Rare clinical aspects in autoimmune diseases: Congenital anomalies should be considered and looked for in pregnant women with SLE. M. Sousa et al. evaluated the performance of the first trimester combined screening in patients with SLE, aiming to assess the influence of pregnancy in SLE women on biochemical parameters mainly on serum chorionic gonadotropin hormone (hCG) and whether this may give an increased rate of false positivity during the first trimester. The finding of high total serum hCG values in pregnant women with a pre-existing autoimmune disease should raise a suspicion of false positive results. Correction factors should be calculated and entered in the risk algorithm, in order to avoid the rise in the number of false-positive results and consequently the overuse of invasive methods [
7]. The association between cryoglobulinemia and malignancy was discussed by Tocut et al. by reporting on a case of 40 years old woman, who developed nephritic syndrome and acute renal failure 2 weeks post-partum. She harbored type I and type II cryoglobulinemia approved by renal and cutaneous biopsies. Monoclonal gammopathy of undetermined source (MGUS) was documented following a bone marrow biopsy. Despite therapy with cyclophosphamide, rituximab, plasmapheresis, and dialysis, the patient died after 8 months. It seems that an overlapping entity of type I and II cryoglobulinemia with severe multi-organ involvement is rare and usually resistant to most available therapies and is fatal [
8]. Immune checkpoint inhibitor (ICI)-induced myositis is a newly emerging systemic inflammatory myopathy following the administration of ICI. In the report by Kadota H. et al. the authors review 15 cases of ICI-induced myositis, mostly developing in patients with melanoma following the treatment with anti-PD-1 alone and anti-CTLA-4 alone or the combination of both. Seven of these patients died due to myocarditis, in two due to respiratory muscle paralysis and cancer progression in two. The introduction of ICI therapy is a revolutionary approach of treatment which improved the survival of advanced melanoma. On the other hand, ICI-induced myopathies are considered to be a major cause of severe morbidity and mortality the prevalence of which should be recorded [
9,
10].