The vitamin D has direct and indirect effects which might be related to the risk of developing a rheumatic disease or the degree of disease activity (6). We have three evidences which support the role of vitamin D in autoimmune diseases. The first is the presence of vitamin D receptor on extra-osseous cells, such as cartilage cells, sinoviocytes and muscle cells. The second evidence is the proven role of vitamin D in the control of transcription of genes involved in rheumatic diseases. The third evidence is that the activation of vitamin D not only presents in the kidneys, but also in monocyte-macrophage and lymphocytic cell lines (6). Most of our patients 98% with different rheumatic diseases had vitamin D deficiency with vitamin D less than 10 ng/ml (severe deficiency) in 60/98 (61%) patients.
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