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Expert Says Vaccines Are Largely Safe for Rheumatology Patients
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…

The Type I Interferon Pathway’s Influence in Connective Tissue Disease
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…

What Attracts Us to Rheumatology? A Veteran Rheumatologist Reflects
What attracts physicians to a career in rheumatology? Traditionally, the foundation of clinical training at both the medical student and house staff level is based on inpatient services. There are many reasons for this, predominantly revolving around access to patients available for teaching. The result: Trainees are predominantly exposed to a group of conditions that…

Case Report: An Adult-Onset Still’s Disease Mimic
A 53-year-old man was hospitalized for pericarditis, abdominal lymphadenopathy of unknown origin and non-bloody diarrhea. He was admitted for four days, and then he was discharged home without incident. Two months after his initial presentation, he was readmitted for the evaluation of several new issues, including symmetric arthralgias, hypovolemia with associated electrolyte abnormalities and concurrent…
Checkpoint Inhibitors May Be Retried after Immune Adverse Event, with Close Monitoring
NEW YORK (Reuters Health)—After an immune-related adverse event, the risk-reward ratio for an anti-PD-1 (anti-programmed death-1) or anti-PD-L1 (anti-programmed death ligand-1) rechallenge seems to be acceptable if patients are closely monitored, researchers say. “The immune checkpoint inhibitors anti-PD-1 and anti-PD-L1 have proven efficacy in the treatment of many cancers, but patients may experience immune-related adverse…

Vaccines & Rheumatology Patients
Vaccines are often safe for rheumatology patients, but precautions may be needed, said Brian Schwartz, MD, at the 2019 ACR State-of-the-Art Clinical Symposium…

Myositis Autoantibodies as Biomarkers
A recent study details the autoantibodies of patients with myositis, confirming most patients carry these antibodies. The results also describe how myositis-specific autoantibodies can be used to identify distinct clinical subsets of idiopathic inflammatory myopathy…

The ACR’s & EULAR’s Gout Guidelines Include Treatment Approaches
SNOWMASS VILLAGE, COLO.—The 2019 ACR Winter Rheumatology Symposium featured a session on gout. Despite a good understanding of its pathogenesis and the many effective therapies to treat it, gout remains a major public health problem in the U.S. Ann K. Rosenthal, MD, Will and Cava Ross professor of medicine and chief of the Division of…

Prevent Osteoporotic Fractures with a Fracture Liaison Service
Imagine leaving the hospital after suffering a heart attack without being treated for hypertension or being started on a beta blocker. What would we think of the hospital where patients are never educated about the relationship between treating hypertension and reducing myocardial infarction and stroke risk? Unfortunately, this happens every day with osteoporosis and fractures…
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