A hematologist outlines how the new drugs can help treat coagulation triggered by rheumatological diseases
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An Interview with Expert Clinician Dr. Fred Wigley
Rheumatologists who are outstanding researchers, educators and/or clinicians, who provide consistently exceptional care to patients, who have achieved a level of distinction in the field and who serve as role models for colleagues and trainees are highlighted in this recurring series. Fred Wigley, MD, MACR, is the Martha McCrory Professor of Medicine at the Johns…
Case Report: Giant Cell Arteritis-Related Stroke
Thromboembolic events are major contributors to the morbidity and mortality of patients with giant cell arteritis (GCA), but little is known about how GCA may increase the risk of ischemic strokes. GCA-related stroke is described as an ischemic cerebral infarct occurring within three to four weeks of GCA diagnosis and treatment. It occurs in 3–7%…
Case Report: A Patient Presents with Digital Ischemia & Gangrene
Defined by the presence of antiphospholipid antibodies (aPL) in individuals with clinical evidence of thrombosis or pregnancy morbidity, antiphospholipid syndrome (APS) is a systemic autoimmune thrombophilia. Clinical thrombosis, which should be confirmed by objective validated criteria (e.g., imaging studies or histopathology), can occur in the arterial, venous or small vessel vasculature and is not limited…
Blood Is Thicker Than Water: Updates on the ACR/EULAR Antiphospholipid Syndrome Classification Criteria
PHILADELPHIA—Ever since the seminal work of C. Lockard Conley, MD, in 1952 of the discovery of the lupus anticoagulant, antiphospholipid syndrome (APS) has been of great interest to rheumatologists, hematologists and many others. At ACR Convergence 2022, the session titled Draft ACR/EULAR Antiphospholipid Syndrome Classification Criteria sought to summarize the rigorous process that went into…
When Rheumatic Disease May Have Affected the Course of Western Civilization
The study of rheumatology (and medicine) in art, history, literature and music is engaging and informative.1-12 In this article, we present some instances when rheumatic and autoimmune diseases in certain individuals may have affected the course of history in Western civilization. Physicians are usually concerned, appropriately, with the effects of illness on the lives of…
A Young Disease: A Holistic Approach to the Treatment of Antiphospholipid Syndrome
Although progress has been made in recent years, rheumatologists still have a lot of questions regarding best management practices for antiphospholipid syndrome (APS). During a session of EULAR 2022, Ricard Cervera, MD, PhD, described a holistic approach.
Case Report: MPA Hiding in Plain Sight
The COVID-19 pandemic has filled hospitals with patients with rapidly progressive respiratory failure and diffuse bilateral opacities on chest X-ray.1 Additionally, many patients with severe COVID-19 develop acute kidney injury and require dialysis.2 Pulmonary-renal syndromes are also important to consider in this setting. Although alveolar hemorrhage is a cardinal feature of this syndrome, many patients…
Case Report: Blunt Smoker Denies Tobacco Use, Delaying Diagnosis
Cannabis arteritis mirrors thromboangiitis obliterans in its clinical and arteriographic presentation, but its relevant exposure is cannabis rather than tobacco.1 Whether cannabis arteritis is a subset of thromboangiitis obliterans or a unique pathologic entity is debatable. Delta-9-tetrahydrocannabinol, the primary psychoactive component of cannabis, is a peripheral vasoconstrictor.2 This offers mechanistic insight into how cannabis may…
Case Report: An Unusual Presentation of Neuro-Behçet’s Disease
A 44-year-old woman presented to the emergency department with bifrontal headaches that had started approximately one month earlier. She was diagnosed with migraines and discharged home. Three days later, the patient returned to the emergency department upon recurrence of her headaches, and this time she also reported abnormal leg movements. A computerized tomography (CT) scan…
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