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,…
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.
For many months, the healthcare world has been significantly affected by the swift and pervasive effects of SARS-CoV-2, which causes COVID-19. The virus has severely affected the delivery of patient care by all providers, including those in hospitals and emergency care settings, who grappled with the response to massive influxes of COVID-19 patients, and those…
Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disease of immune dysregulation characterized by unchecked inflammatory responses leading to end-organ dysfunction. Primary HLH results from inherited mutations that impair the capacity for immune regulation; secondary HLH arises from the inappropriate response to an immune stimulus, such as infection, malignancy or autoimmunity. What is less well known is…
The diagnosis of rheumatic diseases requires the exclusion of other systemic disorders. Infection, hematologic conditions, malignancies and some drugs may all lead to syndromes that closely mimic rheumatic diseases, which may lead to diagnostic delays. Idiopathic multicentric Castleman disease (iMCD) is a heterogeneous group of lymphoproliferative diseases (LPDs) characterized by systemic inflammatory manifestations.1,2 As with…
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…
The ACR has released clinical guidance documents for pediatric patients with rheumatic disease in the context of the COVID-19 pandemic, including one for multi-system inflammatory syndrome in children (MIS-C). Jay Mehta, MD, MS, an attending physician in the Division of Rheumatology and director of the Pediatric Rheumatology Fellowship at the Children’s Hospital of Philadelphia (CHOP),…
The ACR, on behalf of its more than 7,700 members of the professional rheumatology community, wishes to express strong support for Anthony S. Fauci, MD, director of the National Institute of Allergy and Infectious Diseases (NIAID), and his continued and close involvement in the work to address the nation’s response to the COVID-19 pandemic. During…
(Reuters Health)—During the COVID-19 pandemic, an inflammatory condition similar to Kawasaki disease has been reported in children and adolescents, and now two groups of New York doctors each describe a case, one in a 36-year-old woman and one in a 45-year-old man.1 “We’re still learning how COVID-19 is affecting children and adults. The better we…