Think back to your time as a trainee. Do you remember an interaction with a consultant in which you learned something, felt your opinion was heard, were empowered to collaborate with the consulting team and knew you were providing outstanding care? We suspect a number of examples come to mind, regardless of the amount of…
Eosinophilia is usually defined as an eosinophil count of more than 500/microL in peripheral blood.1 An eosinophil count of more than 1,500 is referred to as hypereosinophilia (HE); hypereosinophilic syndrome (HES) is defined as HE associated with organ dysfunction attributable to eosinophilia.2 Eosinophilia can occur due to infectious, malignancy, autoimmune or allergic etiologies. However, a…
Immunoglobin G4-related disease (IgG4-RD) is a rare fibro-inflammatory disease of unknown etiology that has been recently recognized. It can cause fibro-inflammatory masses in almost every organ of the body and is associated with dense lymphoplasmacytic infiltration of IgG4-postitive plasma cells, storiform fibrosis and elevated levels of serum IgG4.1 IgG4-RD is a systemic disease that may…
New research raises questions about the cardiovascular safety of febuxostat for gout patients compared with allopurinol. The study found that although febuxostat was noninferior to allopurinol, febuxostat-treated patients had similar overall rates of major adverse cardiovascular events as allopurinol-treated patients, but had higher rates of all-cause mortality and cardiovascular mortality…
There has long been a wall separating adult rheumatologists from pediatric rheumatologists. A recent review article published in the January edition of Arthritis & Rheumatology (A&R) suggests that genetics, rather than age, may be a better way to categorize forms of primary inflammatory arthritis across the lifespan.1 “Pediatric and adult rheumatologists don’t generally interact that…
For patients with hip osteoarthritis (OA), pain management and maintaining function are primary therapy goals. Current guidelines offer recommendations on nonpharmacologic and pharmacologic approaches to addressing these issues in hip OA. For patients in whom pharmacologic management is considered, the use of intra-articular steroid injections is one option. In its 2012 guidelines (the most current…
Pulmonary arterial hypertension (PAH) in connective tissue disease (CTD) features significant morbidity and mortality. Standard therapies with endothelin receptor antagonists and phosphodiesterase-5 inhibitors have shown some clinical improvement in patients, but these clinical improvements have proved modest when compared with other types of PAH. As our case below suggests, rituximab may show promise as a…
You see a patient for the first time to establish care for Sjögren’s disease. She complains of dry eyes, dry mouth and diffuse arthralgias. You do not appreciate any synovitis on physical exam. Of note, you are the fourth rheumatologist she has seen during the past year. Toward the end of the clinic visit, she…
For people with rheumatoid arthritis (RA), fatigue can be a debilitating symptom that interferes with daily life and significantly reduces quality of life. Managing fatigue can be difficult; it is linked to disease activity and a host of other conditions that commonly accompany RA, such as depression, sleep problems and obesity. A new study, however,…
Potential federal drug pricing proposals could shuffle Part B drug coverage into the Part D program and restructure reimbursements for new drugs, moves that would jeopardize patient access to care, explains Kent “Kwas” Huston, MD, a rheumatologist in Kansas City, Mo., and a member of the ACR’s Government Affairs Committee (GAC). “We believe Part D…