Vasculitis is a group of chronic inflammatory diseases in which the blood vessel is the target of an immune reaction. They can be secondary to connective tissue disease, idiopathic or due to infection, neoplasm or drugs.1 Primary angiitis of the central nervous system (PACNS) is a rare syndrome characterized by inflammatory cell infiltration and necrosis…
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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…
Celiac Awareness Makes a Difference for Rheumatology Patients
Celiac disease and gluten sensitivity are difficult to diagnose, but they affect multiple systems and are associated with other autoimmune diseases. Lan Chen, MD, PhD, believes better testing and clearer education will be a gamechanger for celiac patients…
Bone Mineral Density Most Important Determinant of Fracture Risk
NEW YORK (Reuters Health)—In what is believed to be the largest study investigating genetic and clinical determinants of osteoporotic fracture risk, only a genetic predisposition to low bone mineral density (BMD) had a potential causal role to play. “Notably, genetic predisposition to lower levels of vitamin D and estimated calcium intake from dairy sources were…
Dietary Recommendations for Psoriasis Patients
The National Psoriasis Foundation says weight loss and other dietary interventions may benefit psoriasis patients. New recommendations note the benefits of a gluten-free diet for patients who test positive for gluten sensitivity, but also found little evidence to support the use of fish oil supplements for psoriasis patients…
Improve Your Recognition & Treatment of Osteoporosis
BALTIMORE—Rheumatologists may not think about osteoporosis on a daily basis, but they should, said Dr. Karl Insogna, the Ensign Professor of Medicine at Yale University School of Medicine and director of the Yale Bone Center in New Haven, Conn., in his recent lecture at the Maryland Society for the Rheumatic Diseases. With approximately 75 million…
Little Evidence to Support Most Dietary Interventions for Psoriasis
NEW YORK (Reuters Health)—New recommendations from the National Psoriasis Foundation Medical Board suggest that losing weight by following a low-calorie diet can reduce psoriasisseverity in overweight patients, but there is little evidence to support other dietary interventions. “Our psoriasis patients have long asked us about the role of diet on psoriasis,” Dr. April Armstrong of the…
Case Illustrates the Difficulty Diagnosing Granulomatosis with Polyangiitis
Granulomatosis with polyangiitis (GPA) was first described in the British Medical Journal in 1897 by Scottish otolaryngologist Peter McBride.1 GPA is a relatively rare, systemic necrotizing vasculitis that can make diagnosis challenging. The incidence has been estimated anywhere between two and 12 cases per million.2 GPA mainly affects adults between the ages of 45 and…
Case Review: MRI Leads to Non-Rheumatic Diagnosis Surprise
Rheumatologists often rely on magnetic resonance imaging (MRI) in the evaluation of suspected muscular diseases. Here, we describe a case in which unexpected findings on MRI pointed to a diagnosis rarely considered as a mimicker of rheumatologic disease. The Case A 19-year-old man of Middle Eastern descent was admitted to our hospital for evaluation of…
Case Report: Refractory Calciphylaxis in Lupus
Calciphylaxis is a poorly understood and life-threatening ischemic vasculopathy characterized by calcification of the small- and medium-size arteries in the skin, subcutaneous tissue and internal organs, which leads to thrombosis, tissue necrosis and painful skin ulcerations that won’t heal. The disease has a 50–80% mortality rate. Although affected patients typically have end-stage renal disease (ESRD)…
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