I glanced up from Amanda Wolf’s chart as the emergency department nurse, followed by the lab technician (tech), followed by the electrocardiogram (ECG) tech flowed into cubicle No. 5. John Benner, MD, pulled up a chair to review the case with me at the nursing station. “Here’s what we’ve got. Thirteen-year-old girl with a one-week…
Search results for: Pregnancy
TNFi Exposure in Utero
Vinet et al. evaluated the risk of serious infections in children of women with RA exposed to TNFi’s in the gestational period compared with unexposed offspring of women with RA, as well as with children from the general population. Although the research did not demonstrate a marked excess risk for serious infections, the authors could not exclude a differential risk according to specific TNFi, with infliximab potentially resulting in a threefold increase in the risk of serious infections compared with other TNFi’s. More studies are needed…
Case Report: A Psoriatic Arthritis Patient with Dactylitis & Enthesitis
A 36-year-old woman presented at the Johns Hopkins Arthritis Center for a second opinion regarding a diagnosis of psoriatic arthritis (PsA). One year prior to our evaluation, she had developed pain and stiffness in her hands, feet, knees, ankles, elbows and shoulders. She had mild plaque psoriasis of the scalp and base of the neck,…
The 2018 ACR/ARHP Annual Meeting Program Preview
Save the date for the 2018 ACR/ARHP Annual Meeting, Oct. 19–24 in Chicago. Connect with your colleagues for an unmatched educational experience featuring exceptional sessions by leading rheumatology experts. The ACR/ARHP Annual Meeting is your gateway to global rheumatology education. With more than 450 sessions—including The Great Debate—the meeting provides boundless opportunities for professional development,…
The Classification & Diagnosis of Granulomatosis with Polyangiitis
Based on the classification system developed by the Chapel Hill Consensus Conference, anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis is defined as a necrotizing vasculitis involving small vessels that is associated with myeloperoxidase (MPO) ANCA or proteinase 3 (PR3) ANCA and displays minimal immune deposits. The mechanism behind the pathogenesis of ANCA-associated vasculitis is not fully…
Antiphospholipid Syndrome: The Risk of Travel at High Altitudes
Antiphospholipid syndrome (APS) is an autoimmune clotting disorder that may present catastrophically with multiple thromboses over a short period of time. In this article, we examine the case of a woman with undiagnosed APS whose first symptoms presented during a long-haul flight. A review of the literature on thrombosis at high altitudes and during long…
When & How to Talk to Your Patients About Their Gender & Sex
How do you ask a new patient about sex and gender—or know which pronoun to use? Keep the conversation straightforward and respectful to put everyone at ease, says Morgan Orndorff, a transgender man who works as an administrator at a major academic medical center. “Everyone is a little different in terms of their sensitivity level”…
Prenatal TNF Inhibitor Exposure Not Linked to Serious Infections
NEW YORK (Reuters Health)—Children of women with rheumatoid arthritis (RA) who are exposed to tumor necrosis factor-alpha inhibitors (TNFis) in the womb are not at markedly increased risk of serious infections, new findings suggest. “It’s reassuring for mothers who need to take these medications during pregnancy,” Evelyne Vinet, MD, of McGill University Health Center in…
Improved Family Planning Counseling Needed
In the U.S. today, approximately 45% of pregnancies are unintended or unplanned.1 Although this rate is considerably lower than in the past, women with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) or inflammatory myopathies tend to have better pregnancy outcomes if their disease is well controlled when they conceive. In addition, women taking certain medications…
Using Ultrasound to Diagnose Carpal Tunnel Syndrome
Note: Updated May 2, 2018, to correct a link in the reference section. The error was introduced in editing. A 44-year-old Caucasian woman presented to the outpatient rheumatology clinic that had followed her for several years for rheumatoid arthritis. She was compliant with her regimen of hydroxychloroquine, etanercept and salsalate. Her chief complaint was worsening…
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