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Acute Microcrystalline Arthropathy Masquerades as Infectious Discitis

Jessita Albert Messiah Dhas, MD, Erik O’Connell, DO, & Lisa L. Schroeder, MD  |  June 17, 2019

Monosodium urate (MSU) crystal deposition commonly occurs within the distal appendicular skeleton. The peripheral nature of gout is a hallmark feature described in the ACR and the European League Against Rheumatism (EULAR) clinical practice guidelines.1 In this article, we report a rare presentation of a common disease: a case of axial gouty arthropathy masquerading as…

Advocacy Leads to Legislator Access

Paula Marchetta, MD, MBA  |  June 17, 2019

We have often heard it said that opportunity arises from challenges. Challenge, of course, is really just a polite way of saying problem—and for our patients, problems abound when it comes to obtaining timely and affordable access to the rheumatologic care they need. Access in this context has many meanings: There is access to life-changing…

Thinking Big, Thinking Small

Philip Seo, MD, MHS  |  June 17, 2019

I would like to tell you a story. Two, actually. I am just returning from the 19th International Vasculitis and ANCA Workshop, which is always a fascinating meeting. In its inception, it was a workshop, in the true sense of the word. Now, we discuss anti-neutrophil cytoplasmic antibody (ANCA) testing as casually as we discuss…

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Case Report: Sjögren’s Syndrome Plus Neuromyelitis Optica Spectrum Disorder

Swosti Roka Magar, MD, Gita Verma, MD, & Aaroop Haridas, MD   |  June 17, 2019

Sjögren’s syndrome is a chronic multi-system autoimmune disease characterized by inflammation and subsequent destruction of exocrine glands. Sjögren’s syndrome can present with glandular or extra-glandular manifestations. Neuromyelitis optica spectrum disorder (NMOSD) is a rare central nervous system (CNS) autoimmune disease that can present as the initial manifestation in less than 5% of patients with Sjögren’s….

Biological DMARDs in Elderly RA Patients: Use, Maintenance & Discontinuation

Natasha Yetman  |  June 17, 2019

A study comparing seven biologic DMARDs in RA patients aged 65 years and older found abatacept had the highest retention rate and the lowest discontinuation rate…

Beyond Addiction: Medical Therapy for Addiction May Benefit Medical Adherence

Thomas R. Collins  |  June 17, 2019

Treating patients with rheumatic disease for their addictions will also encourage patients to address their overall health conditions, resulting in better medical adherence…

Low-Density Granulocytes Activate T Cells in SLE

Lara C. Pullen, PhD  |  June 17, 2019

Recent research indicates that low-density neutrophils, such as low-density granulocytes, exert proinflammatory effects on the T cells of SLE patients. In the study, researchers confirmed SLE patients had a higher prevalence of low-density granulocytes than healthy controls and that these cells appeared to promote a Th1 response…

Checkpoint Inhibitors May Be Retried after Immune Adverse Event, with Close Monitoring

Marilynn Larkin  |  June 13, 2019

NEW YORK (Reuters Health)—After an immune-related adverse event, the risk-reward ratio for an anti-PD-1 (anti-programmed death-1) or anti-PD-L1 (anti-programmed death ligand-1) rechallenge seems to be acceptable if patients are closely monitored, researchers say. “The immune checkpoint inhibitors anti-PD-1 and anti-PD-L1 have proven efficacy in the treatment of many cancers, but patients may experience immune-related adverse…

Risk Assessment & Treatment in APS Patients

Thomas R. Collins  |  June 12, 2019

The pathogenesis of antiphospholipid syndrome (APS) is complicated and may involve local inflammation, vasculopathy, pregnancy complications and thrombosis. During the 2019 ACR State-of-the-Art Clinical Symposium, Lisa Sammaritano, MD, addressed the risk assessment and treatment of APS patients…

The Microbiome: A Predictor of Response?

Natasha Yetman  |  June 12, 2019

New research by Jose Scher, MD, discussed during the 2019 ACR State-of-the-Art Clinical Symposium, demonstrated how clinicians may be able to modify aspects of the microbiome to predict and boost a patient’s treatment response…

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