Calciphylaxis is a poorly understood and life-threatening ischemic vasculopathy characterized by calcification of the small- and medium-size arteries in the skin, subcutaneous tissue and internal organs, which leads to thrombosis, tissue necrosis and painful skin ulcerations that won’t heal. The disease has a 50–80% mortality rate. Although affected patients typically have end-stage renal disease (ESRD)…
Researchers Test Belimumab in Scleroderma
A yearlong pilot study that evaluated the safety and efficacy of belimumab in a small group of patients with early diffuse systemic sclerosis found no significant difference in the number of adverse events between those treated with the drug and those who received a placebo. Currently, no drugs are approved specifically for the treatment of…
Case Report: Skin-Deep Eosinophils
Eosinophilia is usually defined as an eosinophil count of more than 500/microL in peripheral blood.1 An eosinophil count of more than 1,500 is referred to as hypereosinophilia (HE); hypereosinophilic syndrome (HES) is defined as HE associated with organ dysfunction attributable to eosinophilia.2 Eosinophilia can occur due to infectious, malignancy, autoimmune or allergic etiologies. However, a…
Should You Treat SSc with Cyclophosphamide or Mycophenolate?
Patients with scleroderma, systemic sclerosis (SSc), myositis and rheumatoid arthritis (RA) may develop interstitial lung disease (ILD), which affects a patient’s breathing and quality of life. Prospective studies have revealed that in patients with SSc a greater rate of decline of forced vital capacity (FVC) is associated with increased mortality. Although corticosteroids are commonly used…
3 Ways to Improve How You Work with Doctors from Other Specialties
Many trainees tell me they’re attracted to rheumatology because it demands becoming a complete physician. We need knowledge of the brain, eye, lung, kidney, liver, skin, bones and vascular system to be effective rheumatologists. And because our diseases are frequently multisystem diseases, rheumatologists must be the quintessential collaborators. For more than 30 years, I’ve directed…
The ACR’s COIN Department Connects Providers with Communities
Last month I expressed my thoughts on the valuable and varied opportunities the ACR offers for professional and personal growth. Such engagement not only provides an opportunity to connect with your rheumatology colleagues, but also to have a positive impact on patients, supporters and all consumers of healthcare. ACR and ARHP members from every aspect…
Generic-Drug Price Fixing: Is It Happening?
It started with an inhaler. Like many of you, I am a rheumatologist. And like you, I see some patients more often their own primary care provider. This is so often the case that I have gradually devolved into their backup, all-purpose doctor. I am the doc they notify when they get hospitalized for pneumonia…
IgG4-Related Kidney Disease: Diagnostics, Manifestations & More
Immunoglobin G4-related disease (IgG4-RD) is a rare fibro-inflammatory disease of unknown etiology that has been recently recognized. It can cause fibro-inflammatory masses in almost every organ of the body and is associated with dense lymphoplasmacytic infiltration of IgG4-postitive plasma cells, storiform fibrosis and elevated levels of serum IgG4.1 IgG4-RD is a systemic disease that may…
Drug Safety: Fasinumab Evaluated in Clinical Trials, Plus Celecoxib May Not Pose Increased Heart Attack or Stroke Risk
After an independent review, ongoing clinical trials investigating the safety of fasinumab for treating hip or knee OA will discontinue the use of higher fasinumab doses…
Denosumab Is Effective for Glucocorticoid-Induced Osteoporosis
A study identified denosumab as a useful treatment for patients initiating or continuing glucocorticoids who are at risk for fractures. Denosumab had clinical effects similar to risedronate but was more effective than risedronate in the improvement of bone mineral density at the lumbar spine…
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