In the last years we faced many cases of rheumatoid arthritis non-responsive to ordinary treatment including DMARDs and immunosuppressives. Before allocating those patients to biological bDMARDs we reevaluated them using new criteria for classification and diagnosis of many rheumatic diseases as RA SLE and FMS. Intensive investigations lead us to the characterization of a new disease entity definitely including VD3 deficiency and FMS with sometimes coincident secondary HPT. This work was a result of a cohort collaborative studies started 30 years ago with colleagues in the faculties of Science and Pharmacy Al-Azhar University Cairo Egypt to explore the causes of recent widespread deficiency of vitamin D3 in the Middle East and may probably worldwide. We investigated the pollutions of air water and foods. Then we investigated bad dietary habits and smoking deleterious effects on health including vitamin D3 deficiency and its sequelae of osteoporosis musculoskeletal disorders and even renal problems. We published many papers internationally and locally describing the most probable causes of VD3 deficiency. Finally we discovered this new and unique syndrome.