Rheumatoid nodules: a narrative review of histopathological progression and diagnostic consideration

Fareez, Faiha; Moodley, Jinesa; Popovic, Snezana; Lu, Jian‐Qiang

doi:10.1007/s10067-023-06589-6

Cited by 6 publications

(1 citation statement)

References 72 publications

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“…[6] The most prevalent extra-articular manifestation of RA is RNs, which are also seen in other inflammatory and autoimmune diseases. [7] RNs seem to be a sign of more severe disease. [6] Smoking, male gender, elevated levels of serum RF, and anti-cyclic citrullinated peptide antibodies are risk factors for RNs.…”

Section: Introductionmentioning

confidence: 99%

Sulfasalazine’s potential in managing rheumatoid nodules: Insights from a case report

Alaswad,

Hamsho,

Sultan

et al. 2024

Medicine

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Rationale: Rheumatoid arthritis (RA) is a systemic inflammatory disease characterized by joint inflammation and various extra-articular manifestations, including rheumatoid nodules (RNs). This case study aims to explore the effectiveness of alternative treatments for RNs, particularly highlighting the therapeutic potential of sulfasalazine. Patient concerns: A 52-year-old male with established RA presented with worsening joint pain and firm nodules on his elbows, feet, and fingers. Diagnoses: The patient fulfilled the diagnostic criteria for RA and was diagnosed with methotrexate-induced RNs based on their temporal association with methotrexate initiation. Interventions: Methotrexate was discontinued and a combination of leflunomide and sulfasalazine was initiated. Sulfasalazine led to improvement in both joint pain and nodule size. However, due to cost concerns, the patient discontinued sulfasalazine, resulting in a resurgence of both symptoms and nodule enlargement. Reintroduction of methotrexate resulted in significant improvement in joint inflammation, and notably, no new nodules developed at 6 months follow-up. Outcomes: Sulfasalazine demonstrated efficacy in managing RA nodules, suggesting a potential alternative therapy. Lessons: The case highlights the complex etiology of nodules in RA and emphasizes the importance of individualized treatment approaches and close monitoring for optimal management.

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Section: Introductionmentioning

confidence: 99%