NEW YORK (Reuters Health)—Clinicians’ expectations of the benefits and harms of a wide range of treatments and tests are rarely accurate, according to a new study. “There was variation—with benefits and harms sometimes being overestimated and sometimes being underestimated; but there was a tendency for clinicians to more often underestimate (rather than overestimate) harms and…
Rheumatology Case Report: Systemic Capillary Leak Syndrome and Rheumatoid Arthritis
Systemic capillary leak syndrome (SCLS) is a very rare disorder, characterized by recurrent episodes of severe hypotension, hypoalbuminemia and hemoconcentration.1 Attacks of SCLS occur in three phases: 1) prodrome; 2) hypovolemia with weight gain; and 3) hypervolemia with fluid overload and polyuria often complicated by pulmonary edema. Often, compartment syndrome can lead to rhabdomyolysis as…
Systemic Corticosteroid Usage in Stage 4 Pulmonary Sarcoidosis Could Offer Little Benefit, Pose Significant Health Risk
Depending on stage, severity and rate of progression of disease, systemic corticosteroids are commonly used to treat pulmonary sarcoidosis. However, a review of the literature suggests they have limited usefulness in advanced stage IV pulmonary sarcoidosis. Once sarcoidosis has advanced to this degree, steroid use may unnecessarily expose a patient to life-threatening complications, as demonstrated…
Ocular Disease Monitoring Critical to Avoid Retinal Toxicity from Hydroxychloroquine
Both due to its efficacy and favorable side effect profile when compared with alternative drugs for rheumatologic conditions, hydroxychloroquine is an important agent in rheumatologists’ armamentarium. However, one barrier to hydroxychloroquine use can be its effects on the eye (also see “Revised Retinopathy Screening Guidelines,”). Ocular side effects of hydroxychloroquine can include impact on the…
Fellow’s Forum Case Report: Waldenström Macroglobulinemia
A 73-year-old white male presented with a one-day history of a cold, painful, right foot. The foot had a blue discoloration to it, particularly the toes. The emergency physician suspected an atheroembolic cause, given this patient’s age and history of coronary artery disease. However, the patient also reported a one-year history of painful pallor in…
Research Underscores Need to Assess Oral Health in Patients with Systemic Sclerosis
Oral health is not frequently considered within the sphere of a rheumatologist’s practice. However, recent results published by the Canadian Scleroderma Research Group (CSRG) point out the importance of assessing oral health in patients with systemic sclerosis (SSc). Result of 3-Year Grant Between 2008 and 2011, 163 patients with SSc and 231 controls were entered…
Rheumatology Patient, Investigator Reflect on Advancements in Lupus, Rheumatoid Arthritis Treatments
In 1969, Martha Lovato passed away from renal failure due to complications of lupus. Martha was 18 years old and survived only two years following her diagnosis. At the time, Martha’s disease was still a mystery to many physicians and researchers. Her treatment options were limited. In fall 2004, after an unprecedented battle with shingles…
Pharmacokinetics May Be Factor in Success of Pegloticase Therapy for Gout
We read the case report by Dr. Diana Girnita and colleagues (“Severe Refractory Gout: What options are left when pegloticase fails?” The Rheumatologist, August 2016) with interest. A case is reported of a subject with 20 years of chronic refractory gout who failed to respond to pegloticase therapy, and the potential roles of anti-drug antibodies or…
New Large-Vessel Vasculitis Therapies Emerge, but Better Options Still Needed
LONDON—New therapies are emerging for the two main forms of large-vessel vasculitis, giant cell arteritis (GCA) and Takayasu’s arteritis—particularly biologic therapies. But for just about every available treatment gap, drawbacks or limited evidence remain, with the results needing to be borne out in larger trials, an expert said at the Annual Congress of the European…
As Role of Kinase Inhibitors in Rheumatic Disease Treatment Expands, Experts Review Therapy’s Failures, Successes
LONDON—Kinase inhibitors’ profile in the world of rheumatic disease therapy is growing, and they are probably going to play an even larger and more central role as time goes on, experts said at the Annual Congress of the European League Against Rheumatism (EULAR) 2016. But Gary S. Firestein, MD, director of the Clinical and Translational…
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