A 24-year-old woman presented to our rheumatology office in 2017 with a blotchy purple rash on her arms and legs. She reported no history of miscarriage or blood clots. The rash pattern was concerning for livedo reticularis or livedo racemosa, and she was noted to have an anti-nuclear antibody (ANA) titer of 1:160 with a…
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Case Report: Evans Syndrome in Lupus
Rheumatologists are in the unique position of diagnosing and treating rare auto-inflammatory and autoimmune diseases. Although systemic lupus erythematosus (SLE) often has textbook presentations, it is a heterogeneous condition with a wide variety of disease manifestations. In 2019, the European League Against Rheumatism and the ACR introduced new classification criteria to help diagnose this condition.1…
VEXAS: A Newly Identified & Vexing Myeloid-Driven Inflammation
A large, international team of rheumatologists, geneticists, hematologists and other researchers has discovered a severe inflammatory syndrome linked to an acquired genetic mutation in the bone marrow of older men. The X-linked syndrome, they found, is caused by a somatic mutation in myeloid stem cells that hobbles the master regulator of a pathway tasked with…
Support Pediatric Subspecialty Loan Repayment to Boost Workforce Growth
Current legislation that stipulates a loan repayment program for pediatric subspecialists could help the pediatric rheumatology community attract trainees and meet patient demand.
Case Report: Does a Rapid-Onset Neck Mass Have Rheumatic Origins?
A 54-year-old African American man arrived at the emergency department with the acute onset of a tender mass on the left side of his neck. It had been getting progressively larger for the preceding two days. History & Examination His history included chronic right hip osteoarthritis with two surgeries performed five years prior. At his…
Case Report: An Adult-Onset Still’s Disease Mimic
A 53-year-old man was hospitalized for pericarditis, abdominal lymphadenopathy of unknown origin and non-bloody diarrhea. He was admitted for four days, and then he was discharged home without incident. Two months after his initial presentation, he was readmitted for the evaluation of several new issues, including symmetric arthralgias, hypovolemia with associated electrolyte abnormalities and concurrent…
The Case of a 13-Year-Old Girl with Life-Threatening Lupus Onset
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…
Updates on Managing Lupus Complications
SAN DIEGO—To manage patients with systemic lupus erythematous (SLE), rheumatologists must be aware of potentially serious complications affecting many organ systems. On Nov. 7 at the 2017 ACR/ARHP Annual Meeting, two experts offered insights on cardiovascular and hematological complications of lupus. Myocardial Disease in Lupus Lupus patients are at increased risk for heart-related complications, especially…
Diagnostic Challenges of SLE & Celiac Sprue
Systemic lupus erythematosus (SLE) can present in many ways and can be difficult to diagnose. Its association with celiac sprue has been only rarely documented, but has appeared in several case reports. When presenting together, it can be difficult to distinguish the underlying disease, because SLE itself has been known to cause malabsorption. This case…
Rich Furie, MD: Rheumatologist, Researcher, Sailor & Aquarium Enthusiast
Rich Furie, MD, chief of rheumatology at Northwell Health in Long Island, N.Y., loves the ocean. At age 16, Dr. Furie inherited a summer sailing business started by his two older brothers, which Dr. Furie kept profitable for nine years. The young entrepreneurs named their fledgling company Furie Sailing, which offered sailing lessons and sailboat rentals. The…