- Do you have a family history of systemic autoimmune disease?
- Have you ever had a low-grade fever for a few weeks for no specific reason?
- Do you have dry eyes or dry mouth?
- Do your fingers turn white, blue or red when exposed to temperature changes?
- Have you ever had pericarditis?
Questions to help diagnose arthritis:
- Do you have a family history of systemic autoimmune disease?
- Do you have joint pain or swelling?
- Do you have psoriasis?
- Have you had recent infections?
- Do you have a history of inflammatory bowel disease?
Be prepared to ask about family history twice. It may take patients a few minutes to reflect on their family’s health background and see how that may connect to autoimmune disease.
Rheumatology Poster Highlights
In the ECIM’s poster sessions, researchers led by Javier Martinez de Victoria- Carazo, MD, San Cecilio Clinical University Hospital, Granada, Spain, reported on a 29-year-old woman who had been diagnosed with SLE in 2006 and was on regular treatment to achieve remission. Her treatments included aspirin, hydroxychloroquine and deflazacort.
In 2020, the patient presented with lower limb weakness and ascending sensory loss at T6. She previously had a febrile episode with acute urinary retention. A neurological examination confirmed motor deficit and sensory loss below T6. An analysis led to the diagnosis of transverse myelitis as a rare lupus manifestation and was thought to be triggered by a herpes virus reactivation.
Immunocompromised patients with neurological symptoms need a swift differential diagnosis to pinpoint the cause of neurological issues, the researchers concluded.
Researchers from the rheumatology department at PAGNI General Hospital, Herakilon, Greece, led by Konstantinos Giakoumakis, shared the case of a 46-year-old patient who presented with a fever for 20 days, despite treatment for a suspected respiratory infection. Other symptoms included dyspnea, peripheral edema and splenomegaly. He also had a chronic perineal furuncle that was drained weekly.
Lab testing confirmed cytomegalovirus (CMV) and positive serology for anti-nuclear antibodies (ANA 1:640), anti-cardiolipin antibodies and elevated immunoglobulin levels. “This case illustrates the diagnostic complexity of SLE, especially when coexisting with infections such as CMV,” the authors concluded.
Vanessa Caceres is a writer in Bradenton, Fla.
References
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- Distler O, Highland KB, Gahlemann M, et al. Nintedanib for systemic sclerosis-associated interstitial lung disease. N Engl J Med. 2019 Jun 27;380(26):2518–2528.
- Ebata S, Yoshizaki A, Oba K, et al. Safety and efficacy of rituximab in systemic sclerosis (DESIRES): Open-label extension of a doubleblind, investigators-initiated, randomised, placebo-controlled trial. Lancet Rheumatol. 2022 Aug;4(8):e546–e555.
- Abraham D, Black CM, Denton CP, et al. An international perspective on the future of systemic sclerosis research. Nat Rev Rheumatol. 2025 Mar;21(3):174–187.
- Dasgupta B, Cimmino MA, Maradit-Kremers H, et al. 2012 provisional classification criteria for polymyalgia rheumatica: A European League Against Rheumatism/American College of Rheumatology collaborative initiative. Ann Rheum Dis. 2012 Apr;71(4):484–492.
- Kostine M, Finckh A, Bingham CO, et al. EULAR points to consider for the diagnosis and management of rheumatic immune-related adverse events due to cancer immunotherapy with checkpoint inhibitors. Ann Rheum Dis. 2021 Jan;80(1):36–48.
