RheumMadness is an online tournament in which a bracket of teams, representing key learning concepts in rheumatology, compete against each other in a series of head-to-head matchups, much like basketball teams in the NCAA’s March Madness. The 2023 tournament theme was The All Star Season. Each team represented one all star article competing to be…
How does a rheumatologist treat a pregnant woman when many medications are not approved for pregnancy or safety data are limited?
Historically, the early approach for treating interstitial lung disease (ILD) due to systemic sclerosis (SSc) involved immunosuppressant therapy, primarily with cytotoxic agents.1 Glucocorticoids in combination with another immunosuppressant agent, such as oral azathioprine or cyclophosphamide, were often used to treat patients with severe, progressive SSc-ILD.2 However, direct evidence to support this therapeutic approach was lacking…
Vasculitis is a group of chronic inflammatory diseases in which the blood vessel is the target of an immune reaction. They can be secondary to connective tissue disease, idiopathic or due to infection, neoplasm or drugs.1 Primary angiitis of the central nervous system (PACNS) is a rare syndrome characterized by inflammatory cell infiltration and necrosis…
Varicella-zoster-virus (VZV) reactivation, which can cause patients to develop herpes zoster (i.e., shingles), occurs more frequently in patients with systemic vasculitis and systemic lupus erythematosus (SLE) who have received intravenous cyclophosphamide than in otherwise healthy adults, according to a retrospective study published in The Journal of Rheumatology by researchers in France.1 The study also shows…
I glanced up from Amanda Wolf’s chart as the emergency department nurse, followed by the lab technician (tech), followed by the electrocardiogram (ECG) tech flowed into cubicle No. 5. John Benner, MD, pulled up a chair to review the case with me at the nursing station. “Here’s what we’ve got. Thirteen-year-old girl with a one-week…
CHICAGO—About 30 years ago, pulmonary arterial hypertension (PAH) and interstitial lung disease (ILD) began to outpace renal crisis as the main causes of death in scleroderma (SSc). But treating these lung complications has proved vexing for clinicians. There is no easy way to predict who will develop PAH. There is no telltale antibody and no…
Patients with scleroderma, systemic sclerosis (SSc), myositis and rheumatoid arthritis (RA) may develop interstitial lung disease (ILD), which affects a patient’s breathing and quality of life. Prospective studies have revealed that in patients with SSc a greater rate of decline of forced vital capacity (FVC) is associated with increased mortality. Although corticosteroids are commonly used…
A recent systematic review found no clear evidence that rheumatoid arthritis patients treated with cyclophosphamide have better lung function than those treated with mycophenolate mofetil. The researchers caution that physicians should expect treatment with cyclophosphamide may only result in a modest improvement in the preservation of forced vital capacity…
According to a large cohort study of pediatric patients, rituximab use is on the rise in the treatment of children diagnosed with vasculitis. Treatment with cyclophosphamide remains common, but it’s beginning to wane. Dialysis and mechanical ventilation also remain common, the study indicates. The retrospective study of hospitalized children in the U.S. included the largest…