Tubulointerstitial nephritis and uveitis (TINU) syndrome, also known as Dobrin syndrome, is a rare oculo-renal inflammatory disease. It was first described in 1975 by American physician Robert Dobrin, MD.1 It manifests as acute interstitial nephritis and bilateral uveitis. In addition, patients often experience nonspecific systemic findings, such as fever, weight loss, malaise, myalgia and arthralgia. TINU…
Rheumatologist’s Ping-Pong Prowess Sharpens His Skills with Patients
Roughly 15 years ago, Steven K. Magid, MD, rheumatologist and chief medical information officer at the Hospital for Special Surgery (HSS) in N.Y., attended a social event for hospital employees. While chatting with other physicians, nurses, and lab techs, he watched one of his colleagues slaughter her opponents at Ping-Pong. “She was very skilled,” recalls Dr. Magid,…
Rheumatology Drug Updates: Efficacy Studied Following Accelerated Drug Approvals; Plus Secukinumab Meets Benchmark for Psoriasis
Medications for serious or life-threatening conditions may receive accelerated approval from the U.S. Food and Drug Administration (FDA) by showing an effect on surrogate measures that are reasonably likely to predict a treatment’s clinical benefit. Post-approval confirmatory drug trials are then required to determine whether or not these effects translate into clinical improvements. In recent…
Rheumatology Coding Corner Answer: Evaluation for Possible Systemic Lupus Erythematosus
Take the challenge. CPT codes: 99245/99205 ICD-10: M79.1, R21, R53.83, L65.9, K13.79, R00.0 This visit can be billed out as a 99245 only if the insurance carrier allows the billing of consultation codes. If the carrier does not allow consult codes, then this visit must be billed as a new patient visit. Because many outpatient…
Rheumatology Coding Corner Question: Evaluation for Possible Systemic Lupus Erythematosus
History A 25-year-old female patient is seen in the office after her primary care physician requested a consultation for a possible diagnosis of systemic lupus erythematosus (SLE). The patient presents today with muscle pain in both legs, she rates the pain at an 8 on a scale of 10. She states she experiences throbbing, usually…
Hyperuricemia Doesn’t Always Indicate Gout in Rheumatic Disease
A 57-year-old Ghanaian woman was referred to our rheumatology practice with acute, left elbow swelling and pain. The referring oncologist suspected gout, because the patient had hyperuricemia. Six months before, the patient was diagnosed with stage IV human T-lymphotropic virus type 1 (HTLV-1)-associated adult T cell lymphoma (ATLL). Her initial oncologic manifestations included multiple thoracic,…
Research Targets Interferon Alpha in New Treatment Approach for CNS Lupus
RETRACTED Editor’s note: The study this article reported on was retracted by the researchers. Key aspects could not be replicated, and they said, “Most importantly, the findings from behaviour studies and sequencing of microglia isolated from 564Igi autoimmune mice as shown in Figs. 1a, b, d and 3a, b are not substantiated upon further analysis…
Fellows’ Forum: 7 Tips to Successfully Manage Upward During Fellowship
During the two or three short years of a rheumatology fellowship, there is so much to learn: the subtle art of the musculoskeletal examination, the intricacies of the immune system and the indications for a dizzyingly increasing array of new medications, to name just a few topics. One topic that you rarely hear about, but…
Exercise May Help Prevent Low Back Pain or Make It Less Severe
(Reuters Health)—People who exercise may lower their odds of developing low back pain or may reduce the intensity of back pain they do experience, a research review suggests. Compared to people who didn’t exercise, those who did were 33% less likely to develop low back pain, the analysis of data from 16 previously published studies…
Consumers Sign Up for Obamacare 2018 Individual Plans Despite Uncertainty
NEW YORK (Reuters)— Consumer sign-ups for Obamacare individual insurance plans were more than 600,000 during the first week of enrollment for 2018, a U.S. health agency said on Thursday, a positive sign for insurers who take part in the healthcare program that Republicans are trying to undo. The Centers for Medicare & Medicaid Services, a…
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