CHICAGO—To drive home the importance of how social determinants can make or break a person’s health, Jillian Rose, LCSW, MPH, the director of community, engagement, diversity and research at the Hospital for Special Surgery in New York City, told a story about a gardener planting flowers at the 2018 ACR/ARHP Annual Meeting. In the story,…
CHICAGO—With an ever-strengthening foundation beneath the pathophysiology and prediction of rheumatoid arthritis (RA), the field may soon focus more intently on prevention, an expert said at the 2018 ACR/ARHP Annual Meeting. The session also covered the latest in remission targets and therapy de-escalation. RA Prevention Kevin Deane, MD, PhD, associate professor of medicine and principal…
CHICAGO—Although rare, when a patient has both primary immune deficiency and autoimmune disease, the combination can lead to life-threatening complications requiring careful, long-term therapy. In When Immune Deficiency and Autoimmunity Coexist, a session at the 2018 ACR/ARHP Annual Meeting, M. Eric Gershwin, MD, the Jack and Donald Chia professor of Medicine and chief of Rheumatology,…
CHICAGO—When it comes to correctly diagnosing joint pain in children, “things take time,” said Michael L. Miller, MD, quoting Danish physicist and poet Piet Hein. Children with pain but normal physical examinations may need to return to the clinic for repeat evaluation over several months. “I often tell parents that laboratory tests may help in…
BETHESDA, MD—Rheumatologists from the National Institutes of Health (NIH) and from Jerusalem, Israel, have identified deficiency of adenosine deaminase 2 (DADA2) as an important cause of familial polyarteritis nodosa, which tends to present in childhood and can manifest with hematologic, immunologic and inflammatory signs, says Chip Chambers, MD, founder and president of the DADA2 Foundation….
A 76-year-old Caucasian male with a history of abdominal aortic aneurysm repair five years earlier presented with three months duration of worsening periumbilical abdominal pain associated with nausea, non-bloody emesis, decreased appetite, fatigue and a 40 lb. weight loss. He denied having fever, chills, night sweats, temporal headaches, vision loss, chest pain, shortness of breath and…
One of my fellows could take better care of his patients if it weren’t for the attendings getting in his way. Or so he tells me. I can hear the howls of protest already. This statement isn’t fair—it is too broad, it doesn’t fairly depict the nuances of the situation or his point of view. First,…
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…
Note: Although originally posted in January 2018, the advice below remains valid. We see this issue recur each year. As we begin another new year, many rheumatology practices will again receive prior authorization requests from Medicare Part D for all methotrexate prescriptions. When methotrexate is used as a chemotherapeutic drug, it’s covered by Part B,…
A proof-of-concept study including 10 patients treated for dermatomyositis with tofacitinib, an FDA-approved drug for RA and psoriatic arthritis, shows strong clinical efficacy…