NEW YORK (Reuters Health)—A large population-based study from the U.K. provides more evidence that some autoimmune liver diseases may be triggered by exposure to something in the environment. The study found a significant clustering of cases of primary biliary cholangitis (PBC), autoimmune hepatitis (AIH) and primary sclerosing cholangitis (PSC) in well-defined regions of north-east England…
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Why Fellows Should Care about ACR Advocacy
As a physician, I am an advocate. I am an advocate for my patients individually and collectively, and I am an advocate for my field: pediatric rheumatology. My own experiences as a patient drive me to integrate my patients’ perspectives into my medical decision making, and although my academic training has prepared me to best…

Dr. Brit Adler Treks Across Glaciers & Forages for Mushrooms
In November 2017, Brit Adler, MD, an instructor in the Division of Rheumatology at Johns Hopkins University, Baltimore, was traveling across a glacier in the Cordillera Blanca mountain range in Peru. At nearly 15,000 feet high, the hikers in the caravan were secured to each other by ropes secured to harnesses. At that altitude, no…

Ethics Forum: Patient Safety at Home—What Are Our Legal & Ethical Responsibilities?
A 60-year-old woman with a six-month history of retroperitoneal fibrosis transfers her care to you. She initially presented with severe bilateral flank pain radiating to the abdomen and chest. A computerized tomography (CT) angiogram of the abdomen demonstrated an infrarenal abdominal aortic aneurysm surrounded by a thick inflammatory rind entangling the left renal vein and…

Experts Offer Management Tips, from Contracts to Credentials to Audits
CHICAGO—Medical practice consultant Owen Dahl, MBA, LFACHE, CHBC, looked out at the rheumatology practice managers and physicians, sitting around tables with white tablecloths, and asked what seemed like a simple question: “How many of you have a strategic plan?” he asked. A single hand was raised. “One? How do you know where to go tomorrow…

New Tools for Myositis Diagnosis, Classification & Management
CHICAGO—At Hot Topics in Myositis, a session at the 2018 ACR/ARHP Annual Meeting, three experts discussed new classification criteria for idiopathic inflammatory myopathies (IIM) and offered practical primers on overlap myositis conditions and inclusion body myositis (IBM). New Myositis Classification Criteria After a 10-year development process, the new EULAR/ACR Classification Criteria for Adult and Juvenile…

Did Shiitake Mushrooms Induce Immune-Mediated Necrotizing Myopathy?
Idiopathic inflammatory myopathies are heterogenous, acquired immune-mediated muscle diseases. Over the past decade, immune-mediated necrotizing myopathy has been recognized as a subcategory of idiopathic inflammatory myopathy characterized by myofiber necrosis in the absence of prominent inflammatory cells.1 Autoantibodies against signal recognition particle (SRP) and 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) are thought to be associated with the…

At Vasculitis Conference, Patients Share Hope, Humor & Hardships
SEATTLE—At the first regional vasculitis patient conference ever held in the Pacific Northwest, a panoramic view of Mt. Rainier on a clear January morning set the tone for a day of optimistic talks about recent successes against the various forms of blood vessel inflammation. One attendee at the Jan. 12 conference, sponsored by the Vasculitis…

Mark Andrejeski, Longtime ACR Executive Vice President, Retiring
In March 1987, Mark Andrejeski moved from Columbus, Ohio, to Atlanta to lead a brand-new organization: the American Rheumatism Association (ARA). The professional association of rheumatologists had separated from the Arthritis Foundation 15 months earlier. “Initially, I was just trying to make sure the organization survived,” says Mr. Andrejeski, who studied business management and economics…

The ACR Supports Its Members Via Collaboration
We all know words can be powerful. They often resonate with several levels of meaning, enriching our understanding and broadening our perspective. Take the word promise, for example. It implies responsibility, as in, “We promise to do it.” It is also imbued with hope, as in “This idea has great promise.” At the ACR we…
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