Pulmonary nodules are common; most are benign, but the differential diagnosis is broad and includes life-threatening possibilities.1 Our patient is a former smoker who has a history of a complex autoimmune disease and multiple pulmonary nodules. This case was challenging, but clinical, radiographic and histologic clues helped lead to the correct diagnosis. Case Presentation The…
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Case Report: Atypical Presentation of Idiopathic Retroperitoneal Fibrosis
Retroperitoneal fibrosis (RPF) is a rare condition characterized by aberrant fibroinflammatory tissue developing in the retroperitoneum. This disorder was initially called Ormond’s disease. RPF may be idiopathic or secondary to other conditions. Idiopathic RPF is a part of the disease spectrum of chronic periaortitis due to its typical periaortoiliac localization. Idiopathic retroperitoneal fibrosis is a…
How to Avoid Cognitive Errors in Rheumatology
The 1999 Institute of Medicine report To Err Is Human gave a sobering depiction of the magnitude and consequences of medical error.1 The report concluded that approximately 98,000 people die in hospitals annually due to preventable medical errors. Of all the errors detailed in this report, diagnostic errors have since been determined to be the…
Order in the Inflammatory Mess: RheumMadness 2022 Cytokine Networks Scouting Report
Research has identified and described a pro-inflammatory cytokine network shared by four rheumatic conditions that may be particularly active in patients with severe disease.
Study: Pegloticase & Methotrexate Co-Treatment Helps Uncontrolled Gout
A larger proportion of patients with gout had a therapeutic response at six months when treated with methotrexate and pegloticase than with pegloticase alone, according to results from the multi-center, open-label MIRROR (methotrexate to increase response rates in patients with uncontrolled gout receiving KRYSTEXXA) study, recently published in the Journal of Rheumatology.1 The MIRROR study…
Case Report: GPA Presenting as Neuropathy
Granulomatosis with polyangiitis (GPA), is a type of anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV) that affects small- to medium-sized vessels.1 It can occur equally in both men and women, with a reported mean age at onset of 55 years.2 The classical presentation of GPA includes upper respiratory tract (i.e., chronic sinusitis, serous otitis and…
Therapeutics for COVID-19: An update from ACR Convergence 2021
ACR CONVERGENCE 2021—Rheumatology patients who test positive for COVID-19 would benefit from early use of monoclonal antibodies, said Luis Ostrosky-Zeichner, MD, chief of the Division of Infectious Diseases, McGovern Medical School, University of Texas Health Science Center (UTHealth), Houston, in a session about effective treatment options for COVID-19. Acknowledging that the SARS-CoV-2 virus has already…
Tackling Multicomplexity in Aging Patients with RA
Two sessions at ACR Convergence 2021 addressed a holistic approach to taking care of older patients with RA & other rheumatic diseases.
FDA Approves Avacopan for the Treatment of ANCA-Associated Vasculitis
On Oct. 8, ChemoCentryx Inc. announced that the U.S. Food & Drug Administration (FDA) has approved avacopan (TAVNEOS), an orally administered selective complement 5a receptor inhibitor, as an adjunctive treatment of adult patients with severe active anti-neutrophil cytoplasmic autoantibody-associated vasculitis (ANCA-associated vasculitis), specifically granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA) (the two main forms…
Vasculitis Guidelines in Focus, Part 3: EGPA
In this third article in the series, we talk with Philip Seo, MD, MHS, about eosinophilic granulomatosis with polyangiitis (EGPA).
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