CHICAGO—Doruk Erkan, MD, MPH, a rheumatologist at the Hospital for Special Surgery and Weill Cornell Medicine in New York City, described recent developments in the field of antiphospholipid syndrome (APS) to the rheumatologists gathered for the ACR’s State-of-the-Art Clinical Symposium in April. He introduced APS as a “field with limited data and lots of controversies,” although,…
Amyloidosis Is Often Underdiagnosed, Undertreated
CHICAGO—Caryn A. Libbey, MD, clinical associate professor of medicine at Boston University School of Medicine, described the evolving in our understanding of amyloid at the ACR’s State-of-the-Art Clinical Symposium in April. Amyloidosis is a rare disease that is often underdiagnosed and undertreated. “Even though this disease has been around for 150 years, I still consider it…
A Stiff Man: A Case Study in Ankylosing Spondylitis
First Appearances I watched the old man, his back painfully bent, shuffle toward the scale. A blocky rigidity draped over him. His feet seemed stuck to the floor. His head hung heavily over his chest. Observing him from the end of the hallway, instead of a face, I saw only a mound of shaggy, matted…
Clinical Guidelines for Sjögren’s Syndrome Focus on Biologics, Fatigue, Inflammatory Musculoskeletal Pain
The first clinical practice guidelines for Sjögren’s syndrome have been released, the culmination of an initiative by the Sjögren’s Syndrome Foundation.1 These standard-of-care recommendations are intended to provide consistency in practice patterns, inform coverage and reimbursement policies, lead to the design and implementation of educational programs, highlight the needs for future research and fill a…
Somatic Mosaicism Can Complicate Diagnosis of Autoimmune Disease
New methods of gene sequencing have resulted in improved identification of mutations in patients and increased availability of genetic testing in rare diseases. Despite these exciting advances, a majority of patients lack identifiable mutations and the underlying disease etiology remains an enigma. Somatic mosaicism (SM) may be an explanation for some of these clinically challenging…
Rheumatologist Dr. Sandra Pagnussat Recalls Journey from Patient to Physician
When she was in elementary school, Sandra Pagnussat, MD, began experiencing unrelenting pain and stiffness, first in her pinky and then in her other fingers. Her pediatrician diagnosed her with polyarticular juvenile idiopathic arthritis (JIA). In high school, Sandra decided to pursue a career in medicine and began taking advanced placement classes in biology and chemistry….
Psoriasis May Itch as Intensely as Atopic Dermatitis
NEW YORK (Reuters Health)—Itch intensity in moderate to severe plaque psoriasis can be substantial, and may be on a par with the notoriously itchy skin condition atopic dermatitis, new research suggests. “Both conventional wisdom and some of our classic dermatologic textbooks have stated that psoriasis is not particularly itchy,” corresponding author Dr. Alexa B. Kimball…
Innate Immune Response Predicts Development of Non-Hodgkin’s Lymphoma in Sjögren’s Syndrome
The P2X7 receptor inflammasome axis may have a role in the pathogenesis of Sjögren’s syndrome and non-Hodgkin’s lymphoma. According to new research, patients with Sjögren’s syndrome who developed non-Hodgkin’s lymphoma had an increased expression of the P2X7R-inflammasome axis and the glandular expression of IL-18, suggesting a possible novel biomarker…
IBD Treatments Don’t Seem to Raise Extracolonic Cancer Risk
NEW YORK (Reuters Health)—Immunosuppressants and anti-TNF drugs do not appear to increase the risk of extracolonic cancers in patients with inflammatory bowel disease (IBD), researchers from Spain report. IBD patients face an increased risk of colon cancer, and some studies have suggested there might be an increased risk of extracolonic cancer. Dr. Maria Chaparro from…
Optical Workings: Specialists Must Communicate to Treat Eye Disease
In an age of new medications for eye disease, rheumatologists and ophthalmologists must work together and communicate, says James Rosenbaum, MD. Teamwork and understanding how each specialty approaches the physical exam will aid patient care…
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