NEW YORK (Reuters Health)—Self-monitoring of methotrexate therapy may curb healthcare utilization in rheumatoid arthritis (RA) and psoriatic arthritis, according to a new trial. The study indicates “that this novel model of care led to significant reductions in outpatient visits to the (clinical nurse specialist) and a reduction in visits to the GP, while maintaining the…
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Depression May Increase Risk of Cardiovascular Disease for RA Patients
(Reuters Health)—Mental health problems, like anxiety and depression, may partly explain why people with rheumatoid arthritis have an increased risk of cardiovascular disease, according to a new study. Researchers linked anger, anxiety, depressive symptoms, job stress and low social support to increasing risk of hardening of the arteries, or atherosclerosis, for people with rheumatoid arthritis…

Epratuzumab Results Disappointing, but Adalimumab Promising
Two Phase 3 trials have shown that epratuzumab did not meet its primary endpoints for treating SLE. Meanwhile, a Phase 3 study has shown adalimumab is effective for treating enthesitis-related arthritis in juveniles…

RA Diagnosis Uses Lab Tests, Clinical Insight to Rule Out Lyme
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…

Fellow’s Forum Case Report: Aneurysm in Takayasu’s Arteritis
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…

Catastrophic Antiphospholipid Syndrome with Pulmonary Hemorrhage: A Case Report
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…

Can Systemic Inflammation Influence Mood?
The Friday night press release: When a politician or any public figure needs to disclose unfavorable news, chances are they will release it sometime on a late Friday afternoon or evening, hoping that nobody is paying attention. In fact, this behavior was coined “the take out the trash day” on the television political drama, The…

7 Tips for New Rheumatology Fellows
About a year ago, I stuffed all my earthly belongings into my black Volkswagen Jetta and set out on a 10-hour interstate journey. I had just graduated from residency at the University of Kentucky and was headed westward, to Iowa City, for a fresh start as a rheumatology fellow. During the 10 hours I spent…
Rheumatology Coding Corner Question: Office Visit for Chronic Idiopathic Gout
Follow-up Visit with Time A 62-year-old male patient returns to the office for a follow-up visit for chronic idiopathic gout without tophi. The patient’s present uric acid level is 4.0, and he is now taking allopurinol 450 mg per day. Previously, he was taken off indapamide due to an increase in his uric acid. He…

Intensive Program Relieves Symptoms of Juvenile Fibromyalgia
Pain can be reduced and functionality significantly improved for children with fibromyalgia without drug therapy, according to a study of 64 children in Philadelphia. Researchers combined intensive physical therapy and psychotherapy in individualized programs to treat the fibromyalgia patients…
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