Granulomatosis with polyangiitis (GPA) was first described in the British Medical Journal in 1897 by Scottish otolaryngologist Peter McBride.1 GPA is a relatively rare, systemic necrotizing vasculitis that can make diagnosis challenging. The incidence has been estimated anywhere between two and 12 cases per million.2 GPA mainly affects adults between the ages of 45 and…
Preventing adverse outcomes in individuals who have rheumatic diseases is a daily goal for rheumatologists. For example, rheumatologists prescribe medications and perform screening to prevent erosions in rheumatoid arthritis (RA), renal failure in systemic lupus erythematosus and flares across all diseases. Many of these actions are classified as secondary or tertiary prevention, because individuals have…
Immunoglobin G4-related disease (IgG4-RD) is a rare fibro-inflammatory disease of unknown etiology that has been recently recognized. It can cause fibro-inflammatory masses in almost every organ of the body and is associated with dense lymphoplasmacytic infiltration of IgG4-postitive plasma cells, storiform fibrosis and elevated levels of serum IgG4.1 IgG4-RD is a systemic disease that may…
In 1866, Adolf Kussmaul, an internist, and Rudolf Maier, a pathologist, published the classic characterization of what eventually became known as polyarteritis nodosa.1 It was the first scientific clinical characterization of a noninfectious vasculitis. As such, it became a paradigmatic point of contrast to other types of vasculitides that were later described. Their description also…
This past June, a 64-year-old man with a history of psoriatic arthritis and severe arthritis appeared at our clinic for his regular follow-up with concerns about a letter from his insurance company. The letter stated the company wouldn’t pay for the patient’s secukinumab (i.e., Cosentyx) prescription anymore and suggested he take ixekizumab (i.e., Taltz) instead,…
There is an old adage that there are two types of people—lumpers and splitters. For some, people are easily categorized into liberal vs. conservative, Democrat vs. Republican, Donald Trump supporter vs. Hillary Clinton supporter. For others, everyone is a snowflake, and what makes us different is much more important than what makes us the same….
In the complex web of interactions between systemic inflammatory response, rheumatic disease and disease-modifying anti-rheumatic drugs (DMARDs), what is the potential for using rheumatologic therapies to treat other medical conditions linked to inflammation? Some medical researchers have looked at cardiac conditions, and others have examined the overlap with Alzheimer’s disease and other dementias. Positive effects…
Despite our best efforts and modern interventions, we still have patients in the intensive care unit with organ failure. Although renal failure can be mitigated by dialysis, patients with cardiac or respiratory failure secondary to active autoimmune disease raise difficult clinical and ethical issues. Two recent cases, both with organ failure, led us to examine…
SAN DIEGO—In a session at the 2017 ACR/ARHP Annual Meeting, Kam Nola, PharmD, MS, professor in the College of Pharmacy and vice chair in the Department of Pharmacy Practice at Lipscomb University in Nashville, Tenn., updated participants on new medications and new indications for rheumatology treatments and safety labeling changes approved by the U.S. Food…
SAN DIEGO—To manage patients with systemic lupus erythematous (SLE), rheumatologists must be aware of potentially serious complications affecting many organ systems. On Nov. 7 at the 2017 ACR/ARHP Annual Meeting, two experts offered insights on cardiovascular and hematological complications of lupus. Myocardial Disease in Lupus Lupus patients are at increased risk for heart-related complications, especially…