Our hospitals have had their finest hour in the care of acutely ill inpatients during the COVID-19 pandemic, including dealing with allocation decisions fairly and transparently, maximizing good outcomes and remaining cognizant of the enduring ethics of healthcare. The honorable traditions of self-effacing conduct and acceptance of some level of personal risk by healthcare professionals…
Ironically, chronic exposure to minocycline has also been associated with a variety of autoimmune syndromes, including drug-induced lupus, autoimmune hepatitis, serum sickness and vasculitis.1 Minocycline is associated with an 8.5-fold increased risk of drug-induced lupus.2 Minocycline and nitrofurantoin are implicated in 90% of cases of drug-induced autoimmune hepatitis.3 Minocycline-induced vasculitis is much less common and,…
(Reuters Health)—In a case series report, researchers describe rapid symptom improvement in three patients with polymyalgia rheumatica (PMR) when high glucose levels were brought down. After glucose was controlled, patients experienced improvement in both symptoms and laboratory measures of PMR without glucocorticoid administration or an increase in glucocorticoid dosage, according to the report in the…
Physical inactivity significantly affects disease burden and reduces the overall quality of life in patients with knee osteoarthritis (OA), according to a study from Losina et al. The researchers calculated the total quality-adjusted life-years lost for U.S. patients with OA due to inactivity.
A 67–year-old white woman with primary Raynaud’s phenomenon presented following a week of progressively worsening shortness of breath, dry cough and generalized malaise. An avid tennis player, she first noticed dyspnea while playing, but a few days later grew short of breath even at rest. She went to an urgent care center, where a computed…
A study from October 2019 describes the clinical characteristics of pediatric patients with undefined systemic autoinflammatory diseases. Researchers conducted a genetic analysis and outlined specific variants. They found patients with pericarditis and intellectual impairment may have distinct clinical phenotypes, which may lead to improved diagnostic and treatment options.
Rhabdomyolysis is a clinical syndrome characterized by muscle tissue necrosis and release of intramuscular components into the circulation. Typical manifestations include muscle pain and myoglobinuria, causing dark urine. Serum creatinine kinase (CK) enzyme levels are usually markedly elevated. Severity can range from muscle enzyme elevation in the serum of an otherwise asymptomatic patient to extremely…
Based on data from two clinical trials, the FDA has approved guselkumab to treat adult patients with active psoriatic arthritis…
A 61-year-old Caucasian woman with a history of seropositive rheumatoid arthritis (RA) was hospitalized for a several-month history of progressively worsening left ankle pain and swelling. She had been unable to bear weight on her left leg for several days and did not notice improvement in symptoms with 20 mg of prednisone daily, which she…
As rheumatologists, we relish the thrill of diagnostic conundrums that accompany our immune-mediated multi-system and often undifferentiated disease processes. Many rheumatologic diagnoses are essentially diagnoses of exclusion. We’re accustomed to diagnosing iatrogenesis, infection and malignancy as often as we diagnose rheumatic disease. Complex clinical problem solving and critical reasoning are our forte, and to do…