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An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

Search results for: fever

How to Recognize an Autoinflammatory Disorder

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Autoinflammatory disorders may involve genetic mutations of the inflammasome or an environmental trigger in a genetically susceptible host. Dr. Jay Mehta discussed a practical, clinical approach to caring for patients with autoinflammatory disorders, such as periodic fever syndromes, during the 2022 ACR Education Exchange.

Case Report: Abscess as a Manifestation of Autoinflammatory Disease

Katherine Chakrabarti, MD, & Andrew Vreede, MD  |  

Abscesses are typically caused by infections, but some are, instead, sterile. Aseptic abscesses (AAs) are characterized by the same neutrophil-rich histo­pathology as infectious abscesses; however, they don’t improve with antibiotics. Rather, AAs require treatment with anti-inflammatory medications. Although relatively rare, this phenomenon is important for rheumatologists to recognize given its frequent association with under­lying systemic…

Case Report: MPA Hiding in Plain Sight

Benjamin Aronow, MD, Eduardo Mantovani Cardoso, MD, Steffi Thomas, DO, Prashant Grover, MD, & Weishali Joshi, MD  |  

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…

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Diagnostic Challenges of MIS-C

Brian L.P. Dizon, MD, PhD, & Sangeeta Sule, MD, PhD  |  

During the peak of the coronavirus pandemic in Washington, D.C., we were asked to evaluate a 14-year-old boy admitted to the pediatric hospitalist service. He had been healthy until two weeks before, when he noted a sore throat, and soon after he developed fevers and rashes without congestion, shortness of breath, conjunctivitis or swollen lymph…

Case Report: Lipoma Arborescens of the Knee

John Nawrocki, MD, Kevin Hess, DO, & Maryah Mansoor, MBBS  |  

Lipoma arborescens is a rare, benign intra-articular lesion characterized by diffuse replacement of synovial tissue by mature adipocytes, causing a villous lipomatous proliferation of the synovial membrane.1 Typically, this is a mono­articular condition, with the knee being the most commonly affected although it has been rarely reported to occur in an oligo-/polyarticular fashion and in…

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Case Report: Blunt Smoker Denies Tobacco Use, Delaying Diagnosis

Rachel E. Elam, MD, ScM, Vishal Arora, MD, & Alyce M. Oliver, PhD, MD  |  

Cannabis arteritis mirrors thrombo­angiitis obliterans in its clinical and arteriographic presentation, but its relevant exposure is cannabis rather than tobacco.1 Whether cannabis arteritis is a subset of thromboangiitis obliterans or a unique pathologic entity is debatable. Delta-9-tetrahydrocannabinol, the primary psychoactive component of cannabis, is a peripheral vasoconstrictor.2 This offers mechanistic insight into how cannabis may…

Case Report: Pulmonary Sarcoid-Like Reaction in Patient Treated with Etanercept

Luis Lora Garcia, MD, Sneha Centala, MD, MS, Gitanjali Lobo, MD, Shahla Mallick, MD, & Diana Girnita, MD, PhD  |  

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…

Case Report: An Unusual Presentation of Neuro-Behçet’s Disease

Zeba Faroqui, MD  |  

A 44-year-old woman presented to the emergency department with bifrontal headaches that had started approximately one month earlier. She was diagnosed with migraines and discharged home. Three days later, the patient returned to the emergency department upon recurrence of her headaches, and this time she also reported abnormal leg movements. A computerized tomography (CT) scan…

Case Report: Perplexing Pulmonary Nodules

Monsoon Rashid, DO, & Deana Lazaro, MD  |  

Pulmonary nodules are com­mon; most are benign, but the differential diagnosis is broad and includes life-threatening possibilities.1 Our patient is a former smoker who has a history of a complex autoimmune disease and multiple pulmonary nodules. This case was challenging, but clinical, radiographic and histologic clues helped lead to the correct diagnosis. Case Presentation The…