Patients with autoimmune diseases, such as spondyloarthritis, are at risk of developing inflammatory bowel disease. Here are considerations for its management and treatment.
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IgG4-Related Disease: The Latest On Its Presentation, Diagnosis & Management
In 1888, Dr. Jan Mikulicz-Radecki reported a case of chronic, bilateral, painless enlargement of the salivary and lacrimal glands that appeared to be idiopathic.1 In subsequent years, other patients with these findings were reported, and the term Mikulicz syndrome was used to describe these cases. Although Mikulicz syndrome is now known to be associated with…
A 2021 Update on Lupus Management & Treatment
At the 2021 ACR State-of-the-Art Clinical Symposium, Saira Sheikh, MD, associate proÂfessor of Medicine and director of the Rheumatology Lupus Clinic, University of North Carolina, Chapel Hill, provided an update on the past, present and future of the management of systemic lupus erythematosus (SLE). This year, hydroxychloroquine received a great deal of attention, given early…
7 Key Insights Into the Evaluation of Central Nervous System Vasculitis
Many a rheumatology consult has centered on a perplexing question: Does this patient have central nervous system (CNS) vasculitis? At the 2021 ACR State-of-the-Art Clinical Symposium, Rula Hajj-Ali, MD, FACP, professor of medicine and associate director of vasculitis care and research, Cleveland Clinic Lerner College of Medicine, discussed this topic in detail, providing a series…
A Mystery Case of Abdominal Masses
Common variable immunoÂdeficiency (CVID) is a common primary immunoÂdeficiency disease, with an estimated incidence of one per 25,000–50,000 individuals.1 The classic presenÂtation includes frequent bacterial infections, secondary to dysfunctional B cell differÂentiation, impaired immunoglobulin production and diminished antibody response. The clinical presentation may be heterogenous and may include granulomatous disease as an uncommon manifestation. GranuloÂmatous…
Case Report: A Rare But Severe Complication of Dermatomyositis
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,…
Study: Can Avacopan Replace Steroids in ANCA-Associated Vasculitis?
A phase 3 trial described in The New England Journal of Medicine (NEJM) highlights the potential of a C5a receptor inhibitor, avacopan, for anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis.1 Avacopan may potentially offer a steroid-sparing option for the treatment of this serious disease. Current Treatment of ANCA-Associated Vasculitis Morbidity and mortality from ANCA-associated vasculitis have…
ACR, Ophthalmologists & Dermatologists Issue Joint Hydroxychloroquine Statement
Since 1991, hydroxychloroquine (HCQ) has been a staple for the treatment of patients with systemic lupus erythematosus; it has been shown to improve survival, reduce cardiovascular risk, thrombosis and renal damage, delay or prevent lupus cerebritis and more. However, HCQ can potentially bind in the retinal pigment epithelium and cause degeneration of photoreceptors, leading to…
Extreme & Uncontrollable Circumstances Application for 2020 Merit-Based Incentive Payment System Reopened
The Centers for Medicare & Medicaid Services reopened the Extreme & Uncontrollable Circumstances application and indicated they will automatically apply the policy to individuals who do not submit data for 2020 Merit-based Incentive Payment System.
Case Report: Mycosis Fungoides in Dermatomyositis
Dermatomyositis (DM) is an idiopathic inflammatory myopathy involving proximal muscle weakness and skin rash. An associated increased risk of malignancy is well established.1 The most frequent malignancies are related to the ovary, endometrium, lung, gastrointestinal tract, prostate, breast and lymphatics.2 On rare occasions, DM has been reported with certain types of non-Hodgkin’s lymphoma, specifically cutaneous…
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