A 59-year-old woman with rheumatoid arthritis (RA) presented to our pulmonary clinic for progressively worsening dyspnea of five years’ duration. She described progressively worsening dyspnea after a few minutes of walking on level ground. In addition, she noted worsening pain and morning stiffness of the wrists, knees and metacarpophalangeal (MCP) joints, with subcutaneous nodules. She…
A 14-year-old girl is referred to your office for fatigue and arthralgias. While you’re obtaining her past medical history, she divulges that she has had four episodes of bilateral parotitis, each lasting two weeks. An otolaryngologist evaluated her. She lacked sicca symptoms, had a normal complete blood count (CBC), normal inflammatory markers and a negative…
A 42-year-old man with a history of ulcerative colitis (UC), primary sclerosing cholangitis (PSC) and chronic sinusitis was referred to a rheumatologist to evaluate for a possible diagnosis of systemic vasculitis. This patient had developed new skin lesions, gingival hypertrophy and ulcerating tracheobronchitis, concerning for possible granulomatosis with polyangiitis (GPA). Since 1994, the patient had…
A study published in Arthritis & Rheumatology highlights how the presence of autoantibodies to peptidylarginine deiminase (PAD) may eventually be used to influence treatment decisions in the management of rheumatoid arthritis (RA), sharpening our understanding of disease subtypes.1 Although follow-up prospective studies are needed, these findings underline some intriguing areas for future investigations in immunobiology….
Immunoglobulin G4-related disease (IgG4-RD) can cause fibroinflammatory lesions in nearly any organ, and diagnosis is challenging. ACR/EULAR classification criteria for IgG4-RD have been developed and validated in a large cohort of patients. These criteria have performed well in tests and should contribute substantially to future clinical, epidemiologic and basic science investigations.
The idiopathic inflammatory myopathies (IIM) encompass eight categories: 1) dermatomyositis (DM) in adults, 2) juvenile dermatomyositis, 3) amyopathic DM, 4) cancer-associated DM, 5) polymyositis, 6) immune-mediated necrotizing myopathy, 7) inclusion body myositis, and 8) overlap myositis.1 These categories help classify the myopathies based on clinical and histologic features. The incidence of IIM is estimated at…
NEW YORK (Reuters Health)—The osteoporosis drug denosumab is associated with a higher incidence of serious infections compared with placebo, but the risk is similar to comparator drugs, a systematic review and meta-analysis reveals. Talia Diker-Cohen, MD, PhD, of Tel Aviv University, and colleagues searched the literature through May 2019 for randomized controlled trials of denosumab…
Often, rheumatoid arthritis (RA) patients struggle with fatigue, and the cause of the fatigue remains unclear. Past research suggests RA-related fatigue may be moderately improved by physical activity. A recent narrative review supports these prior findings, noting that patients also benefit moderately from psychosocial interventions…
In a systematic literature review, researchers found that rheumatoid arthritis patients taking etanercept were less likely to discontinue their treatment than patients using any of five other tumor necrosis factor inhibitors…
NEW YORK (Reuters Health)—The risk of malignancy in patients with systemic necrotizing vasculitis varies according to the treatment received, according to an analysis of five randomized controlled trials. Previous studies reported an increased risk of malignancy in patients with systemic necrotizing vasculitis, and a more recent study from the European Vasculitis Study Group, based on…