The Presentation A pale, quiet woman—her mother—wheeled the girl into my clinic. It was a blistering Florida day, and the girl was shivering. She glanced up at me when I said hello and asked her name. “Hi,” she said, giving me a broad smile. Her smile was the only broad thing about her. Her elbows…
It’s one thing for a developing country to lack physicians due to a scarcity of training. It’s quite another for such a vacuum to exist because the physicians were executed. In Cambodia in the 1970s, genocide perpetrated by the Khmer Rouge spared few of the educated class. If they were spared, chances were they lost…
SAN DIEGO—After sifting through the nitty-gritty of the rheumatic disease literature on basic science, Richard Pope, MD—professor of medicine specializing in rheumatology at Northwestern University Feinberg School of Medicine—underscored several findings he thought stood out from the pack in his Year in Review talk at the 2017 ACR/ARHP Annual Meeting. He reviewed findings from November…
Necrotizing autoimmune myopathy (NAM) is a relatively recently discovered subgroup of inflammatory myopathies. NAM is characterized by predominant muscle fiber necrosis and regeneration with little or no inflammation.1 One subgroup of NAM is 3-hydroxy-3-methylglutaryl-CoA reductase antibody (HMGCR Ab)-related immune-mediated necrotizing myopathy (IMNM), which occurs (rarely) after statin exposure, with a rough incidence of two per…
Mysterious Ways The juxtaposition of the old and the new was readily evident that busy Wednesday morning. My first patient, a 94-year-old gentleman, Hal, arrived with a precise request. His rheumatologist for the past 40 years had just retired, and he was searching for a doctor with expertise in the use of gold sodium aurothioglucose,…
During the ACR/ARHP Annual Meeting, Richard Pope, MD, highlighted some of the top scientific literature on rheumatic disease from 2017. The review session discussed research on the effects of microglia on the central nervous system of SLE patients, the role of adenosine in osteoarthritis and more…
Systemic sclerosis (SSc) is a disease characterized by immunologic abnormalities, microvascular involvement and tissue fibrosis. In previous studies, 10-year survival rates ranged from 50–84%. However, there are concerns that these studies, using prevalent cohorts, are underestimating mortality. “While the prognosis of many rheumatic diseases has improved with the availability of more effective and targeted therapies,…
Interest in viewing the nail capillaries dates to the late 17th century. Later research by Maurice Raynaud and others in the late 19th and early 20th century first established a direct link between the nailfold capillaries and certain medical conditions. Although underutilized in the past, with the advent of modern digital equipment and the validation…
MADRID—Research into pharmacodynamic biomarkers has shown that macrophages may have an important role in the pathogenesis of several diseases, including systemic sclerosis, an expert said at the 2017 Annual European Congress on Rheumatology (EULAR). The findings were discussed in a session that also covered how an understanding of M1 macrophages’ role in fibrosis has evolved…
Rheumatoid arthritis (RA) is a systemic autoimmune disease associated with erosive destruction of diarthrodial joints. Patients who are seropositive are more prone to developing extra-articular manifestations, such as rheumatoid lung, rheumatoid nodules and others. With the development of disease-modifying anti-rheumatic drugs (DMARDs), the incidence and severity of these extra-articular manifestations has declined. Below, we describe…