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 61-year-old white woman presented to our rheumatology clinic in New England to establish care in early June 2018, following a move from Texas. She reported a medical history of inflammatory bowel disease, uveitis and seronegative inflammatory arthritis, which was difficult to control and required the use of multiple medications. At her initial visit, she…
Some artists paint with oils or watercolors, others with acrylics. Shivani Garg, MD, MS, prefers Nescafé or Maxwell House coffee. A faculty member in the Division of Rheumatology in the Department of Medicine at the University of Wisconsin School of Medicine and Public Health (UWSMPH), Madison, Dr. Garg learned this technique—painting with instant coffee mixed…
Common variable immunodeficiency (CVID) is a common primary immunodeficiency disease, with an estimated incidence of one per 25,000–50,000 individuals.1 The classic presentation includes frequent bacterial infections, secondary to dysfunctional B cell differentiation, impaired immunoglobulin production and diminished antibody response. The clinical presentation may be heterogenous and may include granulomatous disease as an uncommon manifestation. Granulomatous…
Dermatomyositis is an uncommon autoimmune condition involving skeletal muscle characterized by subacute onset of progressive weakness, intramuscular inflammatory infiltrates and the presence of myositis-specific autoantibodies.1 Immune-mediated myopathies may exert some pathogenic effects on the muscle tissue by targeting the microvasculature.1 Capillary inflammation, fragility and loss may contribute to heightened bleeding events in these patients. Here,…
AMA Honors Mark Andrejeski with Lifetime Achievement Award In November 2020, the American Medical Association (AMA) presented Mark Andrejeski, the recently retired executive vice president of the ACR, with its Medical Executive Lifetime Achievement Award. The award honors a medical association executive who has contributed substantially to the goals and ideals of the medical profession….
As with rheumatology care in general, the current demand for pediatric rheumatologists is greater than the supply of providers available. That imbalance is expected to increase significantly by 2030 unless action is taken, according to a new workforce study published in Arthritis Care & Research.1 The lack of pediatric providers is a serious problem that…
As more people get vaccinated for COVID-19, there’s hope that the long days of a pandemic, which has claimed more than 2.5 million lives globally and 500,000 in the U.S., will soon draw to a close and allow daily life to return to normal. However, for some people, this recovery may take longer, because the…
We report on a 77-year-old patient who was diagnosed with giant cell arteritis (GCA) on histopathology of the submandibular gland and eventually went on to develop classic signs and symptoms of GCA. This observation highlights neck swelling as a rare initial presentation of GCA. Case Presentation A 77-year-old previously healthy man presented to his primary…
ACR CONVERGENCE 2020—Myalgic encephalomyelitis/chronic fatigue syndrome, postural orthostatic tachycardia syndrome (POTS) and mast cell activation syndrome were the topics of the day in the ever-popular Curbside Consults session in November 2020. POTS An anxious woman with a chronic headache and constant myofascial pain in the neck and upper back, assorted gastrointestinal symptoms, chronic severe fatigue,…