CHICAGO—Is erosive, inflammatory osteoarthritis (EOA) a separate condition from osteoarthritis (OA)? Roberta Ramonda, MD, PhD, a rheumatologist at the University of Padova, Italy, spoke at the 2018 ACR/ARHP Annual Meeting on the clinical presentation of EOA and how it differs from OA. EOA is characterized by a frequent aggressive clinical course and occurs most often…
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The ACR Has Introduced a New Reproductive Health Guideline Draft
CHICAGO—Reproductive health can be a concern for patients with rheumatic diseases, and practitioners in both disciplines often work closely together. The Reproductive Health in Rheumatic and Musculoskeletal Diseases Guideline, a draft of new clinical recommendations developed by an ACR-convened group for pregnant women, post-menopausal women, lactating women, and women and men trying to conceive or…
Pediatric Rheumatologist Dr. Lynn Punaro Loves a Good Mystery
When Marilynn “Lynn” Punaro, MD, MACR, isn’t working with medical students, seeing patients in the clinic, participating in translational research or performing leadership duties, she’s enjoying a good book—especially a good mystery. This shouldn’t be a surprise. It was mystery that led Dr. Punaro to a career in pediatric rheumatology more than 30 years ago,…
Canakinumab Treatment Effective for Familial Mediterranean Fever
Canakinumab may be a useful first-line treatment for renal transplant recipients with familial Mediterranean fever (FMF), according to recent research. Immunosuppressive drugs can interact with colchicine, the standard first-line treatment for FMF, and increase the incidence of side effects, such as diarrhea and myopathy…
The Latest Autoinflammatory Discoveries & Tips
SAN DIEGO—Since the identification of the autoinflammatory disease, familial Mediterranean fever (FMF), researchers have identified an alphabet soup of other autoinflammatory diseases with genetic underpinnings, from PAPA (pyogenic arthritis with pyoderma gangrenosum and acne) to NIAID (NLRP1-associated autoinflammation with arthritis and dyskeratosis) to TRAPS (TNF receptor-associated periodic syndrome). The torrent of discoveries, brought about largely…
How to Recognize, Diagnose Periodic Fever Syndromes in Adults
A number of autoinflammatory syndromes that result from genetic mutations have been described recently. The vast majority occur in children. However, three periodic fever syndromes are important for rheumatologists who treat adults to know about. The goal of this review is to provide a concise description of each condition, and to help the clinician understand…
Rheumatology Case Report: Monoarticular Arthritis in Pregnancy
Limited data exist on the clinical presentation of Muckle–Wells syndrome (MWS) during pregnancy. The purpose of this case report is to highlight the diagnosis of MWS in a pregnant woman. Many rheumatic diseases affect women of childbearing age, and their management during pregnancy can be challenging. Case A 33-year-old, 18-weeks’ pregnant woman was hospitalized for…
Fellows’ Forum Case Report: Hemophagocytic Lymphohistiocytosis
The patient was a 48-year-old woman who saw her primary care physician for a flu-like illness three months prior to admission. Her symptoms initially improved, but recurred one month later; she was treated symptomatically, and again symptoms resolved. Two months later, she presented to an outside facility’s emergency department with fever to 103ºF, with associated…
Diagnosis of Acute Gouty Arthritis Obscured by Anchoring Bias
A 56-year-old African American man presents to the emergency department with polyarthralgias and a fever of 103ºF. One month prior to admission, he presented with right knee pain and swelling. Blood cultures grew S. epidermidis. He was treated for presumed septic arthritis complicated by MSSE bacteremia. He was treated with meropenem and a prolonged course…
Anti-Interleukin-6 Therapy for Erdheim-Chester Disease Warrants Study
Erdheim-Chester disease (ECD) is a rare, non-Langerhan’s cell histiocytosis characterized by tissue infiltration of CD68-positive and CD1a-negative foamy histiocytes.1 ECD was discovered as a lipid granulomatosis in 1930 by Jakob Erdheim and his pupil, William Chester, and approximately 500 cases have been described to date.1 ECD has a heterogeneous course and prognosis ranging from an…
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