We examined a case of a 51-year-old Ugandan man who experienced recurring lower limb weakness linked to pernicious anemia, an autoimmune condition causing vitamin B12 deficiency. After initial treatments, his symptoms reappeared, leading to further testing that confirmed the diagnosis.
Treatment with vitamin B12 injections significantly improved his condition. This case emphasizes the need for healthcare providers to recognize the signs of vitamin B12 deficiency early, particularly in resource-limited settings, to ensure timely diagnosis and treatment.
Read More
9
B12 treatment for autoimmune disorder
Neurological and Cardiovascular Complications Revealing Biermer's Disease: A Case Report.
We explored the intriguing case of a 56-year-old man diagnosed with Biermer's disease, also known as pernicious anemia, an autoimmune condition that leads to a lack of intrinsic factor and, consequently, vitamin B12 malabsorption. This patient presented with unusual symptoms: not just digestive concerns like melena, but also notable neurological effects such as memory issues and gait disturbances.
During our examination, we discovered symptoms indicative of cerebellar ataxia, along with a red and swollen limb that pointed toward deep vein thrombosis (DVT). The tests revealed severe macrocytic anemia and confirmed a deficiency in vitamin B12 while keeping folate levels normal. Following a thorough diagnosis—including gastroscopy, ultrasound, and blood tests—we initiated a treatment plan that included vitamin B12 supplementation and anticoagulant therapy.
The outcome of our intervention was promising, with significant clinical improvement observed in the patient’s condition. Our findings reinforce the essential role of vitamin B12 in managing this type of autoimmune disorder, particularly when neurological and cardiovascular complications arise.
Read More
8
Vitamin B12 may treat arthritis
Vitamin B12 inhibits peptidylarginine deiminases and ameliorates rheumatoid arthritis in CAIA mice.
We investigated the potential of vitamin B12 as a treatment for rheumatoid arthritis, particularly focusing on its ability to target an enzyme called peptidylarginine deiminase isoform 4 (PADI-4). PADI-4 plays a crucial role in a process called citrullination, which is often disrupted in autoimmune conditions like rheumatoid arthritis.
Our findings revealed that vitamin B12 effectively inhibits PADI-4, showing a preference for this enzyme over another similar one, PADI-2. This inhibition corresponds to a decrease in overall cellular citrullination, including the citrullination of histone H3, which is also mediated by PADI-4.
Additionally, we observed that hydroxocobalamin, a special form of vitamin B12, significantly reduced the severity of collagen type II antibody-induced arthritis in mice. It also lowered the expression of key inflammatory factors and cytokines associated with rheumatoid arthritis, such as IL-17A, TNFα, and IL-6.
These promising results suggest that vitamin B12 might be an effective therapeutic avenue for managing rheumatoid arthritis, warranting further investigation in future studies.
Read More
Most Useful Reviews
7.5
Improved mental clarity
25 people found this helpful
I was constantly exhausted, struggling with headaches and poor sleep due to stress at work. After researching, I realised my symptoms matched a vitamin B12 deficiency. Though I originally didn't use prescribed medication, I began taking vitamin B12 supplements, which significantly improved my energy levels, reduced headaches, and lightened my body. My mind felt clearer, and I noticed a remarkable difference in my overall well-being. For anyone facing similar challenges linked to autoimmune disorder, I highly recommend giving it a try.
Read More
9
Boosted vitamin levels
1 people found this helpful
I absolutely love this company's B vitamins! My husband and I have issues related to our folate cycle, so we consistently take this B-12, which has improved our levels considerably, as confirmed by tests. The dosage is excellent, it tastes lovely, and it effectively helped me manage my autoimmune disorder symptoms and eliminate anaemia.
Read More
9
Effective absorption
1 people found this helpful
This is an excellent methyl B12 product! It absorbs well, and I can certainly notice a difference. The taste is fruity and enjoyable. I will definitely reorder; it has been beneficial for my health.
We explored the impact of vitamin B12 on patients with autoimmune disorders, particularly those experiencing symptoms often attributed to their underlying conditions. The study presented three cases of individuals with neuropathic pain, depression, fatigue, and muscle weakness, who had their symptoms initially misattributed to rheumatic diseases.
Upon starting vitamin B12 supplementation, these patients showed nearly complete resolution of their symptoms, highlighting the potential benefits of this vitamin in treating related health issues. Interestingly, several participants did not display obvious deficiencies in vitamin B12 levels according to lab tests, suggesting that even those who appear to have sufficient levels could still benefit from supplementation.
Furthermore, we delved into research indicating the nerve-protective properties of vitamin B12, which could play a crucial role in managing pain and neuropathy associated with long-standing rheumatic diseases. Therefore, we recommend that healthcare providers consider checking vitamin B12 levels early in the diagnostic journey for autoimmune conditions, and think about offering supplementation regardless of laboratory findings.
Read More
9
Pernicious anemia diagnosis and treatment
Rural health challenges in Western Uganda: pernicious anemia masquerading as recurrent lower limb weakness-a case report.
We examined a case of a 51-year-old Ugandan man who experienced recurring lower limb weakness linked to pernicious anemia, an autoimmune condition causing vitamin B12 deficiency. After initial treatments, his symptoms reappeared, leading to further testing that confirmed the diagnosis.
Treatment with vitamin B12 injections significantly improved his condition. This case emphasizes the need for healthcare providers to recognize the signs of vitamin B12 deficiency early, particularly in resource-limited settings, to ensure timely diagnosis and treatment.
Read More
9
Case of combined autoimmune disorders
Coexistence of Guillain-Barré Syndrome and Subacute Combined Degeneration of the Spinal Cord Due to Autoimmune Gastritis: A Case Report and Literature Review.
We examined a fascinating case of a 54-year-old man experiencing the rare overlap of Guillain-Barré Syndrome (GBS) and autoimmune gastritis. After a thorough medical evaluation, which included MRI and biopsy, he was diagnosed with both GBS and a vitamin B12 deficiency linked to atrophic gastritis.
Treatment with intravenous immunoglobulin and methylcobalamin (vitamin B12) led to substantial improvement in his symptoms. This case highlights the importance of recognizing potential nutrient deficiencies, especially those impacting autoimmune disorders like GBS and autoimmune gastritis.
Read More
9
B12 treatment for autoimmune disorder
Neurological and Cardiovascular Complications Revealing Biermer's Disease: A Case Report.
We explored the intriguing case of a 56-year-old man diagnosed with Biermer's disease, also known as pernicious anemia, an autoimmune condition that leads to a lack of intrinsic factor and, consequently, vitamin B12 malabsorption. This patient presented with unusual symptoms: not just digestive concerns like melena, but also notable neurological effects such as memory issues and gait disturbances.
During our examination, we discovered symptoms indicative of cerebellar ataxia, along with a red and swollen limb that pointed toward deep vein thrombosis (DVT). The tests revealed severe macrocytic anemia and confirmed a deficiency in vitamin B12 while keeping folate levels normal. Following a thorough diagnosis—including gastroscopy, ultrasound, and blood tests—we initiated a treatment plan that included vitamin B12 supplementation and anticoagulant therapy.
The outcome of our intervention was promising, with significant clinical improvement observed in the patient’s condition. Our findings reinforce the essential role of vitamin B12 in managing this type of autoimmune disorder, particularly when neurological and cardiovascular complications arise.
Read More
8
Vitamin B predicts GBS prognosis
Correlation of Serum Vitamin B and Muscle Enzyme (CK-NAC) Level with Severity of Guillain-Barre Syndrome and Its Prediction in Respiratory Failure.
We examined the levels of vitamin B and creatine kinase (CK-NAC) in 50 patients with Guillain-Barré Syndrome (GBS). Through clinical assessments, we compared the patients' functional abilities and found that a deficiency in vitamin B was linked to greater disease severity and respiratory complications.
However, while vitamin B levels seemed to offer insight into GBS prognosis, elevated CK-NAC levels did not show a significant correlation with disease severity. This points towards the importance of monitoring vitamin B as a potential prognostic tool in managing GBS.
I was constantly exhausted, struggling with headaches and poor sleep due to stress at work. After researching, I realised my symptoms matched a vitamin B12 deficiency. Though I originally didn't use prescribed medication, I began taking vitamin B12 supplements, which significantly improved my energy levels, reduced headaches, and lightened my body. My mind felt clearer, and I noticed a remarkable difference in my overall well-being. For anyone facing similar challenges linked to autoimmune disorder, I highly recommend giving it a try.
Read More
9
Boosted vitamin levels
1 people found this helpful
I absolutely love this company's B vitamins! My husband and I have issues related to our folate cycle, so we consistently take this B-12, which has improved our levels considerably, as confirmed by tests. The dosage is excellent, it tastes lovely, and it effectively helped me manage my autoimmune disorder symptoms and eliminate anaemia.
Read More
9
Effective absorption
1 people found this helpful
This is an excellent methyl B12 product! It absorbs well, and I can certainly notice a difference. The taste is fruity and enjoyable. I will definitely reorder; it has been beneficial for my health.
Read More
7.5
Increased energy levels
2 people found this helpful
This supplement greatly alleviates my headaches and enhances my mental clarity. I usually take it in the morning, and it's quite pleasant to taste. I even share it with my child during stressful moments, and it calms him down effectively. The quality is impressive, and I've experienced positive results regularly. It has a remarkable effect on my wellbeing, particularly after my spouse returns home stressed from work.
Read More
7.5
Quick vitamin boost
1 people found this helpful
I ordered this for my mother, who was experiencing a vitamin deficiency. After less than two months of continuous use, her levels increased dramatically without any side effects.
Read More
Frequently Asked Questions
An autoimmune disorder occurs when the body's immune system mistakenly attacks its own healthy cells and tissues, believing them to be foreign invaders, such as bacteria or viruses. This reaction can lead to inflammation, tissue damage, and impaired function of the affected organs. There are over 80 known autoimmune diseases, including rheumatoid arthritis, lupus, multiple sclerosis, and type 1 diabetes, each with its own specific symptoms and treatment options. The exact cause of these disorders is still unclear, but a combination of genetic, environmental, and hormonal factors is believed to play a role in their development.
Diagnosis of autoimmune disorders often involves a combination of physical examinations, assessment of symptoms, blood tests, and imaging studies to evaluate organ involvement. Treatment typically focuses on managing symptoms and controlling the immune response using medications such as corticosteroids, immunosuppressants, and biologics. In addition to medication, lifestyle modifications, such as stress management and a balanced diet, can be beneficial in managing symptoms. If you suspect you have an autoimmune condition, it's important to consult a healthcare professional for proper evaluation and tailored treatment options.
Vitamin B12, also known as cobalamin, is a water-soluble vitamin that plays a crucial role in several vital functions in the human body. It is essential for red blood cell formation, neurological function, and DNA synthesis. Naturally occurring in animal products, the vitamin can be found in high concentrations in meat, fish, eggs, and dairy, making it particularly important for those following a vegetarian or vegan diet, as plant-based sources of B12 are limited and often require supplementation.
A deficiency in vitamin B12 can lead to serious health issues, including anemia, fatigue, memory problems, and nerve damage. Due to its significance, it's crucial for individuals, particularly those at risk of deficiency, to ensure adequate intake through diet or supplementation. For most adults, the recommended daily allowance (RDA) is around 2.4 micrograms, though pregnant or breastfeeding women may require higher amounts. If you're considering B12 supplements, it's advisable to consult with a healthcare provider to determine the best option for your specific needs and health status.
Based on user reviews, individuals typically report noticeable improvements within a few weeks to a couple of months after starting vitamin B12 supplementation for autoimmune disorders. One user shared that they experienced a significant boost in energy and overall well-being relatively quickly after beginning their supplementation journey Read Review. Another review indicated that improvements in vitamin levels were observed in less than two months of continuous use Read Review.
Users often noted enhancements in their symptoms such as headaches, energy levels, and mental clarity as early as a few weeks into their regimen. For instance, one reviewer reported alleviation of headaches and improved mental clarity shortly after beginning use Read Review. Overall, it seems that while individual responses may vary, many users find that they begin to feel better within a relatively short period after incorporating B12 supplements into their routine.
Scientific research suggests that vitamin B12 supplementation may play a vital role in managing certain autoimmune disorders. For instance, studies have highlighted that deficiencies in vitamin B12 are linked to increased severity of conditions like Guillain-Barré Syndrome (GBS) and pernicious anemia - an autoimmune disease impacting vitamin B12 absorption. These studies emphasize the importance of monitoring vitamin B12 levels as part of the clinical management of autoimmune disorders, particularly in cases where neurological symptoms are present ([1]; [2]; [4]; [5]).
Moreover, research indicates that vitamin B12 could significantly improve symptoms associated with autoimmune conditions, even when not presenting obvious deficiencies. Some studies have shown that patients with various autoimmune disorders experienced symptom resolution upon vitamin B12 supplementation, suggesting potential benefits beyond simply addressing deficiency. This is particularly relevant as some patients may have normal serum levels but still experience neurological effects due to vitamin B12 malabsorption caused by autoimmune mechanisms ([6]; [15]). Overall, while more research is needed to establish definitively how vitamin B12 interacts with these disorders, the existing evidence supports its adjunctive use in the management of autoimmune conditions.
Based on user reviews, many individuals have reported significant improvements in their symptoms after incorporating vitamin B12 supplements into their routines. For instance, one user noted a striking increase in energy levels, a reduction in headaches, and an overall enhancement in well-being shortly after starting supplementation Read Review. Another review highlighted how consistent use led to considerably improved vitamin levels in under two months, confirming that the product was effective without any side effects Read Review.
Additionally, users have reported benefits such as improved mental clarity and the alleviation of stress-related issues. For example, one reviewer mentioned that the supplement not only relieved headaches but also enhanced their cognitive function, making daily tasks more manageable Read Review. Overall, users' experiences suggest that while individual results can vary, many find noticeable improvements in their symptoms in a relatively short timeframe after beginning supplementation.
Users report combining vitamin B12 supplements with other B vitamins, particularly in cases where they deal with folate cycle issues. One reviewer indicated that both they and their husband benefited significantly from using a B-12 supplement to help manage their autoimmune disorder symptoms, highlighting improved levels as confirmed by medical tests Read Review. This suggests that pairing B12 with other vitamin supplements may provide synergistic benefits for those with autoimmune disorders.
Additionally, the positive results observed from consistent B12 supplementation extend beyond individual use, with users sharing experiences of clarity and well-being when the supplement is consumed regularly. One user noted that their headaches were alleviated, and mental clarity improved, making it a staple in their routine Read Review. Overall, while individual experiences may vary, it seems that users who combined vitamin B12 with other B vitamins generally report satisfactory improvements in managing their symptoms related to autoimmune disorders.
Users report experiencing significant health improvements after taking vitamin B12 supplements for treating symptoms related to autoimmune disorders. Many found that B12 helped alleviate fatigue, headaches, and anxiety, indicating a positive correlation with symptom management in those with autoimmune conditions. One reviewer noted a marked improvement in energy levels and clarity of mind after starting B12 supplementation, strongly recommending it to others facing similar issues linked to autoimmune disorders Read Review.
The right dosage seems to be a common concern among users, with some reporting excellent results from their chosen brands, emphasizing the importance of absorption and taste. For example, another user mentioned that their B12 levels improved significantly, confirming effectiveness through blood tests after regular intake, reflecting a proper expectation around dosing Read Review. Overall, while specific dosages were not universally disclosed, the general consensus suggests that consistent and properly absorbed B12 supplements can greatly aid in managing the challenges associated with autoimmune disorders.
7.5
Improved mental clarity
25 people found this helpful
I was constantly exhausted, struggling with headaches and poor sleep due to stress at work. After researching, I realised my symptoms matched a vitamin B12 deficiency. Though I originally didn't use prescribed medication, I began taking vitamin B12 supplements, which significantly improved my energy levels, reduced headaches, and lightened my body. My mind felt clearer, and I noticed a remarkable difference in my overall well-being. For anyone facing similar challenges linked to autoimmune disorder, I highly recommend giving it a try.
7.5
Quick vitamin boost
1 people found this helpful
I ordered this for my mother, who was experiencing a vitamin deficiency. After less than two months of continuous use, her levels increased dramatically without any side effects.
7.5
Increased energy levels
2 people found this helpful
This supplement greatly alleviates my headaches and enhances my mental clarity. I usually take it in the morning, and it's quite pleasant to taste. I even share it with my child during stressful moments, and it calms him down effectively. The quality is impressive, and I've experienced positive results regularly. It has a remarkable effect on my wellbeing, particularly after my spouse returns home stressed from work.
9
Boosted vitamin levels
1 people found this helpful
I absolutely love this company's B vitamins! My husband and I have issues related to our folate cycle, so we consistently take this B-12, which has improved our levels considerably, as confirmed by tests. The dosage is excellent, it tastes lovely, and it effectively helped me manage my autoimmune disorder symptoms and eliminate anaemia.
8
Vitamin B predicts GBS prognosis
Correlation of Serum Vitamin B and Muscle Enzyme (CK-NAC) Level with Severity of Guillain-Barre Syndrome and Its Prediction in Respiratory Failure.
We examined the levels of vitamin B and creatine kinase (CK-NAC) in 50 patients with Guillain-Barré Syndrome (GBS). Through clinical assessments, we compared the patients' functional abilities and found that a deficiency in vitamin B was linked to greater disease severity and respiratory complications.
However, while vitamin B levels seemed to offer insight into GBS prognosis, elevated CK-NAC levels did not show a significant correlation with disease severity. This points towards the importance of monitoring vitamin B as a potential prognostic tool in managing GBS.
7
Case on B12 and autoimmune relation
A long-standing undiagnosed case of vitamin B12 deficiency: a case report.
We explored a fascinating case of a 40-year-old woman suffering from long-standing, unclear symptoms, initially misdiagnosed with various conditions. After years of monitoring, her critically low vitamin B12 levels were finally recognized, revealing pernicious anemia as the root cause.
Thanks to treatment with B12 injections, we observed significant improvement in her neurological symptoms. This case illustrates the need for thorough evaluations in patients with non-specific symptoms, as addressing vitamin B12 deficiency can lead to meaningful improvements—even when classic signs are absent.
9
Pernicious anemia diagnosis and treatment
Rural health challenges in Western Uganda: pernicious anemia masquerading as recurrent lower limb weakness-a case report.
We examined a case of a 51-year-old Ugandan man who experienced recurring lower limb weakness linked to pernicious anemia, an autoimmune condition causing vitamin B12 deficiency. After initial treatments, his symptoms reappeared, leading to further testing that confirmed the diagnosis.
Treatment with vitamin B12 injections significantly improved his condition. This case emphasizes the need for healthcare providers to recognize the signs of vitamin B12 deficiency early, particularly in resource-limited settings, to ensure timely diagnosis and treatment.
9
Case of combined autoimmune disorders
Coexistence of Guillain-Barré Syndrome and Subacute Combined Degeneration of the Spinal Cord Due to Autoimmune Gastritis: A Case Report and Literature Review.
We examined a fascinating case of a 54-year-old man experiencing the rare overlap of Guillain-Barré Syndrome (GBS) and autoimmune gastritis. After a thorough medical evaluation, which included MRI and biopsy, he was diagnosed with both GBS and a vitamin B12 deficiency linked to atrophic gastritis.
Treatment with intravenous immunoglobulin and methylcobalamin (vitamin B12) led to substantial improvement in his symptoms. This case highlights the importance of recognizing potential nutrient deficiencies, especially those impacting autoimmune disorders like GBS and autoimmune gastritis.
7
B12 impacts autoimmune neurological disorders
Transcobalamin receptor antibodies in autoimmune vitamin B12 central deficiency.
Our exploration focused on how vitamin B12 affects autoimmune disorders, particularly in patients with neurological symptoms like tremors and ataxia. We discovered that some patients have autoantibodies that hinder the body's ability to absorb B12 effectively.
Despite normal levels in the blood, these individuals often had low B12 in their cerebrospinal fluid. Encouragingly, high-dose B12 supplementation alongside immunosuppressive treatments led to improvements in symptoms and increased B12 levels in the cerebrospinal fluid. However, not all patients showed clear B12 deficiency signs from regular blood tests.
We explored the impact of vitamin B12 on patients with autoimmune disorders, particularly those experiencing symptoms often attributed to their underlying conditions. The study presented three cases of individuals with neuropathic pain, depression, fatigue, and muscle weakness, who had their symptoms initially misattributed to rheumatic diseases.
Upon starting vitamin B12 supplementation, these patients showed nearly complete resolution of their symptoms, highlighting the potential benefits of this vitamin in treating related health issues. Interestingly, several participants did not display obvious deficiencies in vitamin B12 levels according to lab tests, suggesting that even those who appear to have sufficient levels could still benefit from supplementation.
Furthermore, we delved into research indicating the nerve-protective properties of vitamin B12, which could play a crucial role in managing pain and neuropathy associated with long-standing rheumatic diseases. Therefore, we recommend that healthcare providers consider checking vitamin B12 levels early in the diagnostic journey for autoimmune conditions, and think about offering supplementation regardless of laboratory findings.
References
Jatav VS, Sardana V, Bhushan B, Maheshwari D, Garg S, et al. Correlation of Serum Vitamin B and Muscle Enzyme (CK-NAC) Level with Severity of Guillain-Barre Syndrome and Its Prediction in Respiratory Failure. J Assoc Physicians India. 2025;73:48. 10.59556/japi.73.0892
Mesgarankarimi A, Rezapour M, Tabrizi N. A long-standing undiagnosed case of vitamin B12 deficiency: a case report. J Med Case Rep. 2025;19:151. 10.1186/s13256-025-05149-7
Ma XY, Hao Y, Xie YH, Cao Q, Sun DF, et al. Risk Factors Analysis and Predictive Model Construction for Autoimmune Gastritis: A Nationwide Multicenter Case-Control Study in China. J Gastroenterol Hepatol. 2025. 10.1111/jgh.16912
Mswelo VE, David MM, Banturaki A, Munyambalu DK, Hassan HA, et al. Rural health challenges in Western Uganda: pernicious anemia masquerading as recurrent lower limb weakness-a case report. J Med Case Rep. 2025;19:60. 10.1186/s13256-025-05095-4
Xiang H, Cai M. Coexistence of Guillain-Barré Syndrome and Subacute Combined Degeneration of the Spinal Cord Due to Autoimmune Gastritis: A Case Report and Literature Review. Cureus. 2024;16:e63084. 10.7759/cureus.63084
Pluvinage JV, Ngo T, Fouassier C, McDonagh M, Holmes BB, et al. Transcobalamin receptor antibodies in autoimmune vitamin B12 central deficiency. Sci Transl Med. 2024;16:eadl3758. 10.1126/scitranslmed.adl3758
Subtil J, Carvalho R, Rebelo AF, Subtil P. Autoimmune Polyglandular Syndrome Type 3: A Case Report. Cureus. 2024;16:e76152. 10.7759/cureus.76152
Mansour M, Shamasnah A, Alsaadi D, Abu Saif S, Krama A. Evans syndrome as a presentation in systemic lupus erythematous, coexisting with Hashimoto's thyroiditis and pernicious anemia: a case report. J Med Case Rep. 2024;18:643. 10.1186/s13256-024-05002-3
Hijjawi N, Tout FS, Azaizeh B, Aljaafreh B. The role of vitamins D, B12, C, and K in modulating inflammation and disease management in rheumatoid arthritis: a comprehensive review. Clin Rheumatol. 2025;44:591. 10.1007/s10067-024-07285-9
Lang C, Huang P, Gao J, Chen Y, He Z. Co-existence of autoimmune polyglandular syndrome type 3b and undifferentiated connective tissue disease with subacute combined degeneration of spinal cord in children: a case report and literature review. BMC Pediatr. 2024;24:817. 10.1186/s12887-024-05262-4
Haddad F, Boukhal Z, El Rhaoussi FZ, Tahiri M, Hliwa W, et al. Neurological and Cardiovascular Complications Revealing Biermer's Disease: A Case Report. Cureus. 2024;16:e58601. 10.7759/cureus.58601
Fernandez I, Touzot F. Looking for ALPS: The value of a combined assessment of biochemical markers. Pediatr Allergy Immunol. 2024;35:e14135. 10.1111/pai.14135
Yamada H, Toko M, Nakamori M, Ueno H, Aoki S, et al. Progressive multifocal leukoencephalopathy associated with systemic lupus erythematosus: longitudinal observation of lymphocytes, JC virus in cerebrospinal fluid, and brain magnetic resonance imaging. J Neurovirol. 2024;30:197. 10.1007/s13365-024-01203-0
Yang CW, Hsu HY, Lee YZ, Lee SJ. Vitamin B12 inhibits peptidylarginine deiminases and ameliorates rheumatoid arthritis in CAIA mice. Biochem Biophys Res Commun. 2024;704:149668. 10.1016/j.bbrc.2024.149668
Dułak NA, Rytlewska M, Jaskólska M, Chmielewski M. A new perspective on vitamin B12 deficiency in rheumatology: a case-based review. Rheumatol Int. 2024;44:737. 10.1007/s00296-024-05539-y