Many practitioners can relate to the epiphany of Roy Basch, MD, the lead character in Samuel Shem’s satirical novel The House of God.1 During his first on-call shift as a medicine intern, long work hours combined with jaded advice from his senior resident leave Dr. Basch feeling disenchanted with the medical profession until he cares…
Laura Coates, MBChB, MRCP, PhD, described & compared the intricacies of different outcome measures, as well as implications for clinical practice & trials, for patients with psoriatic arthritis.
Common variable immunodeficiency (CVID) is a common primary immunodeficiency disease, with an estimated incidence of one per 25,000–50,000 individuals.1 The classic presentation includes frequent bacterial infections, secondary to dysfunctional B cell differentiation, impaired immunoglobulin production and diminished antibody response. The clinical presentation may be heterogenous and may include granulomatous disease as an uncommon manifestation. Granulomatous…
Dermatomyositis is an uncommon autoimmune condition involving skeletal muscle characterized by subacute onset of progressive weakness, intramuscular inflammatory infiltrates and the presence of myositis-specific autoantibodies.1 Immune-mediated myopathies may exert some pathogenic effects on the muscle tissue by targeting the microvasculature.1 Capillary inflammation, fragility and loss may contribute to heightened bleeding events in these patients. Here,…
As we emerge from the grips of a global pandemic, we are taking this opportunity to pause and reflect on the ARP and what our division brings to the care of our patients. I found the words of Amanda Gordon’s inaugural reading of her poem, “The Hill We Climb,” inspirational and instructive for our past,…
Clinicians can help their patients tap into personal resilience, and such characteristics as grit, gratitude and grace, to manage their chronic pain, says Afton L. Hassett, PsyD.
A 24-year-old woman presented to our rheumatology office in 2017 with a blotchy purple rash on her arms and legs. She reported no history of miscarriage or blood clots. The rash pattern was concerning for livedo reticularis or livedo racemosa, and she was noted to have an anti-nuclear antibody (ANA) titer of 1:160 with a…
ACR CONVERGENCE 2020—Myalgic encephalomyelitis/chronic fatigue syndrome, postural orthostatic tachycardia syndrome (POTS) and mast cell activation syndrome were the topics of the day in the ever-popular Curbside Consults session in November 2020. POTS An anxious woman with a chronic headache and constant myofascial pain in the neck and upper back, assorted gastrointestinal symptoms, chronic severe fatigue,…
The occurrence of opportunistic infections is an established complication in patients diagnosed with systemic lupus erythematosus (SLE). The foremost challenge in such circumstances is differentiating between an exacerbation or progression of SLE, and the effects of the infection itself.1 Toxoplasma gondii is a ubiquitous parasite that often causes an asymptomatic infection in healthy, immunocompetent adults….
In phase 3 clinical trial, upadacitnib proved superior to placebo and adalimumab in improving the signs and symptoms of RA in patients on stable background methotrexate.