Idiopathic inflammatory myopathies are heterogenous, acquired immune-mediated muscle diseases. Over the past decade, immune-mediated necrotizing myopathy has been recognized as a subcategory of idiopathic inflammatory myopathy characterized by myofiber necrosis in the absence of prominent inflammatory cells.1 Autoantibodies against signal recognition particle (SRP) and 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) are thought to be associated with the…
Draft Classification Criteria for IgG4-Related Disease Introduced
CHICAGO—John H. Stone, MD, MPH, director of clinical rheumatology at Massachusetts General Hospital, Boston, took the stage at the 2018 ACR/ARHP Annual Meeting to present, for the first time, a draft of new classification criteria for IgG4-related disease (IgG4-RD), a project supported by both the ACR and EULAR. Even though it was the last day…
Antiphospholipid Antibody Syndrome: Much Remains to be Learned
CHICAGO—Antiphospholipid antibody syndrome (APS) mainly affects young women, but can also affect men. APS patients test positive for multiple antibodies, including lupus anticoagulant (LAC), anti-cardiolipin and/or anti-beta2-glycoprotein I. These antibodies are diagnostic of APS, and they place the patient at increased risk for thrombosis and, in women, pregnancy morbidity. Women with LAC or those who…
Draft Guidelines & Recommendations for Juvenile Idiopathic Arthritis
CHICAGO—The treatment of patients with juvenile idiopathic arthritis (JIA) is historically directed by clinical subtype. During a session at the 2018 ACR/ARHP Annual Meeting, speakers addressed the biological classification and treatment of JIA, discussing draft guidelines and recommendations, the impact of computer modeling on identifying JIA subtypes and subgroups of chronic arthritis. Guidelines & Recommendations…
GI Disease in Early Systemic Sclerosis Associated with Worse Outcomes
In patients with systemic sclerosis (SSc), gastrointestinal disease may be associated with lower quality of life and increased risk of death. Research showed that SSc patients with severe GI disease had markers of muscle inflammation, skin fibrosis and vasculopathy…
Cancer-Associated Myositis: A Case Report & Review of the Literature
Since it was first reported in 1916, a correlation between inflammatory myopathies and cancer has been noted in several studies. Population studies have confirmed this relationship, and the phrase cancer-associated myopathy has entered the vernacular. Over the past decade, research efforts have shifted toward revealing associations between autoantibodies and clinical phenotypes. One subset of auto-antigens…
Initial Sjögren’s Manifestations Can Go Beyond Dry Eyes & Mouth
Primary Sjögren’s syndrome is a systemic autoimmune condition noted for findings of xerostomia, keratoconjunctivitis sicca and focal lymphocyte infiltrate in salivary glands.1 In the initial publications regarding keratoconjunctivitis sicca, Henrik Sjögren, a Swedish ophthalmologist, described a group of 19 women with dry eyes, some of whom had other organ dryness and inflammatory infiltrates.2,3 The syndrome…
Is Hydroxychloroquine Helpful for Patients with Antiphospholipid Syndrome?
Hydroxychloroquine is not currently used to treat patients with antiphospholipid syndrome (APS). But new research in APS-induced mice shows hydroxychloroquine may improve endothelium-dependent dilation and reduce reactive oxygen species generation…
Identifying Cardiovascular Risk Factors in Psoriatic Arthritis
Psoriatic arthritis (PsA), like other inflammatory diseases, has been associated with increased incidence for and mortality from cardiovascular disease (CVD), the most common comorbidity leading to death in many conditions treated by rheumatologists. But beyond recognizing the burden of increased inflammation, the mechanisms behind this association are not well understood, says M. Elaine Husni, MD,…
Sjögren’s Syndrome: Beyond Dryness
CHICAGO—Diagnostic and treatment tips on Sjögren’s syndrome from the experts at the 2018 ACR/ARHP Annual Meeting.
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