Common variable immunodeficiency (CVID) is a common primary immunodeficiency disease, with an estimated incidence of one per 25,000–50,000 individuals.1 The classic presentation includes frequent bacterial infections, secondary to dysfunctional B cell differentiation, impaired immunoglobulin production and diminished antibody response. The clinical presentation may be heterogenous and may include granulomatous disease as an uncommon manifestation. Granulomatous…
A 26-year-old Peruvian woman presented to the emergency department of a large teaching hospital in Lima, Peru, with epistaxis and hematomas that had occurred over the preceding few days; she was found to have severe thrombocytopenia and a normocytic, normochromic anemia. She was treated with pulse doses of methylprednisolone; however, within two days, she presented…
More than 7 million doses of the Johnson & Johnson single-dose vaccine have been administered in the U.S.1 On Apr. 23, the Centers for Disease Control & Prevention (CDC) and the U.S. Food & Drug Administration (FDA) recommended lifting the recommended pause on Johnson & Johnson COVID-19 vaccine use following a thorough safety review. 2…
The Budget Control Act of 2011 cut Medicare physician payments by 2% across the board. The Coronavirus Aid, Relief, and Economic Security (CARES) Act, signed into law in 2020, suspended this sequester (i.e., a cut in government spending) between May 1 and Dec. 31, 2020. In the Consolidated Appropriations Act, signed into law in December…
Calciphylaxis, or calcific uremic arteriolopathy, is a rare disease characterized by calcification of the arterioles and capillaries in the dermis and subcutaneous tissue, resulting in thrombus formation and subsequent skin ischemia and necrosis.1 This serious condition most commonly occurs in patients with end-stage renal disease (ESRD) requiring dialysis or in kidney transplant recipients. In rare…
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,…
Have you ever asked a patient, “How’s your sex life?” If your answer is “No,” you’re not alone. The Centers for Disease Control and Prevention (CDC) finds healthcare providers don’t talk about sex with their patients for a variety of reasons: They feel uncomfortable discussing sex and sexuality with patients; They believe discussing sex will…
We know a large percentage of the U.S. population falls into a vaccine-hesitant group. In fact, only 60% of Americans plan to be vaccinated against COVID-19, according to an article in The Atlantic.1 Given that rheumatology patients are among the vulnerable, we asked a handful of ACR/ARP members whether they have been vaccinated themselves and…
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…
A new Medscape survey found that rheumatology has the second-highest burnout level among the 29 specialties included, with 50% of the rheumatology respondents saying they’re experiencing “burnout.” To which some rheumatologists are responding: Really? “I was quite surprised by this,” says Beth Jonas, MD, chief of the Rheumatology, Allergy and Immunology Division at the University…