Despite our best efforts and modern interventions, we still have patients in the intensive care unit with organ failure. Although renal failure can be mitigated by dialysis, patients with cardiac or respiratory failure secondary to active autoimmune disease raise difficult clinical and ethical issues. Two recent cases, both with organ failure, led us to examine…
SAN DIEGO—Recent research tells us more about giant cell arteritis (GCA) to help rheumatologists more accurately diagnose and effectively treat patients with this type of vasculitis. On Nov. 6 at the ACR/ARHP Annual Meeting, three experts explored the latest findings on GCA pathogenesis, diagnostic approaches, imaging modalities and growing treatment options. GCA: What’s Really Happening?…
SAN DIEGO—Since the identification of the autoinflammatory disease, familial Mediterranean fever (FMF), researchers have identified an alphabet soup of other autoinflammatory diseases with genetic underpinnings, from PAPA (pyogenic arthritis with pyoderma gangrenosum and acne) to NIAID (NLRP1-associated autoinflammation with arthritis and dyskeratosis) to TRAPS (TNF receptor-associated periodic syndrome). The torrent of discoveries, brought about largely…
Systemic lupus erythematosus (SLE) can present in many ways and can be difficult to diagnose. Its association with celiac sprue has been only rarely documented, but has appeared in several case reports. When presenting together, it can be difficult to distinguish the underlying disease, because SLE itself has been known to cause malabsorption. This case…
When Marc McClintock first began experiencing back pain, he chalked it up to the rigors of his racing career. For more than 36 years, Mr. McClintock has built and raced stock cars, high-powered race vehicles that compete on short oval or circular dirt or paved tracks. “I live in a commercial building, with my residence on…
SAN DIEGO—An increasing number of patients is being identified with deficiency of adenosine deaminase type 2 (DADA2); fortunately, researchers and clinicians continue to better understand the genetic disease as well, experts said in a session at the 2017 ACR/ARHP Annual Meeting Nov. 3–8. The childhood-onset disease involves loss-of-function mutations to the CECR1 gene (i.e., cat…
SAN DIEGO—In Hot Topics in Myositis, a session held Nov. 7 at the 2017 ACR/ARHP Annual Meeting, rheumatologists discussed treating myositis patients in three different clinical scenarios: persistently elevated creatine kinase (CK), immune-mediated necrotizing myopathies and lung disease. Elevated CK Patients with persistently elevated levels of CK enzyme and normal muscle strength “may still have…
SAN DIEGO—In just two decades, precision medicine has gone from futuristic concept to realistic toolbox for clinical physicians. At the 2017 ACR Clinical Research Conference on Nov. 3, the Precision Medicine in Rheumatic Diseases: Hopes and Challenges lecture featured rheumatologists and experts on genetics, genomics, pharmacogenetics and big data who spoke about the latest research…
SAN DIEGO—At the 2017 Thieves Market, held Nov. 6 at the ACR/ARHP Annual Meeting, rheumatologists from around the world presented patient cases to an audience of colleagues, who then voted via text messaging to choose the cases they felt were most perplexing or intriguing. The winner received a free 2018 Annual Meeting registration, and the…
SAN DIEGO—Top researchers gathered for a review course at the start of the 2017 ACR/ARHP Annual Meeting in November to describe new research, their own treatment strategies and new ways of thinking about an array of rheumatic diseases. Here are the highlights: Raynaud’s & Other Digit Problems When a patient walks into your clinic with…