Patients with chronic kidney disease (CKD) often experience joint pain due to various etiologies, including crystalline arthropathies, renal osteodystrophy, amyloid arthropathy, erosive osteoarthritis, avascular necrosis and even erosive spondylarthrosis.1 Below, we present a case of crystalline arthropathy in a patient with chronic kidney disease, mistaken for gout. The Case A 29-year-old man was admitted to…
Methotrexate (MTX) remains the predominant medication used by rheumatologists to treat rheumatoid arthritis (RA). Doses of 7.5–25 mg per week with daily folic acid are generally prescribed. Despite its common use, MTX must be prescribed cautiously given the potential adverse effects when taken incorrectly or without folic acid supplementation. Cases of MTX-induced cutaneous ulceration have…
In September 2018, the U.S. Food & Drug Administration (FDA) granted fast-track status to FCX‑013, a gene therapy product developed to treat moderate to severe localized scleroderma (morphea). Previously, the treatment received an orphan drug designation for localized scleroderma, as well as a rare pediatric disease designation. Phase 1 and 2 studies will assess safety…
Autoinflammatory diseases are genetically diverse, but clinically similar, conditions distinct from autoimmune illnesses, such as systemic lupus erythematosus or rheumatoid arthritis. Clinically, they are defined by recurrent episodes of inflammation that follow a characteristic pattern each time they occur. Some have a set length of time during which fever, peritonitis or arthritis manifest. Others are…
Eosinophilic granulomatosis with polyangiitis (EGPA), also known as Churg-Strauss syndrome or allergic granulomatosis and angiitis, is a rare small- and medium-vessel vasculitis. This disease was first described by American pathologists Jacob Churg and Lotte Strauss in 1951.1 Although the vasculitis is often not apparent in the initial phases of the disease, EGPA can affect any…
Although the true cause of systemic sclerosis (SSc), or scleroderma, remains unknown, researchers have made progress in detecting the autoimmune disease’s early presence. Beyond the physiological signs of Raynaud’s phenomenon, a capillaroscopy can detect alterations in microcirculation and lab tests can confirm the presence of telltale autoantibodies, such as anti-topoisomerase 1, anti-centromere and anti-RNA polymerase…
Historically, the early approach for treating interstitial lung disease (ILD) due to systemic sclerosis (SSc) involved immunosuppressant therapy, primarily with cytotoxic agents.1 Glucocorticoids in combination with another immunosuppressant agent, such as oral azathioprine or cyclophosphamide, were often used to treat patients with severe, progressive SSc-ILD.2 However, direct evidence to support this therapeutic approach was lacking…
Over the past few years, biosimilars and other new drugs have been introduced to treat rheumatic illnesses. Some of the conditions we treat have numerous drug options, others have few or only off-label options. This series, “Rheumatology Drugs at a Glance,” provides streamlined information on the administration of biologic, biosimilar and small molecule inhibitor drugs…
Despite the presence of a highly effective vaccine, measles (rubeola) is still an important problem worldwide, one that has reemerged in some areas of the world where it had previously been almost eradicated. Rheumatology patients may have questions about whether they are sufficiently protected. Here we discuss key considerations for rheumatologists in light of recent…
A recent gene expression analysis found an enriched downstream interferon signature, with predominantly IFNB1 signatures in systemic lupus erythematosus (SLE) patients. The study also found lower expression of all downstream interferon signatures in the kidneys of lupus nephritis patients…