Case A 17-year-old girl returns to the rheumatology clinic for scheduled follow-up for systemic lupus erythematosus (SLE). She is accompanied by her mother and father. She has a history of autoimmune cytopenias and Class III lupus nephritis. She has responded well to treatment with mycophenolate mofetil and hydroxychloroquine and was successfully weaned off of prednisone…
A recent review investigated risk factors for preeclampsia in early pregnancy, finding that antiphospholipid antibody syndrome may be the strongest risk factor. As a result of these findings, researchers have compiled a list of risk factors to help clinicians determine which women are more likely to develop the condition and aid them in weighing treatment options…
A recent study showed that, when administered during pregnancy, infliximab takes longer to clear an infant’s system than adalimumab…
Sometimes, life calls for you to be out of the office for a length of time. Whether the absence is planned or not, it’s important to consider the best actions to take given the circumstances to ensure patients are cared for during your absence. Alexa Meara, MD, clinical instructor and rheumatologist, The Ohio State University…
A recent case study revealed that an infant from a donor egg developed neonatal lupus erythematosus (NLE) and a congenital heart block, which may have been due to the presence of antibodies to Ro and La in the birth mother—not the genetic mother. The results suggest that a gestational mother with a history of autoimmune disease is sufficient to trigger the pathology of NLE…
NEW YORK (Reuters Health)—Babies born to mothers who took anti-tumor necrosis factor (anti-TNF) agents during pregnancy have detectable drug in their bodies up to 12 months of age, new findings show. These infants should therefore not receive live vaccines during their first year of life, Dr. Mette Julsgaard of Aarhus University Hospital in Denmark and…
When working with a newly diagnosed patient to determine a treatment plan, ensure the patient has a good understanding of the diagnosis, the options available and what the options entail. “It is important to help patients understand that there are choices, and that their decisions should be based on what matters to them,” says Susan…
A recent JAMA Pediatrics article found that 83% of clinicians admitted to coming to work while sick and 95% admitted to knowing that it could be dangerous for their patients.1 “The decision to work sick is shaped by systems-level and sociocultural factors,” the study authors wrote. In speaking with rheumatologists on the matter, I found…
The microbiome comprises diverse microbial flora, including bacteria, viruses and fungi, that live on mucosal surfaces, predominantly the skin and digestive tract. Microbes evolved billions of years prior to the development of modern Homo sapiens 200,000 years ago; we have always existed with their ubiquitous presence. Despite this, the first microbe was not visualized until…
The approach of under-treating rheumatic disease in pregnant patients is changing, according to Bonnie Lee Bermas, MD. Dr. Bermas discusses with The Rheumatologist the need for more research on how drugs affect this patient group, and how timing of conception and disease stability play important roles in the safe outcomes of mother and infant…