Anemia is common in patients with systemic rheumatic disease, yet it may not get the attention it deserves. Anemia can result from chronic inflammation, treatment side effects or other disease factors, or it may signal an unrelated condition. Although diagnosis and treatment of anemia are sometimes challenging, clinicians must do their utmost to rigorously investigate…
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Doctors Who Take Pharmaceutical Money Use Twitter to Hype Drugs
(Reuters Health)—Some cancer doctors use Twitter to promote drugs manufactured by companies that pay them, but they almost never disclose their conflicts of interest on the social media platform, a new study shows. “This is a big problem,” says senior author Dr. Vinay Prasad, a professor at Oregon Health and Science University in Portland. “Doctors…
Rheumatology Case Report: Deep Vein Thrombosis Detected by Point-of-Care Ultrasound
Case A 46-year-old Caucasian female presented to the outpatient rheumatology clinic where she had been followed for several years. Her chief complaint was pain in her right knee, posterior right thigh and right hip that had begun gradually over the previous three weeks. Her past medical history was significant for rheumatoid arthritis (RA), obesity and…
Fellow’s Forum Case Report: Waldenström Macroglobulinemia
A 73-year-old white male presented with a one-day history of a cold, painful, right foot. The foot had a blue discoloration to it, particularly the toes. The emergency physician suspected an atheroembolic cause, given this patient’s age and history of coronary artery disease. However, the patient also reported a one-year history of painful pallor in…
New Criteria Released for Macrophage Activation Syndrome in Juvenile Idiopathic Arthritis
Although most systemic juvenile idiopathic arthritis patients don’t develop macrophage activation syndrome (MAS), the approximately 10% who do have this serious complication can experience widespread, massive inflammation, debilitating symptoms and even death. To improve understanding of MAS among physicians and advance efforts to develop effective therapies to treat it, a panel of 28 international pediatric…
How to Choose the Best Course of Treatment to Manage Rheumatoid Arthritis
Diagnosing rheumatoid arthritis (RA) early in the disease process is ideal, because treatments are more likely to be effective and less damage will occur. Guidelines from the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR) state that using newer biologic medications, in addition to more aggressive dosing of traditional medications, is…
Sjögrens Syndrome: The Need to Bridge Patient Symptoms & Objective Findings
Despite a generation of advances in molecular biology, a huge gap exists between the Sjögren’s syndrome (SS) patient’s description of their symptoms and the objective findings. Current issues include: Many SS patients are misclassified as either rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE), even within rheumatology clinics. Frequently, the sickest SS patients with extraglandular…
Expert Q&A: Dr. Michael Lockshin on APS
Michael Lockshin, MD, reminds medical professionals that patients suffering from antiphospholipid syndrome (APS) don’t respond to medications in the same way as patients with other clotting-related diseases. Insufficient evidence exists to determine whether the new wave of anticoagulant medications is safe for use in patients with APS…
Maintaining Board Certification Has High Hidden Cost
NEW YORK (Reuters Health)—The American Board of Internal Medicine (ABIM) maintenance-of-certification (MOC) program could cost $5.7 billion in physicians’ time and fees over the next decade, according to a new model study. “We estimate that physicians will spend 33 million hours over 10 years to fulfill MOC requirements,” Dr. Dhruv S. Kazi from the University…
John F. Kennedy’s Odyssey in Search of Diagnosis
Myriad health conditions from back pain to gastrointestinal illness plagued the late president and baffled his physicians