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…
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…
CHICAGO—The 2018 ACR/ARHP Annual Meeting session on genetic mimics of rheumatic disease began with a description of a patient who presented with the symptoms of childhood-onset lupus but instead had a well-defined genetic disease: lysinuric protein intolerance (LPI). Lindsay Burrage, MD, PhD, assistant professor of molecular and human genetics at Baylor College of Medicine, Houston,…
CHICAGO—Held during the 2018 ACR/ARHP Annual Meeting, the ACR Review Course covered a wide range of topics for rheumatologists—from advances in pain and rheumatic disease management to the intersection of rheumatology and neurology. Session speakers shared insights, as well as state-of-the-art approaches to diagnosis, management and treatment. Inflammatory Myopathies Julie J. Paik, MD, MHS, assistant…
CHICAGO—The treatment of patients with juvenile idiopathic arthritis (JIA) is historically directed by clinical subtype. During a session at the 2018 ACR/ARHP Annual Meeting, speakers addressed the biological classification and treatment of JIA, discussing draft guidelines and recommendations, the impact of computer modeling on identifying JIA subtypes and subgroups of chronic arthritis. Guidelines & Recommendations…
Editor’s note: In this recurring feature, we first present a series of ultrasound images for your review, and then a brief discussion of the findings and diagnosis. Before you scroll to the discussion, examine these images carefully and draw your own conclusions. History A 2-year-old boy with a history of multiple strokes and vertebral artery…
Research has found age at disease onset has an impact on prognosis for patients with primary Sjögren’s syndrome. In the study, early onset primary Sjögren’s syndrome was associated with severe, systemic disease and development of lymphoproliferative disease…
What does a new patient experience as symptoms develop and diagnosis is confirmed? The ARP Practice Committee is developing persona-based case studies to help answer this and other questions. The latest topic is juvenile idiopathic arthritis…
CHICAGO—When it comes to correctly diagnosing joint pain in children, “things take time,” said Michael L. Miller, MD, quoting Danish physicist and poet Piet Hein. Children with pain but normal physical examinations may need to return to the clinic for repeat evaluation over several months. “I often tell parents that laboratory tests may help in…
BETHESDA, MD—Rheumatologists from the National Institutes of Health (NIH) and from Jerusalem, Israel, have identified deficiency of adenosine deaminase 2 (DADA2) as an important cause of familial polyarteritis nodosa, which tends to present in childhood and can manifest with hematologic, immunologic and inflammatory signs, says Chip Chambers, MD, founder and president of the DADA2 Foundation….