Genes may predispose people to have certain microbial signatures in their gut that, in turn, make them susceptible to developing reactive arthritis. This is the main finding of a recent study in which researchers investigated whether perturbations in the intestinal microbiome play a role in susceptibility to reactive arthritis in the face of triggers, such…
More than 10 years ago, I wrote a commentary in The Rheumatologist, called “Perils of Pain Meds,” about the over-prescribing of opioid analgesics for common causes of chronic noncancer pain, which was a major contributor to the opioid epidemic.1 Since that time, although there has been a greater than 20% decrease in opioid prescribing, the…
ACR guidelines include recommendations for the management of patients with particular conditions or diseases. Guidelines are developed using a systematic process and are based on available evidence and the clinical experience and expertise of rheumatologists and other interested stakeholders. In the January issue of Arthritis & Rheumatology, Arthritis Care & Research and the Journal of…
Varicella-zoster-virus (VZV) reactivation, which can cause patients to develop herpes zoster (i.e., shingles), occurs more frequently in patients with systemic vasculitis and systemic lupus erythematosus (SLE) who have received intravenous cyclophosphamide than in otherwise healthy adults, according to a retrospective study published in The Journal of Rheumatology by researchers in France.1 The study also shows…
When a patient has both primary immune deficiency and autoimmune disease, the combination can lead to life-threatening complications. Here are some insights into the challenges of diagnosing and treating this rare subset of patients…
LONDON (Reuters)—Scientists exploring what may trigger chronic fatigue syndrome (CFS) have found clues in the way some people’s immune systems respond to interferon alpha.1 The researchers used the drug to create a model of the disease in people without CFS but with hepatitis C. Many patients who receive interferon alpha experience extreme fatigue during treatment,…
Editor’s notes: A memorial service for Nadia is being planned for Jan. 16, 2019, from 4:30-6:00 p.m. at Johns Hopkins Bayview Asthma and Allergy Center, Richard A. Grossi Auditorium, 5301 Hopkins Bayview Circle, Baltimore. To honor her life and the impact she made on the Division of Rheumatology, Johns Hopkins is establishing the Dr. Nadia D….
A 39-year-old woman presented at the emergency department with three weeks of progressive, constant and pulsatile right-sided headache. She said her headache was worse in the morning and when she would bend forward. She reported associated nausea and vomiting. On initial assessment, she did not have any focal neurological deficits. Her medical history was significant for…
Primary Sjögren’s syndrome is a systemic autoimmune condition noted for findings of xerostomia, keratoconjunctivitis sicca and focal lymphocyte infiltrate in salivary glands.1 In the initial publications regarding keratoconjunctivitis sicca, Henrik Sjögren, a Swedish ophthalmologist, described a group of 19 women with dry eyes, some of whom had other organ dryness and inflammatory infiltrates.2,3 The syndrome…
Researchers sought to identify predictors of patients with anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV) who took rituximab for maintenance had a better sustained remission rate through 60 months than those taking azathioprine, according to the latest results from the maintenance of remission using rituximab in systemic ANCA-associated vasculitis (MAINRITSAN) trial, a prospective, randomized trial…