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Case Report: Saddle Nose Deformity in IgG4-Related Disease

Alyxandra Soloway, MD, & Stephen Soloway, MD, FACP, FACR  |  June 14, 2021

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…

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The ACR Releases an Updated Treatment Guideline for Rheumatoid Arthritis

Ruth Jessen Hickman, MD  |  June 14, 2021

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: An Underrecognized Piece of the Lupus Puzzle

Lara C. Pullen, PhD  |  June 14, 2021

Platelets may be a key source of mitochondrial antigens in systemic lupus erythematosus, according to a recent study.

Studies Probe Treating Rheumatoid Arthritis with Vagus Nerve Stimulation

Jason Liebowitz, MD, FACR  |  June 14, 2021

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…

Case Report: Digital Ulcers & Weight Loss in a Pediatric Patient

Anusha Vuppala, MD, & Sarwat Umer, MD  |  June 13, 2021

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…

Rheumatology Care: Access & Affordability

Vanessa Caceres  |  June 13, 2021

Presenters at the Access in Rheumatology meeting held in advance of the ACR’s State-of-the-Art Clinical Symposium took a deep dive into the access challenges faced by rheumatology patients and discussed possible solutions. Treatment At least until 2026, prescription drug spending will exceed the U.S. gross domestic product (GDP) and health spending, said rheumatologist Colin C….

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How Immunosuppression May Affect COVID-19 Vaccine Response

Ruth Jessen Hickman, MD  |  June 13, 2021

Although we can expect to learn much more, preliminary data are now available on the potential safety and effectiveness of COVID-19 vaccines in rheumatology patients. The picture is likely to be nuanced, with not all types of immuno­suppressive treatments having identical impacts on vaccine response. Rheumatologists should use caution in interpreting early reports, while continuing…

ACR Advocacy: 2021 Midyear Update

Elizabeth (Blair) Solow, MD  |  June 13, 2021

Beginning in the late 1800s, Eliza Ruhamah Scidmore, U.S. diplomat and writer, spent 24 years advocating for sakura, or Japanese cherry trees, to be planted in Washington, D.C. After unsuccessfully petitioning every U.S. Army Superintendent of Public Buildings and Grounds for over two decades, she wrote a letter to First Lady Helen Herron Taft about…

A Unified Advocacy Voice for Rheumatology

David R. Karp, MD, PhD, & Christine Stamatos, DNP, ANP-C  |  June 13, 2021

One thing that became clear very quickly this past year was that the COVID-19 pandemic would change the way we deliver care to patients. What has not changed amid an evolving healthcare landscape is our driving focus to ensure our patients’ access to rheumatology care and the availability of state-of-the-art treatments. We know you share…

Racism As a Public Health Crisis

Philip Seo, MD, MHS  |  June 13, 2021

On March 29, Brandon Elliot walked up to a 65-year-old Filipino American woman near Times Square and kicked her in the chest. Footage from the security camera of a nearby luxury apartment building recorded the attack: Elliot shoved her to the ground, and then repeatedly kicked and stomped on her, while shouting, “You don’t belong…

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