Which came first? The infectious microorganism or a host’s immune resistance against it? Through the millennia, a raging battle has pitted the hordes of infectious agents surrounding us against, arguably, the most complex biologic structure ever created, the finely tuned human immune system. The stakes are high for both sides. For the infectious agent, an…
Search results for: giant cell arteritis
New Large-Vessel Vasculitis Therapies Emerge, but Better Options Still Needed
LONDON—New therapies are emerging for the two main forms of large-vessel vasculitis, giant cell arteritis (GCA) and Takayasu’s arteritis—particularly biologic therapies. But for just about every available treatment gap, drawbacks or limited evidence remain, with the results needing to be borne out in larger trials, an expert said at the Annual Congress of the European…
Roche Gets Boost from FDA in Bid to Expand Uses for Actemra
ZURICH (Reuters)—The U.S. Food and Drug Administration has granted breakthrough status to Roche’s rheumatoid arthritis medication Actemra (tocilizumab) for giant cell arteritis, the Swiss drugmaker said, a step which could help it broaden applications for the medicine. Giant cell arteritis is a chronic, potentially life-threatening autoimmune condition caused by inflammation of large and medium-sized arteries,…
Corticosteroid Use in Acute Polymyalgia Rheumatica Should be Reassessed
When I started my rheumatology practice 40 years ago, it quickly became apparent that many referrals of presumed polymyalgia rheumatica (PMR) patients and presumed giant cell arteritis (GCA) patients were the recipients of devastating side effects from long-term corticosteroid (CS) use that could not be discontinued due to prompt recurrence of inflammatory phenomena. It was…
Heterogeneity of Vasculitis Challenges Rheumatologists
SAN FRANCISCO—The heterogeneity of systemic vasculitis, a set of diseases characterized by inflammation of blood vessel walls, presents rheumatologists with diagnostic and treatment challenges, said Sharon A. Chung, MD, MAS, director of the University of California, San Francisco Vasculitis Clinic, at the California Rheumatology Alliance 2016 Scientific & Medical Meeting in May. She outlined emerging…
Diagnosis Can Be Elusive for Fever of Unknown Origin
Settling into room 501 at Maine Medical Center, Mrs. N was on her way to the bathroom when she felt it coming on. One moment she was okay; the next, her chest felt damp and cold, even as her face flushed and her temperature spiked. Her forehead glistened beads of warm sweat. She felt the…
How to Manage Polymyalgia Rheumatica
Recognizing the need to provide guidance on the current disparate management of polymyalgia rheumatica (PMR), the American College of Rheumatology (ACR), in collaboration with the European League Against Rheumatism (EULAR), recently published the first international set of recommendations for the screening, treatment and management of PMR.1,2 Specifically, the recommendations offer guidance on the use of…
Rheumatology Research Foundation Scholarships Help Students Attend ACR/ARHP Annual Meeting
Seven students pursuing rheumatology-related careers will head to San Francisco in November on a Student and Resident ACR/ARHP Annual Meeting Scholarship—awards that are open to students and residents from states that are underserved by rheumatology professionals. The Rheumatology Research Foundation has awarded the students $750–1,500 toward travel expenses and registration for the ACR/ARHP Annual Meeting,…
When Sense Disorders Signal Immune System Interactions
I sometimes find myself mired in sticky clinical circumstances. I am facing a distraught patient who is seeking my opinion about a condition that, according to some, may not truly belong in the rheumatologist’s bailiwick. Case example: hearing loss. The Steroid Test Sudden sensorineural hearing loss (SSNHL) and its relative, autoimmune inner ear disease (AIED),…
Case Report: Interstitial Lung Disease with Positive ANCA Test
“Worst of all is the pain in my calves,” she said. “It feels like burning deep inside.” So began my first encounter with a 69-year-old woman who was referred to rheumatology clinic for evaluation of two months of constitutional symptoms and a positive ANCA test, which had been ordered by her primary care doctor. Her…
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