The following summary regarding use of tacrolimus (TAC) in lupus nephritis highlights a number of debatable points. Although the role of TAC in lupus nephritis remains unproved for North American populations, it might be an excellent option in some clinical situations. These situations include lupus flare during pregnancy and also for lupus nephritis when the…
CPT: 99213, 89060 ICD-10: M10.072 Coding Rationale This is an established outpatient visit. The encounter is coded as 99213 because it included: History—Expanded problem-focused history. The history of present illness was brief, the review of systems was extended and the past medical and social history was documented. Examination—Detailed. There were seven organ systems examined. This…
A 55-year-old female patient returns to the office with complaints of gout pain. She is complaining of swelling and a burning pain in her left toe. She has been taking an over-the-counter NSAID to treat the pain, but this has done little to alleviate it. This is her second flare this year. The patient denies…
According to a new study, patients with aggressive rheumatoid arthritis (RA) have lower levels of non-esterified fatty acids, which coincide with an enhanced Th1 response. Researchers suggest that lower EPA and DHA at the onset of RA may exacerbate inflammation, and fatty acids may become a novel therapeutic target for the disease…
The transition from pediatric to adult care can be a rocky one. For many rheumatology patients, any problems in the move can cause gaps in care. To address this issue, the American College of Rheumatology (ACR) joined the American College of Physicians’ (ACP) Pediatric to Adult Care Transitions Initiative. The Initiative is a project spearheaded…
NEW YORK (Reuters Health)—Anti-TNF drugs are more likely to improve growth in children with inflammatory bowel disease (IBD) if they’re given in the earlier stages of puberty, new findings show.¹ Children who achieve remission are also more likely to have satisfactory growth, the research team reported online on Sept. 21 in the Journal of Pediatric…
Physicians have been puzzled by the role of benign joint hypermobility syndrome in the development of gastrointestinal disorders and other autonomic symptoms and co-morbidities. However, new research found that benign joint hypermobility syndrome only minimally affects autonomic abnormalities…
Systemic autoimmune rheumatic diseases are associated with increased rates of adverse pregnancy outcomes, including spontaneous abortion, preeclampsia, fetal growth restriction (FGR) and prematurity. In this study population, preclinical rheumatic disorders were associated with an increased risk of FGR, preeclampsia and small-for-gestational-age infants. The impact of these findings and their utility in screening for fetal growth restriction/preeclampsia need to be confirmed in population studies…
Rheumatologists are already familiar with one mosquito-borne virus, chikungunya, whose presentation mimics arthritis. Now, with its recent spread to Puerto Rico and the Southeastern U.S., Zika, another mosquito-borne virus, has become an international public health concern. Sexual transmission of the virus was recently confirmed, expanding the virus’s threat…
A recent review examined the effectiveness of arthroscopic mensical surgery in treating meniscal injuries. Researchers determined that little evidence exists to support the use of arthroscopic meniscal surgery and more studies that directly compare it with nonoperative treatments are needed…