A number of autoinflammatory syndromes that result from genetic mutations have been described recently. The vast majority occur in children. However, three periodic fever syndromes are important for rheumatologists who treat adults to know about. The goal of this review is to provide a concise description of each condition, and to help the clinician understand…
Fellows’ Forum Case Report: Necrotizing Autoimmune Myopathy
Necrotizing autoimmune myopathy (NAM) is a relatively recently discovered subgroup of inflammatory myopathies. NAM is characterized by predominant muscle fiber necrosis and regeneration with little or no inflammation.1 One subgroup of NAM is 3-hydroxy-3-methylglutaryl-CoA reductase antibody (HMGCR Ab)-related immune-mediated necrotizing myopathy (IMNM), which occurs (rarely) after statin exposure, with a rough incidence of two per…
A History of the Science, Treatment of Rheumatologic Illnesses from Gold to Gene Therapy
Mysterious Ways The juxtaposition of the old and the new was readily evident that busy Wednesday morning. My first patient, a 94-year-old gentleman, Hal, arrived with a precise request. His rheumatologist for the past 40 years had just retired, and he was searching for a doctor with expertise in the use of gold sodium aurothioglucose,…
How to Manage, Treat Anemia of Inflammation in Patients with Rheumatic Disease
Anemia is common in patients with systemic rheumatic disease, yet it may not get the attention it deserves. Anemia can result from chronic inflammation, treatment side effects or other disease factors, or it may signal an unrelated condition. Although diagnosis and treatment of anemia are sometimes challenging, clinicians must do their utmost to rigorously investigate…
Rheumatology Case Report: TINU Syndrome with Concomitant Synovitis
Tubulointerstitial nephritis and uveitis (TINU) syndrome, also known as Dobrin syndrome, is a rare oculo-renal inflammatory disease. It was first described in 1975 by American physician Robert Dobrin, MD.1 It manifests as acute interstitial nephritis and bilateral uveitis. In addition, patients often experience nonspecific systemic findings, such as fever, weight loss, malaise, myalgia and arthralgia. TINU…
Hyperuricemia Doesn’t Always Indicate Gout in Rheumatic Disease
A 57-year-old Ghanaian woman was referred to our rheumatology practice with acute, left elbow swelling and pain. The referring oncologist suspected gout, because the patient had hyperuricemia. Six months before, the patient was diagnosed with stage IV human T-lymphotropic virus type 1 (HTLV-1)-associated adult T cell lymphoma (ATLL). Her initial oncologic manifestations included multiple thoracic,…
Rheumatology Case Report: Monoarticular Arthritis in Pregnancy
Limited data exist on the clinical presentation of Muckle–Wells syndrome (MWS) during pregnancy. The purpose of this case report is to highlight the diagnosis of MWS in a pregnant woman. Many rheumatic diseases affect women of childbearing age, and their management during pregnancy can be challenging. Case A 33-year-old, 18-weeks’ pregnant woman was hospitalized for…
New Studies Examine Impact of Poverty, Race, Ethnicity in Patients with SLE
To correctly address a problem, one must have a handle on its nuances—a clear understanding of what is linked and how. And thus far, when it comes to lupus, we haven’t reached the point of understanding those intricacies. Things are heading in the right direction, however, with two new studies that get us much closer…
The ACR, EULAR Partner to Refine Classification System, Develop New SLE Criteria
MADRID—Systemic lupus erythematosus (SLE) experts in North America and Europe are working together to refine the classification system for the disease, with the goal of producing a new set of criteria that is simpler to use and more scientifically rigorous than any classification approach previously published, speakers involved with the process said at the 2017…
Bipolar Disorder, Nailfold Capillaroscopy Score, Urban Location Among Risk Factors for Developing Lupus
MADRID—Researchers have found that systemic lupus erythematosus (SLE) is independently linked with bipolar disorder and say the findings point to a need for greater awareness of psychiatric problems in patients with SLE. In work led by investigators at Tel Aviv University in Israel and presented at the 2017 Annual European Congress on Rheumatology (EULAR), researchers…
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