Granulomatosis with polyangiitis (GPA) is a primary, necrotizing granulomatous vasculitis, involving small- to medium-sized arteries, that causes systemic disease. Almost any organ can be affected, but the most affected systems are the upper airways, lungs, kidneys, eyes and peripheral nerves. Migratory polyarthritis is reported in approximately 25% of patients with anti-neutrophil cytoplasmic antibody (ANCA) associated…
Studies related to acupuncture and tai chi show some benefits for patients with musculoskeletal disorders, such as fibromyalgia and osteoarthritis. When patients ask about these integrative health approaches, rheumatologists should recommend they use qualified, experienced practitioners.
Biosimilars have become a therapeutic turning point for many patients who are living with rheumatic illnesses. Psoriatic arthritis (PsA) is a complex, multi-faceted chronic inflammatory musculoskeletal and skin disease where the treatment has changed considerably over the past few years. Psoriatic arthritis has an impact on about 30% of people with psoriasis.1 In 2019, the…
“What are you up to this weekend?” “Flying to Guam.” “What? Why?” “I promised an entire island I’d be their doctor.” In fall 2021, Jonathon Thorp, MD, phoned a friend. A passionate internist, he was bound and determined to bring a rheumatologist to Guam. Unlike most primary care providers (PCPs), he was willing to prescribe…
Over the past decade, a number of pilot studies have provided proof of concept for the use of vagus nerve stimulation (VNS) to treat rheumatic conditions. The studies represent an expansion of this treatment approach into rheumatology, building on years of scientific inquiry into the mechanisms of VNS on disease states that led to preclinical…
Neuro-rheumatology is a fast-growing field. Better testing and imaging have increased recognition of once-infrequent diagnoses, such as neuro-sarcoidosis and amyloid beta-related angiitis. Concurrently, the rapid expansion of immunotherapy options to treat cancer and their untoward neurological side effects have increased the frequency of referrals to both neurologists and rheumatologists. Identifying and treating neurologic manifestations of…
Granulomatosis with polyangiitis (GPA) is a type of anti-neutrophil cytoplasmic antibody (ANCA) associated small vessel vasculitis that typically affects the kidneys, lungs and sinuses.1 Due to an overlap in signs and symptoms, GPA may initially be difficult to distinguish from IgG4-related disease, another condition that can affect multiple tissues and has variable presentations. Further complicating…
Spam, spam, advertisement, spam … wait wait, what’s this? A small envelope, addressed from Maine. I wonder what this is about? Usually, when I get an envelope this size, it’s a letter from someone trying to sell me something or complain about something I have no control over. So imagine my surprise when I found…
In a small study, an anti-inflammatory diet helped reduce pain and swelling in a subset of people with rheumatoid arthritis (RA). Diet changes are complementary to standard treatment. Diet-related research can be challenging, but many patients with RA are motivated to try healthy changes.
A minority of patients experience lingering symptoms after infection with SARS-CoV-2, similar to some other previously known post-infection syndromes. Although we are just beginning to understand the different presentations, pathophysiology, risk factors, prognosis and treatment of long COVID, rheumatologists can play a leadership role in managing patients with the illness and contributing to this important research…