Progressive systemic sclerosis (PSS) is a chronic autoimmune illness. Clinical oral manifestations in Scleroderma are very frequent. To explore the oral manifestations, frequent and rare, to investigate whether there are differences between gender and the observed correlation of changes in relation to Antibodies Anti-Topoisomerase I. in the study were included 75 patients (65 females and 10 males), their mean age was 45.2±10, duration of illness was around 5.1±12 years diagnosed according to the ACR criteria and treated in the period 2010-2013. 98.7% of our patients were ANA positive, whereas 49.3% of them were Anti SCL-70 positive. Patients in 91% of cases had one or more oral manifestations of disease. The most frequent oral manifestations are: small mouth (n = 39), the lingua short frenulum (n = 21), Xerostomia (n = 24) and paradontopathia (n = 16), while more rare are: Telangiectasia (n = 14), decreased interincisal distance (n = 9), missing teeth (n = 9), absorption of dental alveoli (n = 5) and Neuralgia n. trigeminus (n = 3). Oral symptoms have been frequent in patients with Scleroderma, SCL -70 positive but not statistically significant difference. Oral changes have high frequency in patients with Scleroderma and these changes provide high discomfort of the mouth and lower quality of life. Oral health care to patients with Scleroderma is very important and it affects a lot in reducing the level of disease and increase the quality of life.

Lithopedion (from the Greek words ‘lithos’ meaning stone and ‘paidion’ meaning child) refers to a rare medical complication in which a fetus dies during an abdominal pregnancy and, unable to be absorbed by the body, calcifies and is gradually turned into stone. This process of calcification serves as the body’s way of protecting itself from the dead tissue, preserving the fetus inside the mother’s abdomen for many years, often without any symptoms. Lithopedion cases are extremely rare, with about 330 to 340 documented cases reported throughout 400 years of medical literature. We report a rare clinical case of retained abdominal pregnancy for decades in a 70-year-old postmenopausal female, who presented with chronic back pain. Multiple fetal bones calcified in the abdomen were observed on computed tomography.

Background: Inflammatory activity in rheumatoid arthritis can be determined by normal blood count ratios such as Neutrophil Lymphocyte Ratio (NLR), Platelet Lymphocyte Ratio (PLR), Systemic Immune Inflammation Index (SII), and C-reactive Protein (CRP). Objective: The aim of this research is to determine how these markers change after therapy and whether their pre- and post-treatment differences follow patterns that allow for simple parametric analyses. Methods: A prospective cohort of 52 RA patients (30 females and 22 males) was examined. The patients’ blood samples were tested at baseline and at the end of their 6-month Infliximab treatment. Hematologic markers such as NLR, PLR, and SII were calculated from the complete blood count (CBC), and CRP levels were measured. The statistical methods of Shapiro–Wilk (SW), Kolmogorov–Smirnov (KS), and Anderson–Darling (AD) were used, and later, paired t-tests were used to generate statistics where necessary. Results: Post-treatment measurements were consistently lower for all four biomarkers. QQ-plots and formal tests revealed that the differences between findings were essentially normal, allowing for paired t-tests. The mean decreases were as follows: NLR −1.10 (95% CI −1.48 to −0.71), PLR −43.0 (−55.4 to −30.7), SII −299 (−388 to −211), and CRP −11.36 (−13.18 to −9.54), all p < 0.001. CRP showed the greatest drop, with significant decreases in PLR and SII and a moderate decline in NLR, indicating therapy-related attenuation of systemic inflammation. Conclusions: The study shows that six months of infliximab therapy results in a consistent post-treatment decrease in all four biomarkers: NLR, PLR, SII, and CRP. Because the pre-post differences were roughly normal, CRP revealed the greatest decrease, with significant decreases in PLR and SII and a moderate decrease in NLR, consistent with systemic inflammation reduction. When combined, the CBC-derived indices track with CRP and can serve as practical, low-cost markers for monitoring therapy response in RA, despite the single-arm design.

Introduction: Antiphospholipid syndrome (APS), or antiphospholipid antibody syndrome, is an autoimmune, hypercoagulable condition caused by antiphospholipid antibodies. Aim: This case study aims to highlight diagnostic challenge of APS and its association with sicca syndrome. Case study: Our case is a female patient who was transferred to Rheumatology Clinic from the Central Intensive Care Unit (CICU) after being unconscious and on assisted breathing for 5 days. In 2006, she suffered a miscarriage and pulmonary thromboembolism. Since then, she has been under anticoagulant treatment. Clinical observation and positivity of laboratory tests such as anti Ro SSA, anti La SSB and Schrimer test confirmed us sicca syndrome. Positivity of lupus anticoagulant, anti-cardiolipin and anti-B2GP1 raise us suspicious about APS. The patient stayed in our clinic for approximately 10 days and based on the anamnesis, objective examination, laboratory and imaging tests, she was discharged home with the diagnosis of APS accompanied by sicca syndrome. Results and discussion: APS is an autoimmune condition, often challenging to diagnose, especially when it occurs in patients without sufficient symptoms and signs and without positivity in blood tests. The diagnosis of APS is often made through a combination of symptoms and laboratory tests. Conclusions: Diagnosing APS is not always easy, it is quite complex. Any case associated with spontaneous abortion and vascular accidents, without risk factors, should be suspected and investigated for APS. APS can often be secondary associated with other autoimmune diseases. Most often APS is associated with systemic lupus erythematosus, but in our case it is associated with sicca syndrome.

Osteoporosis is a major cause of bone fragility and musculoskeletal pain, conditions that substantially reduce quality of life. Vitamin D plays a central role in calcium homeostasis and bone mineralization, while Vitamin B12 deficiency has been associated with impaired bone health and neuromuscular symptoms. However, their combined impact on Bone Mineral Density (BMD) and pain remains incompletely understood. We conducted a cross-sectional study at the Rheumatology Clinic of the University Clinical Center of Kosova (January 2022–August 2024). A total of 136 patients (aged 18–75 years) with chronic musculoskeletal pain underwent Dual-Energy X-Ray Absorptiometry (DEXA) to assess BMD in the lumbar spine and femoral neck. Serum 25-hydroxyvitamin D and Vitamin B12 levels were measured, and pain intensity was evaluated using the Visual Analog Scale (VAS). Osteoporosis was highly prevalent, affecting 59.6% of patients in the right femur, 65.4% in the left femur, and all patients in the spine. Patients with lower Vitamin D levels reported significantly higher pain scores (r = -0.55, p < 0.01), while elevated Vitamin B12 levels showed a positive correlation with pain (r = 0.59, p < 0.01). BMD values in all skeletal sites were negatively correlated with pain severity, with the strongest association observed in the spine (r = -0.73, p < 0.01). Vitamin D deficiency was strongly associated with both lower BMD and greater musculoskeletal pain, whereas Vitamin B12 variations showed complex correlations requiring further study. Early detection of osteoporosis and systematic monitoring of vitamin status may support more effective management of pain and bone health in affected patients.