Granulomatosis with polyangiitis (GPA) is a type of anti-neutrophil cytoplasmic antibody (ANCA) associated small vessel vasculitis that typically affects the kidneys, lungs and sinuses.1 Due to an overlap in signs and symptoms, GPA may initially be difficult to distinguish from IgG4-related disease, another condition that can affect multiple tissues and has variable presentations. Further complicating…
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A Primer on Imaging in Myositis
In medicine, as in advertising, pictures can be worth a thousand words. From arthritis to vasculitis, imaging studies have been variably employed to aid in the diagnosis, treatment, risk stratification and prognostication of patients with rheumatic and musculoskeletal disorders. The same holds true with the idiopathic inflammatory myopathies (IIM), in which the clinical utility is…
Case Report: Sweet Syndrome as an Initial Presentation of Crohn’s Disease
Acute febrile neutrophilic dermatosis, or Sweet syndrome, is an inflammatory disease that classically presents with fever, leukocytosis and tender, erythematous plaques characterized by neutrophilic infiltrates on biopsy. Sweet syndrome has been reported in association with several autoimmune diseases, including inflammatory bowel disease, systemic lupus erythematous, rheumatoid arthritis and sarcoidosis.1 Here, we discuss a case of…
Pearls of Wisdom from an Expert: Challenging ILD Cases with a Pulmonologist-Rheumatologist
Erin Wilfong, MD, PhD, shared her niche expertise in connective tissue disease ILD (CTD-ILD) via case-based learning during a session of the 2022 ACR Education Exchange.
Tips from a Cardiothoracic Radiologist: Interstitial Lung Disease & Radiology for the Rheumatologist
Due to its array of radiographic patterns, interstitial lung disease can be challenging to diagnose and treat. Adam Guttentag, MD, a cardiothoracic radiologist, shared tips for ordering and interpreting chest computed tomography.
Scleroderma & ILD: Practical Tips on the Diagnosis & Management of Systemic Sclerosis-Associated Interstitial Lung Disease
No one-size-fits-all approach exists for the care and treatment of patients with systemic sclerosis (SSc) and SSc with pulmonary involvement. Here, experts discuss some best clinical practices for these patients.
Case Report: MPA Hiding in Plain Sight
The COVID-19 pandemic has filled hospitals with patients with rapidly progressive respiratory failure and diffuse bilateral opacities on chest X-ray.1 Additionally, many patients with severe COVID-19 develop acute kidney injury and require dialysis.2 Pulmonary-renal syndromes are also important to consider in this setting. Although alveolar hemorrhage is a cardinal feature of this syndrome, many patients…
Case Report: Pulmonary Sarcoid-Like Reaction in Patient Treated with Etanercept
Sarcoidosis is a multisystem disease characterized by noncaseating granulomas in affected tissues, mostly involving the lungs and lymph nodes.1,2 The etiology of sarcoidosis remains unknown but is thought to be due to an inflammatory response to an antigen exposure in genetically predisposed individuals.1 Tumor necrosis factor-α (TNF‑α), a pro-inflammatory cytokine, plays an essential role in…
In Memoriam: Samuel Strober, MD
Samuel Strober was born on May 8, 1940, in Brooklyn, N.Y., the oldest son of Lee and Julius Strober. Sam attended Public School 92 in Brooklyn and Stuyvesant High School in Manhattan, and graduated from Columbia College, New York, in 1961, and Harvard Medical School, Boston, in 1966. While in high school, Sam won a…
Case Report: A Polyarteritis Nodosa Conundrum
Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis that typically affects medium-sized muscular arteries. The clinical subsets of PAN are idiopathic, generalized, secondary hepatitis B virus (HBV) associated and cutaneous PAN. These clinical subsets are important because of their therapeutic implications. Virtually any organ system can be affected in generalized PAN, but this vasculitis tends…
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