A recent case study revealed that an infant from a donor egg developed neonatal lupus erythematosus (NLE) and a congenital heart block, which may have been due to the presence of antibodies to Ro and La in the birth mother—not the genetic mother. The results suggest that a gestational mother with a history of autoimmune disease is sufficient to trigger the pathology of NLE…
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Patients with Lupus: Plasmacytoid Dendritic Cells Fail to Induce Regulatory B Cells
A recent study found that plasmacytoid dentricitic cells (pDCs) control the differentiation of immature B cells into regulatory B (Breg) cells or plasmablast, depending on the concentration of IFNα. For patients with SLE, researchers found that immune regulatory feedback between pDCs and Breg cells is dysfunctional, with the exception of patients who respond to rituximab…
2015 ACR/ARHP Annual Meeting: Treatments for Transthyretin-Related Amyloidosis Generate Interest from Researchers, Pharmaceuticals
SAN FRANCISCO—Treatment for transthyretin-related amyloidosis (ATTR) is generating more interest from academic researchers and the pharmaceutical industry, with encouraging early results using a multi-pronged therapeutic approach, a researcher said at a review course held before the 2015 ACR/ARHP Annual Meeting. Amyloidoses are a rare and potentially deadly family of diseases in which misfolded protein builds…
Rheumatic Disease Manifestations in the Central Nervous System
SAN FRANCISCO—Let’s say your radiologist comes to you and says that an angiogram gives a diagnosis of CNS vasculitis on four patients, all with acute onset of headache and stroke: One is a 25-year-old woman who is three months pregnant. Another is a 50-year-old man using excessive doses of nasal decongestants. Another is a 40-year-old…
A Healthy Skepticism: Researchers Evaluate CNS Manifestations of Rheumatic Disease
SAN FRANCISCO—Let’s say your radiologist comes to you and says that an angiogram gives a diagnosis of CNS vasculitis on four patients, all with acute onset of headache and stroke: One is a 25-year-old woman who is three months pregnant. Another is a 50-year-old man using excessive doses of nasal decongestants. Another is a 40-year-old…
Growth Hormone Reduces Fractures in Women with Osteoporosis
NEW YORK (Reuters Health)—Growth hormone is associated with a decrease in fractures in women with postmenopausal osteoporosis even a decade after treatment ceases, researchers from Sweden report. “We were surprised and pleased to find that the patients had a reduced risk of fracture so many years after the growth hormone treatment was ceased,” Dr. Emily…
Rheumatologist Blends Mixology Hobby with Medical Career
It takes adjustment and patience. That sounds like rheumatology. But for Fred Murphy, DO, FACP, FACR, it also defines his other career—drink inventor. From a drink for the whole family to another he claims helps hangovers, creating beverages is a challenge he relishes. “It’s fun to see what I can come up with next,” he…
Catastrophic Antiphospholipid Syndrome with Pulmonary Hemorrhage: A Case Report
Antiphospholipid syndrome (APS) is an autoimmune condition characterized by hypercoagulability often manifested as recurrent thrombosis or pregnancy complications, with persistently circulating antiphospholipid (aPL) antibodies or lupus anticoagulant. Catastrophic APS (CAPS), also known as Asherson syndrome, occurs in less than 1% of cases of APS and involves occlusive microangiopathy in at least three organ systems.1 Case…
Eosinophilia: A Diagnostic Evaluation Guide for Rheumatologists
Clinical Vignette A 45-year-old woman with long-standing asthma and chronic sinusitis has new-onset peripheral neuropathy, arthralgias, fatigue, progressive dyspnea and a nonproductive cough. She has never smoked and has no environmental exposures. Her medications include an albuterol metered-dose inhaler (which she uses daily); an inhaled corticosteroid, montelukast; and ibuprofen (which she takes occasionally). She is…
How Celebrities, Senators, Dietary Supplements Muddle Medicine
It’s disheartening to stand by and watch helplessly as your patient dies a slow, painful death. In spring 1990, I had the misfortune of living through such a distressing experience. Strange happenings in New Mexico & Japan Ellen was a bookkeeper in her late 40s, living quietly in suburban Boston. For years, she hid a…
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