NEW YORK (Reuters Health)—Tocilizumab induced a slow and lasting remission after an ultra-short pulse (three days) of steroids in newly diagnosed giant cell arteritis (GCA) patients, a proof-of-concept trial shows.1 His early research on cytokines and glucocorticoids led Peter Villiger, MD, of Medical Center Monbijou, Bern, Switzerland, to find ways to reduce steroid use, he…
Search results for: Primary care
Case Report: Child Develops Coronary Artery Aneurysms with GPA
In September 2019, a previously healthy, 9-year-old white girl presented to the emergency department following two months of sinusitis and unexplained fever responsive to ibuprofen. She presented with anorexia; a 9 lb. weight loss; intermittent, nonbilious, nonbloody emesis; and occasional epistaxis with digital manipulation of the nose. Six weeks prior to admission, she had presented to…
Case Report: Does a Young Woman with Gitelman Syndrome Have Gout?
Gout is the most common type of inflammatory arthritis in adults, and it typically occurs in men over the age of 50. When gout presents in younger patients or in women, this should warrant consideration of secondary causes. We describe an unusual genetic cause of tophaceous gout in a young, premenopausal woman. Case Report In…
COVID-19 Outcomes in Patients with Rheumatic Disease
In a study of patients with systemic autoimmune rheumatic diseases (ARDs) and matched comparators with COVID-19 but without systemic ARDs, D’Silva et al. found COVID-19 patients with systemic ARDs may be at a higher risk of hospitalization, ICU admission and more than matched comparators.
IgG4-Related Disease: The Latest On Its Presentation, Diagnosis & Management
In 1888, Dr. Jan Mikulicz-Radecki reported a case of chronic, bilateral, painless enlargement of the salivary and lacrimal glands that appeared to be idiopathic.1 In subsequent years, other patients with these findings were reported, and the term Mikulicz syndrome was used to describe these cases. Although Mikulicz syndrome is now known to be associated with…
A 2021 Update on Lupus Management & Treatment
At the 2021 ACR State-of-the-Art Clinical Symposium, Saira Sheikh, MD, associate professor of Medicine and director of the Rheumatology Lupus Clinic, University of North Carolina, Chapel Hill, provided an update on the past, present and future of the management of systemic lupus erythematosus (SLE). This year, hydroxychloroquine received a great deal of attention, given early…
7 Key Insights Into the Evaluation of Central Nervous System Vasculitis
Many a rheumatology consult has centered on a perplexing question: Does this patient have central nervous system (CNS) vasculitis? At the 2021 ACR State-of-the-Art Clinical Symposium, Rula Hajj-Ali, MD, FACP, professor of medicine and associate director of vasculitis care and research, Cleveland Clinic Lerner College of Medicine, discussed this topic in detail, providing a series…
Do Bisphosphonates Reduce Cardiovascular-Related Mortality?
It is well known that hip fractures are associated with significant morbidity and mortality: Mortality increases 15–25% in the year following a hip fracture.1–5 We know that treating osteoporosis prevents fractures and improves patient survival. But is there a relationship beyond this? Several studies have found that bisphosphonate therapy is associated with a reduction in…
3 New Vasculitis Guidelines Discussed
The ACR, in concert with the Vasculitis Foundation, released three new vasculitis guidelines online first in July, with a fourth slated for publication by the end of the year. These are the first ever to be produced and endorsed by the ACR and the Vasculitis Foundation. Although most of the recommendations are conditional, due to…
Therapeutic Drug Monitoring Has Little Value During Infliximab Induction
NEW YORK (Reuters Health)—Results of a randomized controlled trial do not support routine use of proactive therapeutic drug monitoring (TDM) during infliximab induction for improving disease remission rates in patients rheumatoid arthritis (RA) and other chronic immune-mediated inflammatory diseases. Proactive therapeutic drug monitoring tailors biologic therapy to individual patients by measuring serum drug levels and…
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