I often think about medical literature as a sprawling metropolis. There are towering skyscrapers of randomized controlled trials, lofty schools of systematic reviews and meta-analyses, and verdant parks of qualitative studies. Much less assuming are the case reports, which are sort of like homesteads for the majority of people who publish and contribute to the…
Anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis is a rare autoimmune condition characterized by inflammation of small- and medium-sized vessels. ANCA-associated vasculitis can lead to multisystem organ complications, including life-threatening pulmonary hemorrhage, renal failure and death. We present a case of ANCA-associated vasculitis complicated by complement-mediated thrombotic microangiopathy (c-TMA). Of the rheumatic diseases, systemic lupus erythematosus…
In this case report, a patient with voriconazole-induced periostitis exhibits classic symptoms & elevated ALP levels, which quickly resolve following the discontinuation of voriconazole.
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.
Autoimmune rheumatic diseases (AIRDs) are known for their systemic presentations and multi-organ involvement. Numerous infectious diseases, particularly mycobacterial, fungal and indolent bacterial infections endemic to specific geographic regions, present with varied signs and symptoms of multi-system involvement and can mimic AIRDs. Thus, differentiating infection from an AIRD is critical to resolve competing treatment approaches. This…
Renal osteodystrophy is associated with chronic kidney disease (CKD) and its associated metabolic derangements, most commonly CKD stages 3–5. It is often subclassified into four histological subtypes, with definite distinctions unable to be made clinically. These four subtypes, which may only be differentiated by bone biopsy, include: osteitis fibrosa cystica, mixed uremic osteodystrophy, osteomalacia and…
“Our patients’ goals for their care aren’t always the same as ours. We’re typically focused on disease control, and they’re often focused on quality of life. Having ongoing discussions about care goals is the only way to know when it’s time to switch gears. Would you know when to refer your patients to palliative care?…
Granulomatosis with polyangiitis (GPA) is a small vessel vasculitis associated with anti-neutrophil cytoplasmic antibodies (C-ANCA), specifically proteinase 3 (PR3) ANCA. GPA classically presents with multi-organ involvement. The first description of GPA defined a triad of features: 1) systemic necrotizing angiitis, 2) necrotizing inflammation of the respiratory tract and 3) necrotizing glomerulonephritis.1 Few cases of digital…
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…
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…