The mother of a 15-year-old patient with juvenile idiopathic arthritis/enthesitis-related arthritis (JIA/ERA) called the office in tears. She said she was having an insurance problem. Her son had been a star track athlete when he developed severe back pain. Magnetic resonance imaging showed evidence of severe sacroiliitis. He was started on a tumor necrosis factor…
Nancy Bates Allen, MD, now professor emeritus, Duke University Medical School, Division of Rheumatology and Immunology, Durham, N.C., created a legacy of clinical care, clinical research, advocacy for women and collegial respect during her 42-year career at Duke. David S. Caldwell, MD, FACP, FACR, associate professor of medicine, Duke University School of Medicine, says, “[I’m]…
For most doctors, fellowship training represents the final two to three years of formal medical education, and recognition of the unique opportunities of this time period can help aspiring rheumatologists get the most out of their fellowship. Fellowship training is inherently different than residency training, with less structured time, smaller teams (often consisting of only…
NEW YORK (Reuters Health)—Immunomodulatory therapy is not recommended for most children with COVID-19 who typically will have a mild to moderate course of illness, experts advise in a guidance document in the Journal of the Pediatric Infectious Diseases Society.1 For children with severe or critical COVID-19, immunomodulatory agents “may be beneficial,” but the risks and…
A study from October 2019 describes the clinical characteristics of pediatric patients with undefined systemic autoinflammatory diseases. Researchers conducted a genetic analysis and outlined specific variants. They found patients with pericarditis and intellectual impairment may have distinct clinical phenotypes, which may lead to improved diagnostic and treatment options.
NEW YORK (Reuters Health)—A new study of multisystem inflammatory syndrome in children (MIS-C) shows that the immune system is profoundly altered during acute illness, but gradually returns back to normal. MIS-C is distinct from both COVID-19 and Kawasaki disease, but is associated with previous SARS-CoV-2 infection, the immunological profiling study reveals. Dr. Manu Shankar-Hari, an…
Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disease of immune dysregulation characterized by unchecked inflammatory responses leading to end-organ dysfunction. Primary HLH results from inherited mutations that impair the capacity for immune regulation; secondary HLH arises from the inappropriate response to an immune stimulus, such as infection, malignancy or autoimmunity. What is less well known is…
The ACR has released clinical guidance documents for pediatric patients with rheumatic disease in the context of the COVID-19 pandemic, including one for multi-system inflammatory syndrome in children (MIS-C). Jay Mehta, MD, MS, an attending physician in the Division of Rheumatology and director of the Pediatric Rheumatology Fellowship at the Children’s Hospital of Philadelphia (CHOP),…
NEW YORK (Reuters Health)—The COVID-19 pandemic has accelerated the expansion of telemedicine across the U.S., which has opened up access to doctor’s offices for families with limited resources. But at the same time, the health disparity gap could continue to widen unless safeguards are put into place, according to a pair of new editorials. “There…
With usual in-person fundraisers and meetings not possible during the pandemic, RheumPAC is finding creative ways to keep advocating for influential legislation and ensure rheumatology’s voice is heard in Washington, D.C.