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Subcategories:Axial SpondyloarthritisGout and Crystalline ArthritisGuidelinesMyositisOsteoarthritis and Bone DisordersOther Rheumatic ConditionsPain SyndromesPediatric ConditionsPsoriatic ArthritisRheumatoid ArthritisSjögren’s DiseaseSoft Tissue PainSystemic Lupus ErythematosusSystemic SclerosisVasculitis

The Effects of IL-17A Inhibitors on the Microbiota

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The use of an interleukin (IL) 17A inhibitor resulted in gut microbial dysbiosis and features of subclinical intestinal inflammation in a subgroup of psoriatic arthritis (PsA) and spondyloarthritis (SpA) patients, according to a multidisciplinary, collaborative study across several institutions published in Arthritis & Rheumatology.1 Understanding the downstream effects of these perturbations is an important step…

Study Finds NSAIDs Raise Heart Disease Risk in Osteoarthritis Patients

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In a controlled, large-cohort, longi­tudinal study from Canada, Atiquazzaman et al. found that use of non-steroidal anti-inflammatory drugs (NSAIDs) substantially contributes to increased cardiovascular disease risk among people with osteoarthritis (OA).1  This is the first study to evaluate the mediating role that NSAIDs play in the association between OA and cardiovascular disease (CVD), and the…

Case Report: Drug-Induced Lupus & ANCA-Associated Vasculitis Overlap

Mohammad A. Ursani, MD, RhMSUS, Ojas Naik, MD, Rohaan Khan & William F. Glass II, MD, PhD  |  

Drug-induced lupus erythe­matosus and ANCA-associated vasculitis (AAV) are both autoimmune conditions associated with the use of hydralazine, a commonly prescribed drug for hypertension and congestive heart failure. Although the pathogenesis is unknown, it is believed that hydralazine alters neutrophil and lymphocyte function and promotes exposure of antigens, leading to the development of anti-neutrophil antibodies (ANCA)…

Study Finds Renal Arteriosclerosis Is Common in Lupus Nephritis Patients

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Renal arteriosclerosis is common in lupus patients with nephritis and occurs two decades earlier than it does in people without lupus nephritis (LN), report investigators in a study that examined the prevalence of renal arteriosclerosis in LN patients compared with healthy controls.1  The finding suggests that renal arteriosclerosis could be used as a biomarker for…

Case Report: Hydralazine-Induced ANCA-Associated Vasculitis

William J. Scheuing, MD, Nitasha Kumar, MD, William Davis, MD, & Robert Quinet, MD  |  

Hydralazine has been in use as a treatment for hypertension, most notably in heart failure patients, since 1951.1 The drug is a known cause of autoimmune disease, most specifically hydralazine-induced lupus.  Hydralazine-induced lupus occurs in 7–13% of those taking the medication.2-4 It often presents with constitutional symptoms, arthritis/arthralgias, cutaneous lesions, sero­sitis, myalgias and/or hepatomegaly. Features…

Updated Clinical Practice Guidelines for Lyme Disease, Lyme Arthritis

Elizabeth Hofheinz, MPH, MEd  |  

A team of healthcare practitioners and researchers, spearheaded by the Infectious Diseases Society of America (IDSA), the American Academy of Neurology (AAN) and the ACR, has developed updated evidence-based clinical practice guidelines for the prevention, diagnosis and treatment of Lyme disease. The 2020 guidelines cover a wide variety of Lyme disease manifestations, including Lyme arthritis. Linda…

Lost and found

The History of ACE Inhibitors in Scleroderma Renal Crisis

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Scleroderma renal crisis is a true medical emergency in rheumatology, one that requires prompt diagnosis and treatment. Here, we review the historic introduction of the angiotensin-converting enzyme inhibitors in this context, and highlight management and key questions moving forward. Background Awareness of renal disease in scleroderma dates back many years. The revered physician William Osler…

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Case Report: A Lupus Patient with Abdominal Pain

Emily Purcell, MD, Colin Ligon, MD, MHS, & Chris T. Derk, MD, MS  |  

Our patient was a 33-year-old, 5’2″ Asian woman with a past medical history of systemic lupus erythematosus (SLE). The diagnosis was based on serologies positive for anti-nuclear antibodies (ANAs), as well as antibodies to Sm, RNP and SSA. Her illness included neuropsychiatric and cutaneous involvement. She also had a diagnosis of Hashimoto’s thyroiditis.  She presented…