I read with interest the Diagnostic View (TR, April), which, according to the authors, represented a case of rhupus, an overlap syndrome of RA and SLE. I challenge this view. My arguments: In the case of erosive RA, typically erosive changes are seen at MTP joints other than MTP1 (e.g., MTP5). In addition, the erosive…
I’m writing in regard to the article, “Fever of Unknown Origin” (TR, March 2016), by Charles Radis, DO. In regard to the non-caseating granulomas, there was no mention of epithelioid or giant cells. In addition, it was mainly [complement] C4 in the center of the granulomas, which is often found in sarcoidosis. Moreover, whether these…
Rheumatoid arthritis (RA) is rarely associated with renal manifestations, but secondary amyloidosis due to chronic inflammation is reported to be the etiology of renal dysfunction in many cases of RA.1,2 The discovery of biologic therapy, with TNF-alpha inhibitors in particular, made a huge difference in the disease course and prognosis of RA patients. However, TNF-alpha…
When Christopher Ritchlin, MD, MPH, isn’t teaching students, residents and fellows at the University of Rochester Medical Center (URMC), treating patients or conducting medical research in his lab, he’s monitoring the health of another sort of patient—honeybees. For the past four years. Dr. Ritchlin, professor and chief of allergy, immunology and rheumatology at URMC, has…
Etanercept Submitted for Chronic, Severe Plaque Psoriasis in Children The U.S. Food and Drug Administration (FDA) has accepted the supplemental Biologics License Application for etanercept (Enbrel) for treating pediatric patients with chronic, severe plaque psoriasis.1 The application was submitted in early January 2016 and is based on results of a one-year Phase 3 study with…
The American College of Rheumatology (ACR) recognized the 50th anniversary of the Association of Rheumatology Health Professionals (ARHP) during the ACR/ARHP Annual Meeting this past November in San Francisco. The University of Arizona Arthritis Center followed up with a reception in Tucson to honor past presidents of the ARHP. The Tucson area has the highest…
CHICAGO—Celiac disease—the gluten-induced illness that can be seen alongside rheumatic diseases—has been seen much more commonly over the past 20 years than it was previously, but the illness can come with questions that are not always straightforward, an expert said at the ACR’s State-of-the-Art Clinical Symposium. The disease, in which the small intestine becomes inflamed…
CHICAGO—Nine out of 10 scleroderma cases include clinical signs of gastrointestinal (GI) involvement, with severe involvement associated with high mortality rates, but the pathology of this is not very well understood, a GI expert said at the ACR’s State-of-the-Art Clinical Symposium. That has left clinicians with a slate of treatments—anti-reflux, antimicrobials and prokinetics—that address only…
CHICAGO—When it comes to treating patients with rheumatic diseases who are in the intensive care unit (ICU), there are so many complications and considerations that few rules exist as a guide. But Paul Dellaripa, MD, associate professor at Harvard Medical School, said at the ACR’s State-of-the-Art Clinical Symposium that there are basic steps a rheumatologist…
CHICAGO—In October of last year, a 52-year-old woman came to see Kevin Winthrop, MD, MPH, associate professor in infectious diseases, public health and preventive medicine at the Oregon Health & Sciences University. She had rheumatoid arthritis and was taking methotrexate and prednisone. She had had little change in her RA disease severity and was considering…