In Canada, five provinces will now reimburse patients with plaque psoriasis who use risankizumab. Also, Canada Health has approved apremilast for treating adults with plaque psoriasis and psoriatic arthritis…
Search results for: fever
As Lyme Disease Spreads Across the U.S., Stay Alert for Fatal Lyme Carditis
The reach of Lyme disease is expanding across the U.S., and cases may be under-reported. A recent CDC case report describes the experiences of two patients with fatal cases of Lyme carditis…
Coding Corner Questions: Using NP/PA Services in Practice
Scenario 1: Direct Billing A 70-year-old female patient with rheumatoid arthritis in multiple joints and positive rheumatoid factor returns to the practice for her fourth infusion of infliximab with the nurse practitioner (NP). She reports no fevers, cough, dyspnea or concurrent illness. She rates the severity of her joint pain at 6 on a 10-point…
Remembering Etanercept & the Advent of the Biologic Era
As a veteran rheumatologist, I remember the clinical trials of etanercept’s (Enbrel’s) efficacy. And when the drug was first approved in 1998, I participated in those clinical trials and realized the effectiveness was astonishing. It was easy to tell which patients were treated with etanercept vs. those who received placebo, even though both groups were…
Update on the Management of Takayasu Arteritis
A rare form of large vessel vasculitis, Takayasu arteritis persents with no clear patterns, with patients experiencing vascular symptoms, as well as such systemic symptoms as fever and weight loss. A systematic literature review found evidence to guide rheumatologists in monitoring and treating their patients with Takayasu arteritis…
Case Report: Obliterative Bronchiolitis in Rheumatoid Arthritis
A 59-year-old woman with rheumatoid arthritis (RA) presented to our pulmonary clinic for progressively worsening dyspnea of five years’ duration. She described progressively worsening dyspnea after a few minutes of walking on level ground. In addition, she noted worsening pain and morning stiffness of the wrists, knees and metacarpophalangeal (MCP) joints, with subcutaneous nodules. She…
Sjögren’s Syndrome in Kids: Diagnostic Challenges & Treatment Options
A 14-year-old girl is referred to your office for fatigue and arthralgias. While you’re obtaining her past medical history, she divulges that she has had four episodes of bilateral parotitis, each lasting two weeks. An otolaryngologist evaluated her. She lacked sicca symptoms, had a normal complete blood count (CBC), normal inflammatory markers and a negative…
Case Report: Possible Overlapping Vasculitis & Ulcerative Colitis
A 42-year-old man with a history of ulcerative colitis (UC), primary sclerosing cholangitis (PSC) and chronic sinusitis was referred to a rheumatologist to evaluate for a possible diagnosis of systemic vasculitis. This patient had developed new skin lesions, gingival hypertrophy and ulcerating tracheobronchitis, concerning for possible granulomatosis with polyangiitis (GPA). Since 1994, the patient had…
ACR/EULAR Release New Classification Criteria for IgG4-Related Disease
Immunoglobulin G4-related disease (IgG4-RD) can cause fibroinflammatory lesions in nearly any organ, and diagnosis is challenging. ACR/EULAR classification criteria for IgG4-RD have been developed and validated in a large cohort of patients. These criteria have performed well in tests and should contribute substantially to future clinical, epidemiologic and basic science investigations.
Rheum After 5: Dr. Stacy Ardoin & Mr. Mom
In 2004, Stacy Ardoin, MD, MHS, became pregnant with twins during the second year of her fellowship at Duke University School of Medicine, Durham, N.C. Although she and her husband, Adrien, were thrilled by the news, the astronomical cost of day care for two infants was a specter. At the time, Adrien managed a bookstore…
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