Context. The prevalence and incidence of systemic lupus erythematosus (SLE) in the world is significant. In recent years, there has been a tendency of the SLE prevalence increase. despite the undoubted progress in understanding the etiology and pathogenesis of SLE, its diagnosis and treatment, the mortality of patients, including ones at young and working age, is higher than in the general population, and circulatory system lesions are ones of its main reasons in these cases. Objective. To analyze the literature, dedicated to the modern view on the problem of systemic lupus erythematosus with and without comorbid lesions of the circulatory system, describe the clinical case. Materials and methods. Content analysis, method of system and comparative analysis, bibliosemantic method of studying the current scientific investigations on modern principles of diagnosis and treatment of patients with SLE are used. A clinical case is described. Results. The article presents modern ideas about the etiological factors and pathogenesis of the disease. The clinical manifestations of SLE are very diverse. The problem of comorbidity and syntropy of lesions is relevant. Lesions of the cardiovascular system in the case of SLE can manifest itself in the form of pericarditis, myocarditis, endocarditis, lesions of the heart valves, coronary arteries, aorta, conduction system, pulmonary hypertension occurrence. The basic principles of drug therapy are also briefly considered. Conclusions. The results of the literature review indicate the importance of the problem of systemic lupus erythematosus, due to its widespread prevalence among the young and people of working age, lack of accurate knowledge about the etiology and pathogenesis of the disease, comorbid lesions of many organs and systems, including circulatory system, the development of severe and often life-threatening manifestations, the lack of clear recommendations that would predict the differentiated use of drugs taking into account comorbid syntropic lesions, which is also demonstrated in the described clinical case. Given this, systemic lupus erythematosus needs further in-depth study.

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Introduction. Patients with rheumatoid arthritis (RA) are twice as likely to have osteoporosis (OP) compared to the general population. The strength of bones depends on mineral substances, mainly represented by calcium phosphate microcrystals. The chief role in the regulation of calcium-phosphorus metabolism is played by vitamin D and parathormone (PTH). The aim of the study. To investigate markers of calcium-phosphorus metabolism in patients with rheumatoid arthritis accompanied by bone mineral density (BMD) disorders and to find out their diagnostic value. Materials and methods. 76 patients with RA (64 premenopausal women and 12 mature men) were included in the study. All patients with RA were subjected to ultrasound bone densitometry and according to its results, patients were divided into three groups: patients with RA and osteopenia, patients with RA and OP; RA patients without BMD disorders. The control group included 22 healthy individuals of both genders without BMD abnormalities. To evaluate calcium-phosphorus metabolism, ionized calcium, total calcium, phosphorus, PTH, and vitamin D in blood serum, and levels of calcium and phosphorus in urine were detected. Results. It was revealed that concentration of total calcium in blood serum of patients with RA is lower compared to healthy individuals, while the same index in urine of patients with RA accompanied by osteopenia, OP or without BMD disorders is higher compared to healthy people. The concentration of vitamin D is significantly lower in patients with RA and OP compared to patients with RA with osteopenia, without BMD disorders, or healthy individuals. The concentration of PTH is higher in healthy individuals compared to patients with RA without BMD abnormalities or with osteopenia. Conclusions. In patients with rheumatoid arthritis with osteopenia or osteoporosis, significantly more often than in patients with rheumatoid arthritis without a violation of bone mineral density, ionized and total calcium, phosphorus in serum and urine, as well as vitamin D indices have deviations from the reference values and are of diagnostic significance.

Annotation. Systemic lupus erythematosus (SLE) is a chronic disease characterized by a variety of clinical manifestations with phases of exacerbation and remission, which often complicate the clinician in determining treatment tactics or possible impact on its course of comorbid lesions, including those caused by viral infection. It is known that more than 90.0 % of patients with SLE are infected with cytomegalovirus (CMV) and about 99.5 % with Epstein–Barr virus (EBV). Because CMV and EBV can persist in the human body, more and more attention is being paid to elucidating the effects of active viral infection on the course and activity of SLE, the main pathogenetic mechanism of which is the autoimmune process. The aim of the study was to establish the frequency of cytomegalovirus and Epstein–Barr infections, and their combination in patients with systemic lupus erythematosus depending on the duration of the disease and the degree of its activity. The study involved 120 patients with SLE aged 18 to 69 years, who were in the rheumatology department of the Communal Non-Profit Enterprise of the Lviv Regional Council “Lviv Regional Clinical Hospital” in 2014–2019. To diagnose CMV and EBV infection, antibodies of immunoglobulins M and immunoglobulins G to viruses were detected in blood serum, as well as viruses were detected with polymerase chain reaction and groups of patients were formed: patients with active CMV infection; active EBV; active CMV and EBV; without active CMV and EBV. To achieve the goal, the study was conducted in two stages: determining the frequency of CMV and EBV infection and their combination depending on the duration of SLE (first) and the degree of its activity (second). Statistical analysis was performed in MS Excel using descriptive statistics, Student's t-test to compare samples with normal distribution, χ2-test, z-test to compare two particles; statistically significant relationship was considered when p<0.05. According to our results, active CMV infection is more common in patients with systemic lupus erythematosus duration less than 1 year, active EBV infection – in patients with disease duration greater than 10 years, a combination of active CMV and EBV infection – in patients with systemic lupus erythematosus duration less than 1 year. The increase in the degree of activity of systemic lupus erythematosus is accompanied by a significant (p<0.05) increase in the incidence of active CMV and EBV infection, as well as an increase in mean IgM and IgG antibody titers to these viruses in patients with increasing disease activity.

Introduction. Systemic lupus erythematosus (SLE) is a disease with numerous clinical manifestations and an unpredictable course. It often lasts for several months or years, with alternating remissions and exacerbations. Multiple organs can be affected simultaneously with varying degrees of severity, resulting in treatment- and disease-related comorbidities, including circulatory system diseases, which are one of the leading causes of death of SLE patients. The aim of the study. To find out the nature and frequency of the circulatory system organs comorbid lesions in patients with systemic lupus erythematosus, to characterize them depending on the gender, age and the disease duration. Materials and methods. Prior to performing the study all patients signed the voluntary consent to participate in accordance with the requirements of Helsinki Declaration of Human Rights, the Council of Europe Convention on Human Rights and Biomedicine. The cohort under investigation included 112 patients with diagnosed SLE of different severity with preliminary stratification as follows: females 89.29 %, patients of working age (57.14 % – young and 39.29 % – middle aged), unemployed (58.04 %), III disability group patients (45.54 %), city residents (62.50 %). According to the results of the disease duration assessment, a significant number of patients with SLE and circulatory system organs comorbid lesions have been ill for 1–5 years (36.61 %) and more than 10 years (38.39 %). All of them were patients of the rheumatology department of the Communal Non-Profit Enterprise of the Lviv Regional Council “Lviv Regional Clinical Hospital” from 2016 to 2021.The research was carried out in several stages, during which the nature and frequency of the circulatory system comorbid lesions with respect to gender, age and disease duration were estimated. Results. While completing the study, almost half of patients with SLE were diagnosed with Raynaud’s syndrome, mitral valve insufficiency and atherosclerosis, about 1/3 – with myocarditis, retinal angiopathy, symptomatic arterial hypertension and livedo reticularis. The varicose veins of the lower extremities, hypertensive disease, diffuse cardiosclerosis, tricuspid valve insufficiency, vein thrombosis, post-thrombophlebitis syndrome, aortic valve insufficiency, capillaritis, pulmonary hypertension, coronary artery disease (CAD) including stable angina pectoris, cardiomyopathy and post-infarction cardiosclerosis were found with the decreasing frequency. Raynaud’s syndrome was significantly more often diagnosed in females and young people; retinal angiopathy, livedo reticularis and symptomatic arterial hypertension – in females and those patients whose SLE lasted for more than 10 years; myocarditis, varicose veins of the lower extremities – in males; capillaritis – in patients with the shortest duration of SLE; atherosclerosis and mitral valve insufficiency – in elderly patients and patients with SLE lasting for 6–10 years; vein thrombosis and stable angina – in elderly patients and those with SLE lasting for more than 10 years; hypertensive disease, diffuse cardiosclerosis, aortic valve insufficiency, post-infarction cardiosclerosis were the most characteristic for the elderly patients with SLE. Conclusions. In patients with systemic lupus erythematosus, a number of circulatory system organs comorbid lesions were found. Having studied their nature and frequency, characterizing them depending on gender, age and the disease duration, we found out the certain features that should be taken into consideration during the screening examination of circulatory system disorders in patients with systemic lupus erythematosus and providing them the integrated care to improve their life quality. With this in mind, systemic lupus erythematosus requires further detailed study.