CHICAGO—When it comes to correctly diagnosing joint pain in children, “things take time,” said Michael L. Miller, MD, quoting Danish physicist and poet Piet Hein. Children with pain but normal physical examinations may need to return to the clinic for repeat evaluation over several months. “I often tell parents that laboratory tests may help in…
BETHESDA, MD—Rheumatologists from the National Institutes of Health (NIH) and from Jerusalem, Israel, have identified deficiency of adenosine deaminase 2 (DADA2) as an important cause of familial polyarteritis nodosa, which tends to present in childhood and can manifest with hematologic, immunologic and inflammatory signs, says Chip Chambers, MD, founder and president of the DADA2 Foundation….
A 76-year-old Caucasian male with a history of abdominal aortic aneurysm repair five years earlier presented with three months duration of worsening periumbilical abdominal pain associated with nausea, non-bloody emesis, decreased appetite, fatigue and a 40 lb. weight loss. He denied having fever, chills, night sweats, temporal headaches, vision loss, chest pain, shortness of breath and…
One of my fellows could take better care of his patients if it weren’t for the attendings getting in his way. Or so he tells me. I can hear the howls of protest already. This statement isn’t fair—it is too broad, it doesn’t fairly depict the nuances of the situation or his point of view. First,…
Vasculitis is a group of chronic inflammatory diseases in which the blood vessel is the target of an immune reaction. They can be secondary to connective tissue disease, idiopathic or due to infection, neoplasm or drugs.1 Primary angiitis of the central nervous system (PACNS) is a rare syndrome characterized by inflammatory cell infiltration and necrosis…
Note: Although originally posted in January 2018, the advice below remains valid. We see this issue recur each year. As we begin another new year, many rheumatology practices will again receive prior authorization requests from Medicare Part D for all methotrexate prescriptions. When methotrexate is used as a chemotherapeutic drug, it’s covered by Part B,…
A proof-of-concept study including 10 patients treated for dermatomyositis with tofacitinib, an FDA-approved drug for RA and psoriatic arthritis, shows strong clinical efficacy…
Education with recommended first-line care may not improve pain outcomes in patients with acute low back pain. When comparing patients who received education with those who received professional consultation without information or advice, researchers found patient education was no more effective than placebo at reducing depression or incidence of chronic low back pain…
Patients who develop neuropsychiatric symptoms of SLE have a small nucleotide polymorphism (SNP) in an intron in a Ca++ ion channel gene that influences some, but not all, events regulated by Ca++. The SNP appears to influence activation induced apoptosis rates and cytokine production, specifically IL-4, in a disease- and genotype-specific manner…
Systemic lupus erythematosus (SLE) is associated with high rates of cardiovascular disease. However, research has shown that aggressive risk assessment with lipid screenings and treatment with statins may be suboptimal for these patients. A new study compared the rates of screening and treatment between SLE patients, diabetes mellitus patients and the general Medicaid population. The results: Despite having an elevated risk of CVD, SLE patients received less lipid testing and fewer statin prescriptions than other patients…