SAN FRANCISCO—An athletic 19-year-old male has an episode of rhabdomyolysis, a breakdown of muscle tissue that leads to contents of muscle fiber in the blood, after weight-lifting and basketball drills. But his labs come back normal. He cuts down on his exercise, but has a second episode four months later, then finally sees a rheumatologist…
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2015 ACR/ARHP Annual Meeting: Latest Clinical Literature Offers New Strategies in Lupus Nephritis
SAN FRANCISCO—Rheumatologists have to look no further than the American College of Rheumatology guidelines to know that the options for patients with lupus nephritis are sometimes not very appealing. The first-line choices are either mycophenolate mofetil (MMF) plus glucocorticoids or cyclophosphamide (CYC), also with glucocorticoids—and all of their attendant side effects. The problem: evidence, said…
2015 ACR/ARHP Annual Meeting: Skin Issues in Rheumatic Diseases Present Challenges
SAN FRANCISCO—A 40-year-old woman shows up in the clinic with scarring alopecia, with an area of hyperpigmentation on the rim of her scalp, extending from just behind the temple to behind her ears. An examination with a dermatoscope shows hyperkeratotic follicular plugging. The case—in this example, the discoid form of cutaneous lupus erythematosus (DLE)—is one…
2015 ACR/ARHP Annual Meeting: Research Lends Insight Into Osteoporosis Treatment, New Auto-Inflammatory Disease, Scleroderma
SAN FRANCISCO—Post-menopausal women with osteoporosis, previously treated with oral bisphosphonates, had greater increases in bone density when taking denosumab compared with zoledronic acid over a year’s time, according to a study presented at the 2015 ACR/ARHP Annual Meeting. The findings were discussed in the Discovery 2015 plenary session, which focused on new research. In the…
Dermatology & Immunology: Skin Issues Can Present Challenges
SAN FRANCISCO—A 40-year-old woman shows up in the clinic with scarring alopecia, with an area of hyperpigmentation on the rim of her scalp, extending from just behind the temple to behind her ears. An examination with a dermatoscope shows hyperkeratotic follicular plugging. The case—in this example, the discoid form of cutaneous lupus erythematosus (DLE)—is one…
2015 ACR/ARHP Annual Meeting: Stroke Risk Elevated after Herpes Zoster Infection Among Patients with Autoimmune Disease
SAN FRANCISCO—The risk of stroke after herpes zoster (HZ) infection is elevated in the period immediately after infection in patients with autoimmune diseases, according to a study presented at the 2015 ACR/ARHP Annual Meeting.1 The findings were presented in a scientific session, called Discover 2015, that highlighted new research. In another study from the session,…
2015 ACR/ARHP Annual Meeting: How Gender Differences Affect Pain
SAN FRANCISCO—Men and women have different mechanisms that are at work in producing pain in rheumatic diseases—a little-studied and little-appreciated fact that is crucial to developing and using the right kinds of treatments, an expert in rheumatic disease pain said in a talk at the 2015 ACR/ARHP Annual Meeting. The lack of acknowledgment of this…
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…
2015 ACR/ARHP Annual Meeting: Behçet’s Disease Poses Diagnosis, Treatment Challenges
SAN FRANCISCO—Behçet’s disease is a vasculitis that can be hard to pin down, with a wide variety of manifestations, many of which overlap with other auto-inflammatory conditions, an expert said at a clinical review course at the 2015 ACR/ARHP Annual Meeting. The most common feature is oral ulcers, which are expected to be seen at…
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…
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