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Patients should be advised about the urine discoloration (to avoid alarm) and counseled to report any persistent side effects

Macrophage activation is central to PNI pathogenesis, transitioning from a proinflammatory (M1) to an anti-inflammatory (M2) phenotype with distinct functions in inflammation and repair

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A high titer of RF classifies the patient as having seropositive RA, which is characteristically associated with a more aggressive disease course, greater radiographic joint destruction, and a higher likelihood of extraarticular manifestations, such as the subcutaneous nodule seen on Helen's forearm (Shmerling & Greisen, 2025)

Janeski-Feldman, V