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….
“Worst of all is the pain in my calves,” she said. “It feels like burning deep inside.” So began my first encounter with a 69-year-old woman who was referred to rheumatology clinic for evaluation of two months of constitutional symptoms and a positive ANCA test, which had been ordered by her primary care doctor. Her…
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…
Summer is a season for travel, so if your immunocompromised patients plan to journey to regions where there are outbreaks of infections, such as chikungunya, tuberculosis, typhoid, yellow fever or other diseases, communication and preparation may prevent serious health events. “The world teems with disease-causing organisms, and almost every infection is more serious in the…
One parent wishes that she could have consulted a crystal ball at the beginning of her daughter’s illness to have “some kind of idea of what we were in for. There are so many stages of letting go of the idea of what your little kid is in for in life, what they are going…
NEW YORK (Reuters Health)—Adding to earlier evidence, a new study finds kids with septic arthritis who are treated with dexamethasone recover faster. “We expected these results based on our previous randomized double-blind controlled study,” Dr. Itay Fogel from Schneider Children’s Medical Center of Israel and Tel Aviv University told Reuters Health by email. “However, the…
What struck me first as I walked by the exam room where Lynn P. sat was the swelling in her fingers and wrists. The bloated hands rested unnaturally on her thighs, palms up, fingers slightly flexed. Her strawberry-blond curls were offset by a high-neck, loose-fitting, burgundy sweater. Her pale skin matched her trim slacks. She had…
Etanercept Biosimilars A number of Phase 3 trials are ongoing for etanercept biosimilars.1 One evaluation identified three trials in rheumatoid arthritis (RA) patients and one in psoriasis patients. The psoriatic arthritis trial evaluated PASI as a primary endpoint and the following secondary endpoints: PASI50, PASI75, PASI90, PASI score, laboratory values, ECG, adverse events (AEs), injection…
A healthy 30-year-old Indian male was performing his routine workout in the gym when he developed giddiness and transient blackouts. He thought it was due to exercising excessively. Over the next month, he developed a low-grade fever and started feeling lethargic, to the extent that he was unable to exercise or work. He was admitted…
Antiphospholipid syndrome (APS) is an autoimmune condition characterized by hypercoagulability often manifested as recurrent thrombosis or pregnancy complications, with persistently circulating antiphospholipid (aPL) antibodies or lupus anticoagulant. Catastrophic APS (CAPS), also known as Asherson syndrome, occurs in less than 1% of cases of APS and involves occlusive microangiopathy in at least three organ systems.1 Case…