Due to a lawsuit, the FDA has issued only tentative approval for an extended-release oxycodone capsule. Obinutuzumab is in clinical trials for lupus nephritis, and subcutaneous belimumab is being tested for SLE…
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Sjögrens Syndrome: The Need to Bridge Patient Symptoms & Objective Findings
Despite a generation of advances in molecular biology, a huge gap exists between the Sjögren’s syndrome (SS) patient’s description of their symptoms and the objective findings. Current issues include: Many SS patients are misclassified as either rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE), even within rheumatology clinics. Frequently, the sickest SS patients with extraglandular…
When Sense Disorders Signal Immune System Interactions
I sometimes find myself mired in sticky clinical circumstances. I am facing a distraught patient who is seeking my opinion about a condition that, according to some, may not truly belong in the rheumatologist’s bailiwick. Case example: hearing loss. The Steroid Test Sudden sensorineural hearing loss (SSNHL) and its relative, autoimmune inner ear disease (AIED),…
Fellows’ Forum Case Report: Palmar Fasciitis & Polyarthritis Syndrome
Case report: A 78-year-old Caucasian female presented to our outpatient rheumatology clinic with pain in her bilateral shoulders, hands and knees that began suddenly one month earlier. She admitted to stiffness in her hands lasting several hours, and expressed an inability to extend her fingers. She denied fever, rashes, jaw claudication, headache or visual changes….
Research in Temporal Arteritis Suggests Link with Infection, Autoimmune Disease
Temporal arteritis was first described by Sir Jonathan Hutchinson in 1890 in an elderly retired gentleman’s servant who developed red, painful streaks on his temples and was found to have bilaterally swollen temporal arteries with feeble pulses.1 Sir Hutchinson disputed the suggestion that the red streaks were caused by the man’s hat and, instead, called…
Rituximab May Benefit Patients with Refractory JIA-Associated Uveitis
NEW YORK (Reuters Health)—Rituximab may calm juvenile idiopathic arthritis (JIA)-associated uveitis and especially benefit patients who haven’t responded to other biologic treatments, a study from Italy suggests. With its convenient dosing schedule, rituximab may be a new treatment option for patients with autoimmune diseases, especially for those who have not responded to tumor necrosis factor…
Diagnosis, Management of Medication-Induced Osteonecrosis of the Bone
Prior to the widespread use of bisphosphonates for the management of osteoporosis, multiple myeloma and metastatic cancer to the skeletal system, osteonecrosis of the jawbones was an infrequent condition seen after radiation for oral cancers (osteoradionecrosis) and in chronic odontogenic infections.1 Since the mid-2000s, osteonecrosis of the jawbones has been noted to occur as a…
Immunotherapy May Be Effective for Some Patients with Autoimmune Cerebellar Ataxia
NEW YORK (Reuters Health)—Immunotherapy appears to yield neurological improvements in some patients with autoimmune cerebellar ataxia, especially those with nonparaneoplastic disorders, researchers report. “I was surprised that so many patients responded to immunotherapy (steroids, intravenous immunoglobulin (IVIg), and plasma exchange) and remained ambulatory,” Dr. Andrew McKeon from Mayo Clinic in Rochester, Minn., told Reuters Health…
IBD Tied to Higher Risk of Invasive Pneumococcal Disease
NEW YORK (Reuters Health)—Patients with inflammatory bowel disease (IBD) are at slightly increased risk of invasive pneumococcal disease (IPD), according to Danish researchers. In a paper online Sept. 8 in The American Journal of Gastroenterology, Bjørn Kantsø of Statens Serum Institut in Copenhagen and colleagues note that the inappropriate immune response against infective agents seen in…
Systemic Lupus Erythematosus Without Kidney Involvement: A Case Report
A 35-year-old female with a history of systemic lupus erythematosus (SLE) without kidney involvement was admitted to our hospital with low-grade fevers, headache, increasing lower extremity edema and elevated blood pressure. History She was first diagnosed with SLE as a teenager when she developed oral ulcers and pleuritic chest pain and tested positive for anti-Smith…
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