فهرست نشریات علمی دسترسی آزاد ایران

Rheumatoid arthritis (RA) is a chronic autoimmune disease that, if left uncontrolled, can lead to severe systemic complications. While disease-modifying antirheumatic drugs (DMARDs) play an important role in managing inflammation and preventing disease progression, long-term adherence to treatment remains a challenge. We present a case of a 49-year-old woman with a 25-year history of RA who discontinued methotrexate treatment due to cosmetic concerns. Over Rheumatoid arthritis (RA) is a chronic autoimmune disease that, if left uncontrolled, can lead to severe systemic complications. While disease-modifying antirheumatic drugs play an important role in managing inflammation and preventing disease progression, long-term adherence to treatment remains a challenge. We present a case of a 49-year-old woman with a 25-year history of RA who discontinued methotrexate treatment due to cosmetic concerns. Over time, uncontrolled inflammation led to severe systemic involvement, including respiratory complications, progressive cavitary lung lesions, and vascular manifestations culminating in gangrene of the forefoot. The absence of typical vasculitic skin lesions suggests that long-term disease activity, rather than acute vasculitis, contributed to the development of tissue ischemia and necrosis. This case highlights the importance of sustained adherence to treatment and highlights the devastating consequences of disease progression in long-term RA. Early intervention and ongoing monitoring are crucial in preventing irreversible systemic complications.