When rheumatologists think about rheumatoid arthritis (RA), they are apt to picture the synovium, contemplate such antibodies as rheumatoid factor and those to citrullinated proteins, and consider how this interplay of factors manifests in disease. What is not as commonly discussed is the role the autonomic nervous system plays in the pathogenesis and symptomatology of…
A 61-year-old white woman presented to our rheumatology clinic in New England to establish care in early June 2018, following a move from Texas. She reported a medical history of inflammatory bowel disease, uveitis and seronegative inflammatory arthritis, which was difficult to control and required the use of multiple medications. At her initial visit, she…
“‘I didn’t say there was nothing better,’ the King replied. ‘I said there was nothing like it.’” —Lewis Carroll, Through the Looking Glass “Why did I get this? Was it because of my diet? What should I eat now? What diet should I follow? Are there any natural treatments I can take instead of medications?”…
ACR CONVERGENCE 2020—In recent years, a pathophysiological role for the interleukin (IL) 17/IL-23 axis in the development of psoriasis, enthesitis and inflammatory arthritis has been investigated in both rodent and human models. Clinical trials have demonstrated differential benefits for skin disease and joint disease in patients with psoriatic arthritis, axial spondyloarthritis (axSpA) and ankylosing spondylitis…
Research from Ellingwood et al. examines how often patients diagnosed with early RA experience episodic joint inflammation and describes characteristics that may result in RA development.
Drug-induced lupus erythematosus and ANCA-associated vasculitis (AAV) are both autoimmune conditions associated with the use of hydralazine, a commonly prescribed drug for hypertension and congestive heart failure. Although the pathogenesis is unknown, it is believed that hydralazine alters neutrophil and lymphocyte function and promotes exposure of antigens, leading to the development of anti-neutrophil antibodies (ANCA)…
Two experts discussed ongoing difficulties in diagnosing autoinflammatory disease, & promising new studies that point to possible genetic roots of autoinflammatory disease.
Patients who do not fulfill classification criteria for systemic lupus erythematosus (SLE) can be referred to as having probable SLE (pSLE). These patients can be identified with cell-bound complement activation products (CB-CAPs), according to a recently published study in Arthritis & Rheumatology.1 The findings are relevant because the existing Systemic Lupus Erythematosus International Collaborating Clinics…
Tumor necrosis factor-α inhibitors (TNFi’s) have emerged as an integral part of therapeutic strategies for several rheumatic diseases. TNF-α is a pro-inflammatory cytokine implicated in the pathogenesis of rheumatoid arthritis (RA), seronegative spondyloarthropathies and inflammatory bowel disease (IBD). It also plays a central role in the immune response to mycobacterial infection. Many biologic agents, particularly…
Through the development of a multidisciplinary musculoskeletal institute, we have created a model that facilitates coordination of care of complex patients between medical and surgical subspecialists, physical therapists, dieticians and social workers. A case is presented to demonstrate the improved care experience for both patients and providers and to share our learnings more broadly. The…