Toxic metals in rheumatological diseases: A systematic review

Heavy metals exposure might be linked to rheumatic diseases and has been studied in a few articles. The aim of this article is to review the studies that evaluated metal toxicity in rheumatological diseases. A systematic search of PubMed, Embase, and Scielo databases was performed, looking for articles on toxic metals and rheumatic diseases published between 1966 and March 2023. A total of 31 studies (1,559 RA and 4,308 patients with other rheumatic diseases) were included. Most patients were females, ranging from 4 to 62 years old. Although most studies showed higher concentrations of toxic metals in rheumatic diseases, a few showed a positive association with disease activity or severity of the conditions. This systematic review reveals the presence of toxic metals in patients with rheumatic disease. Screening for toxic metals may be elucidative in selected cases.