Rheumatology Research Journal
Volume:7 Issue: 3, Summer 2022

Hypercalcemia is a rare manifestation in systemic lupus erythematosus (SLE) patients. In this case report, a thirty-five-year-old woman with a 3-year-old history of lupus was reported. Our case had symptoms of SLE flare, including joint pain, hair loss, photosensitivity, high level of calcium and creatinine, and lymphadenopathy. In her brain magnetic resonance imaging, intracranial hemorrhage was detected. Given her high serum level of calcium and phosphorus, reduced parathyroid hormone, and normal level of vitamin D, her hypercalcemia was attributed to the presence of stimulating parathyroid hormone receptor autoantibody. Regarding the findings of this study, it is suggested to consider SLE as a rare but possiblecause of severe hypercalcemia.

Extra-nodal natural killer/T cell lymphoma (EN-NK/T) is a highly uncommon, aggressive, mature T or NK-cell lymphoma with a high fatality rate. It has a propensity for infiltrating tissues and spreading to the eye. EN-NK/T-NT is marked by polymorphic clinical characteristics, which can make diagnosis difficult and cause delayed management. This report details a 63-year-old Iranian woman who presented initially with left ocular involvement of unknown cause. Ethmoidal sinusitis, upper nasal obstruction, right proptosis, dacryocystitis, and pulmonary nodules developed later as her disease progressed. Biopsies of the orbit, ethmoidal sinus, and pulmonary nodules were significant for EN-NK/T cell lymphoma. The patient developed and was treated for Covid-19. Due to the progressive lymphoma, chemotherapy was initiated after recovery from Covid-19. After starting the first course of chemotherapy, the patient's condition deteriorated rapidly with the possibility of pulmonary embolism, and she expired inAugust, 2021 2021. This case highlights the diagnostic difficulty of EN-NK/T cell lymphoma and demonstrates its rarity and ability to mimic other diseases.

Wegener’s granulomatosis (WG) is a life-threatening and rare systemic vasculitis associated with anti-neutrophil cytoplasmic antibodies and granulomatous lesions. The disease is primarily associated with pulmonary and renal involvement. Diagnosing this disease is a challenging task because of the lack of specific histological findings and its numerous manifestations. Although WG may affect any organ, the lung is most frequently affected. Herein, we report a case of a granuloma mass in the soft tissue of the leg and chronic ulcer around the talus with fistula to the bone similar to chronic inflammatory osteomyelitis.

Systemic sclerosis (SSc) is an autoimmune rheumatic disorder characterized by vascular damage, sclerotic skin changes, and multi-system involvement of internal organs. Digital ischemic lesions, nailfold capillary abnormalities, and secondary Raynaud’s phenomenon are common manifestations of microvascular injuries. Recent findings have revealed that macrovascular involvement in SSc more prevalent than previously believed. There have been reports of large vessel involvement, such as the ulnar, femoral, carotid, renal, and pulmonary arteries. We report here a case of a young woman with progressive SSc who complained of lower limb pain, dysphagia secondary to esophageal dysfunction, and urinary incontinence.She had symptoms of Raynaud’s phenomenon, skin sclerosis, sclerodactyly, digital pitting ulcers,nailfoldcapillary abnormalities, and digital ischemia. On special examination, the anti-centromere antibody was detected. She developed bilateral popliteal artery occlusion as a complication of SSc.