Case Presentation A 45-year-old man with crystal-proven gout, poorly controlled diabetes and chronic kidney disease was lost to follow-up for six years and presented back to the VA clinic in the midst of a gout flare. He stated he had continued taking 100 mg of allopurinol daily, but his serum urate level was 13.8 mg/dL….
Search results for: inflammatory bowel disease
Eosinophilic Gastroenteritis & Eosinophilic Ascites Associated with RA
Eosinophilic gastroenteritis (EGE) is a rare condition caused by eosinophilic infiltration of the gastrointestinal (GI) tract. The condition is subdivided into the GI layers it affects: mucosal, muscular and subserosal.1 EGE usually presents with non-specific GI symptoms, such as impaired motility, intestinal obstruction and, rarely, ascites.2 Below, we report a rare case of EGE leading…
Case Report: Sjögren’s Syndrome Plus Neuromyelitis Optica Spectrum Disorder
Sjögren’s syndrome is a chronic multi-system autoimmune disease characterized by inflammation and subsequent destruction of exocrine glands. Sjögren’s syndrome can present with glandular or extra-glandular manifestations. Neuromyelitis optica spectrum disorder (NMOSD) is a rare central nervous system (CNS) autoimmune disease that can present as the initial manifestation in less than 5% of patients with Sjögren’s….
Links Between Gut Bacteria and Rheumatoid Arthritis
CHICAGO—At the 2018 ACR/ARHP Annual Meeting, Allen C. Steere, MD, delivered the Rheumatology Research Foundation Memorial Lecture honoring the late Charles M. Plotz, MD: Linking Gut Microbial Immunity with Autoimmunity in Joints in Patients with Rheumatoid Arthritis. Dr. Steere is professor of medicine at Harvard Medical School, Boston, and director of translational research in rheumatology…
Calcineurin Inhibitor Pain Syndrome: A Case Report & Literature Review
CHICAGO—Medications have frequently been implicated as a cause of musculoskeletal complaints, including persistent arthralgias, arthritis and myalgias.1 The list of offending agents is diverse, and the degree of symptoms is variable. In the world of transplant recipients, this list is exhaustive and includes immunosuppressive agents (cyclosporine, tacrolimus); myeloid growth factors, such as G-CSF; antibiotics (quinolones);…
Case Report: The Hairdresser Who Couldn’t Comb Her Hair
Polymyalgia rheumatica (PMR) is an inflammatory rheumatic condition characterized by pain and morning stiffness at the neck, shoulders and hip girdle. It can be associated with giant cell arteritis (GCA); in fact, the two disorders may represent a continuum of the same disease process. This case describes a patient who initially refused treatment for PMR…
Case Report: Ehlers-Danlos Syndrome Mimicking Vasculitis
A 43-year-old man with a past medical history of type 2 diabetes mellitus, bilateral inguinal hernia repair as a child and prior cholecystectomy woke from sleep with sudden-onset periumbilical abdominal pain. He was admitted to another hospital, but required transfer to our surgical intensive care unit after a recurrent episode of severe abdominal pain, during…
Looking for Links Between Rheumatoid Arthritis & Gut Bacteria, Mutations
Patients with a specific genetic predisposition for rheumatoid arthritis (RA) may want to take precautions when consuming certain types of meat, dairy and produce grown with cow manure, according to a new study out of the University of Central Florida (UCF) in Orlando. The study, which assessed 100 RA patients, published in the journal Frontiers…
Prescribing Hope: The Placebo Effect Endures
“Wait. I can explain.” One could imagine this phrase coming up under many conditions in daily life. When I first became a physician, however, I would never have expected to use this phrase in my clinic. In medical school, I was taught the importance of dialogue in establishing a relationship with a patient. Statistics indicate…
Kussmaul, Meier & Polyarteritis Nodosa
In 1866, Adolf Kussmaul, an internist, and Rudolf Maier, a pathologist, published the classic characterization of what eventually became known as polyarteritis nodosa.1 It was the first scientific clinical characterization of a noninfectious vasculitis. As such, it became a paradigmatic point of contrast to other types of vasculitides that were later described. Their description also…
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