Here, we present a case of inflammatory cerebral amyloid angiopathy, discussing its diverse clinical manifestations, diagnostic challenges in view of recently proposed clinical-radiologic criteria and its management.
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The 7 Virtues of Rheumatology We Should Cultivate
1949 was a momentous year—astronomer Fred Hoyle coined the term Big Bang, the North Atlantic Treaty Organization (NATO) was formed, and Rodgers and Hammerstein’s classic musical South Pacific opened on Broadway.1 Much less recognized was the publication of an essay by Richard Asher, FRCP, titled the “Seven Sins of Medicine.”2 Although it’s over 75 years…
Role Reversal: When the Doctor Becomes a Patient
It was like a reverse Uno card had been thrown onto the table. My patient was now asking his rheumatologist, “Are you okay? You look like you’re in a lot of pain.” He was right. I was wincing trying to get up from my seat and limping trying to get a few steps over to…
The ACR and CHEST Release 2 New ILD Guidelines
Clinicians should not rely on glucocorticoids as a first-line treatment of SARD-ILD in patients with systemic sclerosis, according to a strong recommendation in a new ILD treatment guideline from the ACR and CHEST. The guideline is one of two addressing the screening, monitoring and treatment of patients with interstitial lung disease (ILD) secondary to systemic autoimmune rheumatic diseases (SARDs).
Case Report: Diaphragm Ultrasound Reveals Shrinking Lung Syndrome
Shrinking lung syndrome (SLS) is a rare cause of dyspnea that has been most commonly described in patients with systemic lupus erythematosus (SLE), but is also found in systemic sclerosis, Sjögren’s disease and rheumatoid arthritis. Shrinking lung syndrome is characterized by a restrictive pattern on lung spirometry, despite normal lung parenchyma, and an elevated diaphragm.1…
A Case of Lupus Podocytopathy
Kidney involvement is a major cause of morbidity and mortality in systemic lupus erythematosus (SLE). Collectively termed lupus nephritis, SLE with kidney involvement comes in many subtypes. The current classification by the International Society of Nephrology/Renal Pathology Society (ISN/RPS), however, does not include lupus podocytopathy, which, through various clinical and epidemiologic studies, has recently been…
Noncoding Self-RNA Implicated in Lupus Development
In 2022, an international group of researchers reported the seminal finding that a gain-of-function variant of a single-stranded ribonucleic acid (RNA) sensor, known as toll-like receptor 7 (TLR7), can cause human systemic lupus erythematosus (SLE).1 The paper in Nature showed that a newly described variant of TLR7, identified in a child with severe lupus, was…
When Rheumatologists Have Rheumatic Diseases
“I think we learn from medicine everywhere that it is, at its heart, a human endeavor, requiring good science but also a limitless curiosity and interest in your fellow human being, and that the physician-patient relationship is key; all else follows from it.”1 These profound words from Abraham Verghese, MD, MACP, Linda R. Meier…
Mental Health in Rheumatology
Regaining a sense of control, limiting responsibilities and engaging in mindfulness can help rheumatologists manage their mental health needs. Rheumatologists should also address the mental health concerns raised by their patients. Here are insights from a psychiatrist/rheumatologist.
The Roles of the Interdisciplinary Rheumatology Team in Patient Care Highlighted
To work together effectively, clinicians and rheumatology professionals need to understand the roles of every member of the interdisciplinary team. To enhance this understanding, the ARP Interprofessional Practice & Management Committee has undertaken a project to describe the modern roles of members of the interdisciplinary team in a series of fact sheets. The first three…
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