The COVID-19 pandemic has filled hospitals with patients with rapidly progressive respiratory failure and diffuse bilateral opacities on chest X-ray.1 Additionally, many patients with severe COVID-19 develop acute kidney injury and require dialysis.2 Pulmonary-renal syndromes are also important to consider in this setting. Although alveolar hemorrhage is a cardinal feature of this syndrome, many patients…
On Dec. 27, 2017, RaDonda Vaught killed Charlene Murphey, allegedly. Ms. Murphey was a lifelong resident of Gallatin, a suburb of Nashville, Tenn. She was well known from having worked at the local Walmart for 24 years, before she retired in 2012, when she was 65 years old.1 On Dec. 24, 2017, she was helping…
A recent editorial provides new insights by reexamining the definitions of remission for rheumatoid arthritis and outlining concerns with the use of specific metrics for remission in clinical trials.
COVID-19 vaccinations are safe for patients with systemic lupus erythematosus (SLE), with manageable side effects and a low incidence of flare, according to a recently published study in The Lancet.1 The use of mRNA vaccines, such as those from Pfizer-BioNTech and Moderna, which have been viewed as riskier than traditional vaccines because of a concern…
Sarcoidosis is a multisystem disease characterized by noncaseating granulomas in affected tissues, mostly involving the lungs and lymph nodes.1,2 The etiology of sarcoidosis remains unknown but is thought to be due to an inflammatory response to an antigen exposure in genetically predisposed individuals.1 Tumor necrosis factor-α (TNF‑α), a pro-inflammatory cytokine, plays an essential role in…
A 26-year-old woman presented to our emergency department (ED) with intermittent fevers, nausea and vomiting. She had a past medical history of well-controlled, anti-nuclear antibody positive and rheumatoid factor negative polyarticular juvenile idiopathic arthritis (pJIA) and Crohn’s disease. Her maintenance treatment consisted of monthly intravenous infliximab, 10 mg of oral methotrexate weekly and 20 mg…
Let’s start with a couple of short riddles: What question can you never answer “yes” to? Which word does not belong in the following list: stop cop mop chop prop or crop? [The answers appear at the end of this article.] Riddles are designed to make us think beyond the obvious answer. There is usually…
Retroperitoneal fibrosis (RPF) is a rare condition characterized by aberrant fibroinflammatory tissue developing in the retroperitoneum. This disorder was initially called Ormond’s disease. RPF may be idiopathic or secondary to other conditions. Idiopathic RPF is a part of the disease spectrum of chronic periaortitis due to its typical periaortoiliac localization. Idiopathic retroperitoneal fibrosis is a…
The 1999 Institute of Medicine report To Err Is Human gave a sobering depiction of the magnitude and consequences of medical error.1 The report concluded that approximately 98,000 people die in hospitals annually due to preventable medical errors. Of all the errors detailed in this report, diagnostic errors have since been determined to be the…
Rheumatologists can do better at helping systemic lupus erythematosus patients from racial and ethnic minority groups adhere to their lupus medication regimens, according to a paper published in Arthritis Care & Research. Researchers from Duke University examined medication adherence barriers from the perspectives of healthcare providers and patients. Their findings suggest more attention should be…