# A Case Report of Adjuvant Molecular Hydrogen Therapy in Refractory Rheumatoid Arthritis With Atlantoaxial Subluxation.
> 難治性関節リウマチおよび環軸椎亜脱臼を有する高齢患者における分子状水素補助使用の症例報告


## Abstract

An 85-year-old Taiwanese woman with longstanding refractory rheumatoid arthritis (RA) and multiple comorbidities had discontinued methotrexate in 2016 following pancytopenia, and was subsequently managed with oral steroids and hydroxychloroquine, experiencing recurrent hospitalizations due to joint flares. Molecular hydrogen was introduced as an adjuvant in June 2023. Fatigue scores measured by the Taiwan Brief Fatigue Inventory (BFI-T) showed notable improvement across several domains, and dynamic shifts in immune cell populations were documented, suggesting immunomodulatory activity. During the same admission, atlantoaxial subluxation meeting surgical criteria was identified; however, the patient and family declined operative intervention in favor of palliative care, and the patient subsequently died. This case illustrates both the potential immunological benefits of molecular hydrogen in advanced RA and the serious neurological complications that can arise from cervical spine involvement, while underscoring the need for controlled studies with longer follow-up periods.

### Mechanism

Molecular hydrogen is proposed to exert antioxidant and anti-inflammatory effects that modulate immune cell populations, potentially contributing to immunoregulatory changes observed in rheumatoid arthritis.

## Bibliographic

- **Authors**: Ren Y, Lu J, Ho YJ, Lui SW, Hsieh TY, Wang K, et al.
- **Journal**: In Vivo
- **Year**: 2025
- **PMID**: [41167690](https://pubmed.ncbi.nlm.nih.gov/41167690/)
- **DOI**: [10.21873/invivo.14166](https://doi.org/10.21873/invivo.14166)
- **PMC**: [PMC12588223](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12588223/)
- **Study type**: human case report
- **Delivery route**: not specified
- **Effect reported**: mixed

## Delivery context

The delivery route is not clearly identifiable from this paper. For hydrogen intake, inhalation is the most efficient route; inhalation, however, carries explosion risk (empirical LFL of 10%; high-concentration devices are not recommended).

## Safety notes

The delivery route is not clearly identifiable from this paper. For hydrogen intake, inhalation is the most efficient route; inhalation, however, carries explosion risk (empirical LFL of 10%; high-concentration devices are not recommended).

See also:
- [Inhalation concentration and LFL / UFL](https://h2-papers.org/en/safety-notes/inhalation-concentration)
- [Consumer Affairs Agency accident cases](https://h2-papers.org/en/safety-notes/accident-cases)

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> **Cite as**: H2 Papers — PMID 41167690. https://h2-papers.org/en/papers/41167690
> **Source**: PubMed PMID [41167690](https://pubmed.ncbi.nlm.nih.gov/41167690/)