When Eric S. Schned, MD, was 19 years old, he spotted a tiny ad in his local newspaper for a concert. As days and weeks passed, the ad grew bigger as bands were added to the lineup. He, his twin brother and two friends decided the concert “looked really cool” and purchased tickets. That may…
In September 2019, a previously healthy, 9-year-old white girl presented to the emergency department following two months of sinusitis and unexplained fever responsive to ibuprofen. She presented with anorexia; a 9Â lb. weight loss; intermittent, nonbilious, nonbloody emesis; and occasional epistaxis with digital manipulation of the nose. Six weeks prior to admission, she had presented to…
As the novel coronavirus that causes COVID-19 spreads across the globe, innovative thinking is needed more than ever to counter the devastating effects on the physical and socioeconomic health of individuals and communities. Innovations in healthcare delivery not yet fully realized prior to the pandemic, such as the adoption of telehealth, are moving to the…
Gout is the most common type of inflammatory arthritis in adults, and it typically occurs in men over the age of 50. When gout presents in younger patients or in women, this should warrant consideration of secondary causes. We describe an unusual genetic cause of tophaceous gout in a young, premenopausal woman. Case Report In…
Over the past 18 months, the ACR’s Quality of Care (QOC) Committee has helped produce an impressive number of resources that will help rheumatologists deliver the best possible care. Working through specific projects supervised under its Criteria, Guideline, Guidance, and Quality Measure subcommittees, the QOC Committee has developed new sets of disease criteria, clinical guidelines,…
Immunoglobulin G4-related disease (IgG4-related disease) is relatively rare, although with greater recognition it is becoming more frequently diagnosed. Some of the more common presentations of the disease include aortitis, cholangitis, autoimmune pancreatitis, sclerosing sialadenitis, orbital disease with proptosis and subacute mass development in the affected organ.1 It has protean manifestations and is diagnosed by classic…
In early June, the ACR released an updated guideline on the management of rheumatoid arthritis, which includes new recommendations for specific high-risk groups.1 The guideline includes 44 recommendations—seven of which are strong and 37 conditional. It underscores the role of methotrexate as a cornerstone therapy and emphasizes minimizing glucocorticoids, when possible. Guideline Development Process At…
Platelets may be a key source of mitochondrial antigens in systemic lupus erythematosus, according to a recent study.
When rheumatologists think about rheumatoid arthritis (RA), they are apt to picture the synovium, contemplate such antibodies as rheumatoid factor and those to citrullinated proteins, and consider how this interplay of factors manifests in disease. What is not as commonly discussed is the role the autonomic nervous system plays in the pathogenesis and symptomatology of…
Juvenile dermatomyositis (JDM) is a childhood form of inflammatory myopathy affecting children younger than 18 years. The diagnosis of JDM is based on characteristic clinical features of proximal muscle weakness, skin rash, elevated muscle enzymes, magnetic resonance imaging and muscle biopsy.1 Autoantibodies seen in patients with inflammatory myopathy are not only associated with particular phenotypes…