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EN
Introduction and aim. Autoimmune rheumatic diseases are a group of disorders with similar clinical, laboratory and immunological manifestations. Connective tissue diseases include systemic scleroderma, dermatomyositis or polymyositis, Sjögren’s syndrome, rheumatoid arthritis, and systemic lupus erythematosus. If the patient meets the diagnostic criteria for at least two of these diseases and has specific serologic markers, a diagnosis of overlap syndrome is possible. Description of the case. This case describes a 27-year-old man who had a history of paroxysmal fever, night sweats, erythema-like skin lesions on the forearms and lower legs, a feeling of progressive muscle weakness especially in the proximal muscles, and dry mouth. The patient was diagnosed with an overlap syndrome: systemic lupus erythematosus, dermatomyositis, and Sjögren’s syndrome. Conclusion. Overlap syndrome is difficult to treat due to its multisystem nature, requiring a symptomatic therapeutic approach and careful control of medication doses to reduce side effects while controlling disease activity.
EN
Introduction and aim. Granulomatosis with polyangiitis (GPA), formerly known as Wegener’s granulomatosis, presents a formidable challenge in the realm of autoimmune diseases. Granulomatosis, characterized by vasculitis and granuloma formation, exhibits diverse clinical manifestations. The rarity of GPA is evident, with an estimated incidence between 0.4 and 11.9 cases per 1 million person-years. The aim of this report is to show the complex diagnostic challenges inherent in GPA, demonstrating the diagnostic process from initial symptoms. Description of the case. This case report unfolds the diagnostic journey of a 52-year-old Caucasian male. The presented case, initially suspected as a respiratory infection, led to a comprehensive investigation owing to persistent symptoms, abnormal blood counts, and elevated inflammatory markers. This narrative aims to depict the patient’s diagnostic journey. Key diagnostic tools include ANCA testing, imaging studies, and tissue biopsy. Pulmonary nodules, lymphangitic changes, and renal involvement culminating in a GPA diagnosis confirmed by positive ANCA and anti-PR3 antibodies. The successful management of this case involved a tailored therapeutic regimen, including cyclophosphamide and methylprednisolone, addressing both vasculitic and renal components. Conclusion. This case contributes to the understanding of atypical presentations of GPA, emphasizing the importance of a holistic and dynamic diagnostic approach.
EN
Introduction and aim. Oral manifestation of the disorder is the leading cause of common initial features of most autoimmune diseases. Therefore, this study aimed to present different oral manifestations of selected autoimmune diseases. Material and methods. We systematically reviewed the etiology, signs and symptoms, oral manifestations, epidemiology, diagnosis, treatment plan, and prognosis. We searched the articles on PubMed, Google Scholar and Web of Science for the following search term: Behcet’s disease, lichen planus, mucous membrane pemphigoid and bullous pemphigoid, pemphigus vulgarisms and paraneoplastic pemphigus, rheumatoid arthritis, Sjögren’s syndrome, IgG4-related disease, systemic lupus erythematous, and granulomatosis with polyangitis. Analysis of the literature. We conducted that the disorder’s oral manifestation causes most autoimmune illnesses’ earliest symptoms. Conclusion. Clinical-pathological is a piece of requisite knowledge for the dentist to recognize and diagnose in the early phase of the symptoms.
EN
In the twenty-first century, we are constantly facing allergic diseases, autoimmune diseases and cancers. Despite the genetic predisposition to the above-mentioned diseases, there is a possibility of supporting the organism with substances with immunomodulatory properties, such as vitamin D. Although it has been known so far mainly for the regulation of calcium and phosphate metabolism, its role in supporting the immune system is being discovered. The evidence for this is the demonstration that genes regulated by vitamin Dencode proteins involved in the processes of cell differentiation, proliferation and apoptosis and the detection of vitamin D receptors in cells of the immune system – thymus, B and T lymphocytes and bone marrow. Vitamin D occurs in foods of animal origin in the form of cholecalciferol, and in plant products in the ergocalciferol form. Cholecalciferol can also be obtained through the synthesis by human skin under the influence of UVB radiation. In Poland, there is a common deficiency of vitamin D – during summer, on average, 50% of the population is deficient, while in the winter, this percentage increases to 80%. The deficiency may predispose to many diseases. The objective of this paper was to examine the potential impact of vitamin D in terms of preventing and/or improving selected autoimmune and allergic diseases. Clinical studies in the scientific literature have been analyzed to determine the influence of vitamin D supplementation on the prevention and/or course of cancer in adults, autoimmune diseases in adults, and allergic diseases in children and adults. The conclusions are based on a meta-analysis of 8 clinical studies and 1 in vitro study on cell culture. The results of the study show that the compensation of 25(OH)D deficiency results in a milder course of systemic lupus erythematosus and Hashimoto’s disease. The supplementation of at least 1,200 IU of vitamin D reduces the incidence of cancer by an average of 35% among adults at risk compared to people without supplementation. The recommended intake of vitamin D by pregnant women also reduces the risk of allergic diseases in children from age 1 to 10. Moreover, vitamin D (2000 IU) supplementation in adults suffering from asthma supports a milder course of asthma and reduces the incidence of upper respiratory tract infections compared to the group not using supplementation.
EN
Hashimoto disease is one of the autoimmune diseases which etiology and course are not totally known. It affects women more often. In addition to characteristics of endocrine diseases of certain etiology, there is an uncertainty among patients due to uncertainties of factors associated with diagnosis and treatment of Hashimoto disease. Experience of illness reduces sense of well-being. In various diseases, especially psychosomatic with increased anxiety, presence of other important people in social support network play an important role in this situation. It was assumed that there is relationship between type and network of support and well-being. There were 60 people in each control and clinical group. The clinical group mean age M = 32.17; SD = 7.81. The control group mean age M = 33.23; SD = 8.35. Following measures were used in this study: Kmiecik-Baran Social Support Scale, Happiness Index and Author’s personal questionnaire. There was no statistically significant difference between group of sick and healthy people due to type of support received. There are statistically significant differences in support networks. In clinical group, there is a relationship between types of support and some support networks, e.g. emotional, evaluative, informative, instrumental, family, friends, health care and well-being.
PL
Choroba Hashimoto należy do chorób autoimmunologicznych, których etiologia i przebieg nie są w pełni znane. Częściej dotyka kobiet. Oprócz cech charakterystycznych dla chorób endokrynnych o znanej etiologii pojawia się u pacjentów niepewność wynikająca z niejasności czynników związanych z rozpoznaniem i leczeniem choroby Hashimoto. Doświadczenie choroby obniża poczucie dobrostanu. W chorobach, zwłaszcza psychosomatycznych, w sytuacji nasilonego lęku szczególną rolę odgrywa obecność innych ważnych osób, tworzących sieć wsparcia. Założono, że podobnie jak w przypadku innych chorób przewlekłych istnieje zależność między rodzajem i siecią wsparcia a dobrostanem. Zbadano 120 kobiet, po 60 w grupie klinicznej i kontrolnej. W grupie klinicznej średnia wieku M = 32,17, a odchylenie standardowe SD = 7,81. W grupie kontrolnej średnia wieku M = 33,23, a odchylenie standardowe SD = 8,35. Wykorzystano następujące narzędzia: Skalę Wsparcia Społecznego Kmiecik-Baran, Kwestionariusz Szczęścia w adaptacji Kaczmarka, Stańko-Kaczmarek i Dombrowskiego, autorską ankietę personalną. Nie wykazano statystycznie istotnej różnicy między grupą osób chorujących i zdrowych ze względu na rodzaj otrzymywanego wsparcia. Wykazano natomiast statystycznie istotne różnice dotyczące sieci wsparcia. W grupie klinicznej wystąpiła zależność między rodzajami wsparcia i niektórymi sieciami wsparcia, np. emocjonalnym, wartościującym, informacyjnym, instrumentalnym, rodziną, przyjaciółmi, służbą zdrowia a dobrostanem.
EN
Leaky gut syndrome (LGS) is associated with increased permeability of the intestinal mucosa due to the destruction of its structure and associated abnormal function. Heterogeneous etiology includes infections, stress, pregnancy, diet, menopause, medication, and food allergies. The end result is damage and destabilization of the intestinal mucosa leading to loss of the ability to properly fi lter nutrients and other substances. As a result of increased intestinal permeability, incompletely digested nutrients, microbes and toxins that would be removed in normal conditions enter the bloodstream, thereby adversely affecting the whole organism. Chronic exposure to foreign antigens overloads the immune system. Finally, disorders of the digestive system may appear, resulting in chronic fatigue, food intolerances, joint pain and dermopathy. Dysregulation of the immune response in the course of LGS may fi nally lead to chronic autoimmune diseases including diabetes, systemic lupus erythematosus, Crohn’s disease, colitis, multiple sclerosis, Hashimoto’s disease, or rheumatoid arthritis (RA).
PL
Zespół nieszczelnego jelita (ZNJ, zespół cieknącego jelita) to stan związany ze zwiększoną przepuszczalnością błony śluzowej jelit z powodu jej uszkodzenia i destabilizacji. Heterogenna etiologia schorzenia obejmuje infekcje, stres, niewłaściwą dietę, ciążę, menopauzę, stosowanie leków oraz alergie pokarmowe. W konsekwencji do krwi przedostają się niekompletnie strawione składniki pokarmowe, drobnoustroje oraz toksyny, które negatywnie wpływają na pracę całego organizmu. Przewlekłe narażenie na obce antygeny przeciąża układ odpornościowy, co może prowadzić do trwałego obniżenia odporności. Ostatecznie mogą się pojawiać zaburzenia ze strony układu pokarmowego, przewlekłe zmęczenie, nietolerancje pokarmowe, bóle stawowe oraz dermopatie. Rozregulowanie odpowiedzi immunologicznej może być wreszcie przyczyną przewlekłych chorób autoimmunologicznych, jak cukrzyca, toczeń układowy, choroba Crohna, zapalenie jelita grubego, stwardnienie rozsiane, choroba Hashimoto czy reumatoidalne zapalenie stawów (RZS).
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