He advised, “Don’t make the diagnosis of ANA [antiphospholipid antibody] negative lupus. It’s very, very rare.”
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The index finger could hold a clue to myositis in interstitial lung disease patients. A myositis panel may be indicated in these patients. Dr. West said, “Look at the radial side of their index finger—that’s where you’ll see mechanic’s hands. It may be all over their hands. But if it’s subtle, it’ll always be on the radial side of their index finger.”
Beware certain foods for patients with immune-mediate necrotizing myositis. It’s known that statins may induce myositis, but some foods—oyster, portabella mushrooms and red yeast rice—can as well.
“There are some foods that have statins in them,” Dr. West said. “It’s important to tell your people who do have statin-induced myositis, if you take them off statins, to stay [away from] those particular foods.”
Thomas R. Collins is a freelance writer living in South Florida.
- Stone JH, Tuckwell K, Dimonaco S, et al. Trial of tocilizumab in giant cell arteritis. N Engl J Med. 2017 Jul 27;377(4):317–328.