CHICAGO—David A. Isenberg, MD, academic director of rheumatology, University College London, presented the ACR Systemic Lupus Erythematosus (SLE) State-of-the-Art Symposium at the 2018 ACR/ARHP Annual Meeting. Dr. Isenberg began by noting lupus is now widely covered in the news, but singer Selena Gomez has probably done the most to increase awareness of the disease; her…
State-of-the-Art Approaches to Rheumatic Disease Diagnosis, Management & Treatment
CHICAGO—Held during the 2018 ACR/ARHP Annual Meeting, the ACR Review Course covered a wide range of topics for rheumatologists—from advances in pain and rheumatic disease management to the intersection of rheumatology and neurology. Session speakers shared insights, as well as state-of-the-art approaches to diagnosis, management and treatment. Inflammatory Myopathies Julie J. Paik, MD, MHS, assistant…
Metabolic Profiling of SLE
Research examining the metabolic profile of SLE found increased oxidative activity, as well as lower levels of tyrosine and tryptophan, in SLE patients relative to controls, suggesting increased activity of aromatic amino acid decarboxylase. The results suggest metabolomics may have the ability to measure disease severity in SLE…
History of Depression Is a Risk Factor for SLE in Women
Results from a 20-year, cohort study add to the evidence that depression increases the risk of developing an autoimmune disease, specifically SLE in women. Lead investigator Andrea Roberts, PhD, says, “There may be direct biological effects of depression that increase the risk of autoimmune disease.”…
Mortality Trends in Lupus Nephritis
According to results of a recent study of all-cause and cause-specific mortality trends of end-stage renal disease due to lupus nephritis from 1995 to 2014, the all-cause premature mortality rate improved among white, African American and Hispanic patients, with reduced risk of death from CVD and infection. Jorge et al. observed a 32% reduction in mortality. This improved survival may be explained by a combination of improvements in the management of ESRD and of underlying SLE…
Diagnosing & Managing Pulmonary & Kidney Manifestations in Lupus
CHICAGO—In systemic lupus erythematosus (SLE), most types of severe pulmonary manifestations are relatively rare, but it’s crucial they be caught because of the potentially dire consequences, said Richard Silver, MD, professor in the Rheumatology Division at the Medical University of South Carolina, Charleston, at the 2018 ACR/ARHP Annual Meeting. Pulmonary Manifestations Parenchymal disease—seen in the…
These 3 Tough Cases from the 2018 Thieves Market Underscore Need for Clinical Diligence
CHICAGO—In the Thieves Market session at the 2018 ACR/ARHP Annual Meeting, rheumatologists from around the country presented a slate of challenging cases that emphasized the importance of clinical persistence and attention to detail, and the need to consider diagnoses that might not be common or obvious. Three of them are summarized below. (Look for more…
Alterations in Macrophage Activation May Signal a Lupus Flare
New data suggest myeloid cells in SLE patients skew B and T cell activation status toward the M1 proinflammatory phenotype, thereby directing SLE flares and remission…
PAD2 & PAD4 Modulate Immune Response in TLR-7-Dependent Lupus
A study in mice suggests that targeting peptidyl arginine deiminases in lupus patients may have a therapeutic role in T cell-mediated diseases, affecting innate and adaptive immunity, as well as modulating dysregulated toll-like receptor 7-dependent immune responses…
Intronic Polymorphism Associated with Risk of Neurological Disorders in SLE
Patients who develop neuropsychiatric symptoms of SLE have a small nucleotide polymorphism (SNP) in an intron in a Ca++ ion channel gene that influences some, but not all, events regulated by Ca++. The SNP appears to influence activation induced apoptosis rates and cytokine production, specifically IL-4, in a disease- and genotype-specific manner…
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