C-C 2 chemokine receptor (CCR2): CCR2+ and CCR2−. There are a number of studies describing their function and the changes in the population makeup between normal conditions and different illnesses; however, to our knowledge, there has not been one touching on the matter of changes occurring in the populations of heart macrophages during MAS and their possible consequences. This review summarizes the most recent knowledge on heart macrophages, the influence of select cytokines (those particularly significant in the development of MAS) on their activity, and both the immediate and long-term consequences of changes in the makeup of specific macrophage populations—especially the loss of CCR2− cells that are responsible for regenerative processes, as well as the substitution of tissue macrophages by the highly proinflammatory CCR2+ macrophages originating from circulating monocytes. Understanding the significance of these processes may lead to new discoveries that could improve the therapeutic methods in the treatment of MAS.
Fatigue is a prevalent symptom in various rheumatic diseases, such as rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. It is characterised as a subjective, enduring feeling of generalised tiredness or exhaustion, impacting the patient’s life quality and exacerbating disability. The fatigue nature is multifaceted, encompassing physiological, psychological, and social factors, and although the exact cause of inflammatory joint diseases is not fully understood, several factors are believed to contribute to its development. Despite high prevalence and importance, the symptom is often underestimated in clinical practice. Chronic inflammation, commonly associated with rheumatic diseases, has been proposed as a potential contributor to fatigue development. While current treatments effectively target inflammation and reduce disease activity, fatigue remains a persistent problem. Clinical evaluation of rheumatic diseases primarily relies on objective criteria, whereas fatigue, being a subjective symptom, is solely experienced and reported by the patient. Managing fatigue in inflammatory joint diseases involves a multifaceted approach. Identifying and comprehensively assessing the subjective components of fatigue in individual patients is crucial for effectively managing this symptom in everyday clinical practice.
Macrophage activation syndrome is a severe and potentially fatal condition in rheumatology. It can involve many different organs and systems, including the cardiovascular system, but heart failure due to its course is a relatively rare occurrence. In the following paper, we present a case of a young woman with newly diagnosed systemic lupus erythematosus who, in the span of two months, developed macrophage activation syndrome and acute heart failure, which caused her death. We analyze potential causes that may have led to that outcome, and present a brief review of the current literature concerning different macrophage groups in the heart and their potential involvement in the development of heart failure.
Behçet's disease is a rare systemic vasculitis that involves both arteries and veins of various sizes. The main symptoms of the condition are aphthous mouth ulcers and genital ulcers, skin and ocular lesions, neurological disorders, arthritis and gastrointestinal (GI) complications. Ocular manifestations have the greatest impact on the deterioration of patients' quality of life, as they may cause vision loss. The most typical ocular lesion is posterior uveitis. Often ocular involvement may initially be asymptomatic and difficult to diagnose on standard ophthalmic examination. All patients diagnosed with Behçet's disease should have regular check-ups using the latest diagnostic methods. The treatment of patients with Behçet's disease and ocular manifestations requires the cooperation of a rheumatologist and an ophthalmologist to achieve the best results.
Introduction: Behçet disease (BD) is a rare systemic vasculitis of unknown aetiology, which can involve different size arteries and veins. The syndrome is characterized by oral aphthous ulcers, genital ulcers, skin and ocular lesions, arthritis, gastrointestinal ulcers, and neurological signs. Aim: The aim of this paper is to discuss comorbidity of BD with other autoimmune diseases referring to a clinical case report. Case study: The study presents a case of BD concurrent with vitiligo, psoriasis and scleritis in a 22-year-old patient. Results and discussion: The aetiology and pathogenesis of BDare unknown. The presented case of BD was accompanied by psoriasis, nodular scleritis, and vitiligo, which is uncommon. In Poland, since the disease is rare and only single cases have been identified, the precise epidemiology is unknown. Currently, more cases are being diagnosed. Conclusions: Due to nonspecific symptoms and rarity in some countries, BD diagnosis can be delayed, which may have a negative effect on a patient’s life quality. Further studies exploring the correlation between BD, psoriasis, vitiligo, and nodular scleritis are needed to better understand the pathogenesis and relationship between the diseases.
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