Many a rheumatology consult has centered on a perplexing question: Does this patient have central nervous system (CNS) vasculitis? At the 2021 ACR State-of-the-Art Clinical Symposium, Rula Hajj-Ali, MD, FACP, professor of medicine and associate director of vasculitis care and research, Cleveland Clinic Lerner College of Medicine, discussed this topic in detail, providing a series… [Read More]
Vasculitis is a group of chronic inflammatory diseases in which the blood vessel is the target of an immune reaction. They can be secondary to connective tissue disease, idiopathic or due to infection, neoplasm or drugs.1 Primary angiitis of the central nervous system (PACNS) is a rare syndrome characterized by inflammatory cell infiltration and necrosis… [Read More]
SAN FRANCISCO—Let’s say your radiologist comes to you and says that an angiogram gives a diagnosis of CNS vasculitis on four patients, all with acute onset of headache and stroke: One is a 25-year-old woman who is three months pregnant. Another is a 50-year-old man using excessive doses of nasal decongestants. Another is a 40-year-old… [Read More]
Case report: A 60-year-old Hispanic male with poorly controlled hypertension was sent from the primary care clinic for evaluation of malignant hypertension with a systolic blood pressure above 200 mmHg. His symptoms at the time of presentation included episodic confusion, worsening vision and an unsteady gait. A head computed tomography (CT) scan showed a subacute… [Read More]
Without reliable diagnostic tests or evidence-based treatment guidelines, patient symptoms critical to diagnosing disease... [Read More]
Although systemic lupus erythematosus (SLE) affects both the central nervous system (CNS) and peripheral nervous system (PNS), past research has primarily focused on how lupus affects the CNS. Now, an international, inception cohort study, “Peripheral Nervous System Disease in Systemic Lupus Erythematosus,” published in Arthritis & Rheumatology, has examined different types of PNS disease to… [Read More]
The disease called systemic lupus erythematosus (SLE) went through many different stages of classification before reaching the modern criteria reflecting our current understanding of its pathogenesis. In 1872, the Viennese dermatologist Moriz Kaposi, MD, published a paper, “New Contributions to Knowledge of Lupus Erythematosus,” which provided a significant leap forward in the characterization of this… [Read More]
LONDON—Despite the detailed terminology for describing vasculitis established by the Chapel Hill Consensus (CHC) in 2012, the field badly needs better classification and diagnostic criteria for the group of diseases, an expert said in a presentation at the Annual Congress of the European League Against Rheumatism (EULAR 2016). It’s a topic that is now being… [Read More]
The FDA has issued new safety guidelines for systemic fluoroquinolones, restricting their use to patients with no alternative treatment options…... [Read More]
I sometimes find myself mired in sticky clinical circumstances. I am facing a distraught patient who is seeking my opinion about a condition that, according to some, may not truly belong in the rheumatologist’s bailiwick. Case example: hearing loss. The Steroid Test Sudden sensorineural hearing loss (SSNHL) and its relative, autoimmune inner ear disease (AIED),… [Read More]