We report on a 77-year-old patient who was diagnosed with giant cell arteritis (GCA) on histopathology of the submandibular gland and eventually went on to develop classic signs and symptoms of GCA. This observation highlights neck swelling as a rare initial presentation of GCA. Case Presentation A 77-year-old previously healthy man presented to his primary…
A 24-year-old woman presented to our rheumatology office in 2017 with a blotchy purple rash on her arms and legs. She reported no history of miscarriage or blood clots. The rash pattern was concerning for livedo reticularis or livedo racemosa, and she was noted to have an anti-nuclear antibody (ANA) titer of 1:160 with a…
Rheumatologists are in the unique position of diagnosing and treating rare auto-inflammatory and autoimmune diseases. Although systemic lupus erythematosus (SLE) often has textbook presentations, it is a heterogeneous condition with a wide variety of disease manifestations. In 2019, the European League Against Rheumatism and the ACR introduced new classification criteria to help diagnose this condition.1…
ACR CONVERGENCE 2020—In a year like no other, the 2020 virtual ACR Convergence was a meeting like no other. Nonetheless, the meeting introduced a healthy mix of clinical insights and take-home pearls, according to panelists in the meeting’s closing session, Bright Future: Discovery & Growth. In this session, panelists discussed some of the biggest news…
ACR CONVERGENCE 2020—In recent years, a pathophysiological role for the interleukin (IL) 17/IL-23 axis in the development of psoriasis, enthesitis and inflammatory arthritis has been investigated in both rodent and human models. Clinical trials have demonstrated differential benefits for skin disease and joint disease in patients with psoriatic arthritis, axial spondyloarthritis (axSpA) and ankylosing spondylitis…
ACR CONVERGENCE 2020—Research has shown time and again the benefits and low risk of physical activity for people with rheumatic diseases, but only a third or less of patients meet guidelines for this activity, Patricia Katz, PhD, professor of medicine and health policy at the University of California, San Francisco, said in the ARP Distinguished…
ACR CONVERGENCE 2020—Sjögren’s syndrome requires care from several specialists, and presenters at the Sjögren’s Syndrome: Dental and Ocular Perspectives session shared diagnostic and treatment pearls from their respective specialties. Rebecca Manno, MD, MHS, of the Comprehensive Arthritis and Rheumatology Center of the U.S. Virgin Islands moderated the session. Oral Health Dry mouth is famously associated…
ACR CONVERGENCE 2020—Myalgic encephalomyelitis/chronic fatigue syndrome, postural orthostatic tachycardia syndrome (POTS) and mast cell activation syndrome were the topics of the day in the ever-popular Curbside Consults session in November 2020. POTS An anxious woman with a chronic headache and constant myofascial pain in the neck and upper back, assorted gastrointestinal symptoms, chronic severe fatigue,…
ACR CONVERGENCE 2020—With the inevitable decline in organ function that comes with age, and the likelihood that older patients (i.e., generally defined as older than 60 or 70, depending on the study) are on more than one medication due to multiple comorbidities, therapeutic drug treatment for older patients requires persistent vigilance and know-how, two experts…
The occurrence of opportunistic infections is an established complication in patients diagnosed with systemic lupus erythematosus (SLE). The foremost challenge in such circumstances is differentiating between an exacerbation or progression of SLE, and the effects of the infection itself.1 Toxoplasma gondii is a ubiquitous parasite that often causes an asymptomatic infection in healthy, immunocompetent adults….