Autoinflammatory diseases are genetically diverse, but clinically similar, conditions distinct from autoimmune illnesses, such as systemic lupus erythematosus or rheumatoid arthritis. Clinically, they are defined by recurrent episodes of inflammation that follow a characteristic pattern each time they occur. Some have a set length of time during which fever, peritonitis or arthritis manifest. Others are…
“And of course, I am not telling you to do it. That would be illegal.” As a general rule, I try not to instruct my patients to break the law. My business model depends on repeat customers, so placing a patient at risk of getting arrested—even if that risk is remote—doesn’t seem like a good…
CHICAGO—Rheumatologists often come to Brian Schwartz, MD, associate professor of medicine and vice chief for clinical affairs in the Division of Infectious Diseases, University of California, San Francisco, with a concern: A patient on immunosuppression has a family member who needs a live vaccine, but the patient may be vulnerable to the vaccine’s effects. Should…
When Liz Morasso, LCSW, facilitates a Families Living with Rheumatic Diseases support group at Children’s Hospital Los Angeles, she empathizes with the struggles and challenges of her young patients. Ms. Morasso was only 16 years old when she was diagnosed with both systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). She knows all too well…
Type I interferon appears to play a role in disease susceptibility and pathogenesis in several classic connective tissue diseases, at least in some patients. Below, I present evidence supporting this connection, explore potential missing links in pathogenesis and discuss biological treatments that target the pathway. The Type I Interferon Pathway Interferons are a class of…
A five-year study in patients with juvenile idiopathic arthritis-associated uveitis found drug-induced disease remission did not persist once adalimumab was stopped after long-term treatment.
SAN FRANCISCO—The 13th International Congress on Systemic Lupus Erythematosus (SLE), held April 5–8, highlighted continuing advances in the fight against lupus, a chronic, inflammatory, autoimmune disease affecting multiple organ systems. The rheumatologist’s ability to control this incurable and life-threatening condition is limited both by its heterogeneous presentation and by the lack of successful treatment options,…
A recent analysis of retrospective clinical data on patients with systemic lupus erythematosus (SLE) at 14 Canadian centers found that a surprisingly high proportion—at least one-third—had active disease at any point over five years of data collection.1 It has been a longstanding belief among clinicians that SLE becomes less active over time, although its accumulation…
Eosinophilic gastroenteritis (EGE) is a rare condition caused by eosinophilic infiltration of the gastrointestinal (GI) tract. The condition is subdivided into the GI layers it affects: mucosal, muscular and subserosal.1 EGE usually presents with non-specific GI symptoms, such as impaired motility, intestinal obstruction and, rarely, ascites.2 Below, we report a rare case of EGE leading…
Sjögren’s syndrome is a chronic multi-system autoimmune disease characterized by inflammation and subsequent destruction of exocrine glands. Sjögren’s syndrome can present with glandular or extra-glandular manifestations. Neuromyelitis optica spectrum disorder (NMOSD) is a rare central nervous system (CNS) autoimmune disease that can present as the initial manifestation in less than 5% of patients with Sjögren’s….