In recent months, many rheumatologists and rheumatology professionals have noted issues related to obtaining supplies of injectable and oral methotrexate for their patients with rheumatoid arthritis (RA). A conventional synthetic disease-modifying anti-rheumatic drug (csDMARD), methotrexate is available as both oral tablets and as a subcutaneous injection for the treatment of RA and other autoimmune diseases.1…
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ACR Image Competition 2022 Results, Part 6
Diffuse Cutaneous Scleroderma with Interstitial Lung Disease: Radiological Findings A 44-year-old woman with cutaneous manifestations, tightening of her face with a reduced oral aperture and a healing digital tip ulcer (Figures 1 and 2) has had a known case of diffuse scleroderma since 2008. The patient presented with complaints of shortness of breath along with…
Case Report: Migratory Polyarthritis as the Presenting Symptom of GPA
Granulomatosis with polyangiitis (GPA) is a primary, necrotizing granulomatous vasculitis, involving small- to medium-sized arteries, that causes systemic disease. Almost any organ can be affected, but the most affected systems are the upper airways, lungs, kidneys, eyes and peripheral nerves. Migratory polyarthritis is reported in approximately 25% of patients with anti-neutrophil cytoplasmic antibody (ANCA) associated…
ACR Image Competition 2022 Results, Part 5
Resolution of GAVE After aHSCT for Progressive Systemic Sclerosis A 30-year-old man with RNA polymerase III (Pol III)-positive, diffuse, progressive systemic sclerosis had a persistent microcytic anemia with a hemoglobin level of 8 g/dL and evidence of gastric antral ventral ectasia (GAVE) on gastroscopy. He underwent autologous hematopoietic stem cell transplantation (aHSCT). After six months,…
Case Report: GPA or IgG4-Related Disease in an 11-Year-Old Girl?
Granulomatosis with polyangiitis (GPA) is a type of anti-neutrophil cytoplasmic antibody (ANCA) associated small vessel vasculitis that typically affects the kidneys, lungs and sinuses.1 Due to an overlap in signs and symptoms, GPA may initially be difficult to distinguish from IgG4-related disease, another condition that can affect multiple tissues and has variable presentations. Further complicating…
Long COVID: Experts Weigh in on Increasingly Common Syndrome
A minority of patients experience lingering symptoms after infection with SARS-CoV-2, similar to some other previously known post-infection syndromes. Although we are just beginning to understand the different presentations, pathophysiology, risk factors, prognosis and treatment of long COVID, rheumatologists can play a leadership role in managing patients with the illness and contributing to this important research…
Case Report: Is It Cardiac Sarcoidosis or COVID-19 Myocarditis?
COVID-19 causes myriad cardiac dysfunctions, ranging from mild to fulminant disease, including myocarditis, acute congestive heart failure, cardiogenic shock and sudden cardiac death.1,2 COVID-19 myocarditis can mimic cardiac sarcoidosis clinically and on cardiac imaging, which can lead to diagnostic challenges and treatment delays. We present a case of cardiac sarcoidosis with interval development of metabolic…
Case Report: World Trade Center Dust Stokes a Foreign Body Reaction
The terrorist attacks on the Twin Towers at the World Trade Center (WTC) that led to their destruction on Sept. 11, 2001, as well as the subsequent year-long cleanup of the site (i.e., Ground Zero) in 2001 and 2002, not only had immediate implications for the lives and health of thousands of individuals at the…
Case Report: A Long, Arduous Evaluation Capped by Genetic Testing
Systemic autoinflammatory diseases (SAIDs) are rare syndromes characterized by alterations in innate immunity that result in a variety of clinical manifestations that are usually associated with recurrent fevers.1 Thanks to advances in genetic sequencing over the past few years, monogenic causes for some of these autoinflammatory diseases, such as Yao syndrome, have been discovered.2 Previously…
A World of Difference: Updates from the Global Rheumatology Summit
The second annual Global Rheumatology Summit focused on climate change, conflict and migration, as well as other global issues in rheumatology.
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