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….
Case Report: Coccidioides Immitis Infects a Patient’s Vascular Graft
AÂ 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…
Predicting the Unpredictable – Taming the Impulse to Treat
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,…
Case Report: Lymphocytic Vasculitis of the Central Nervous System
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…
Reminder: How to Handle Part D Prior Authorization Requests
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,…
Tofacitinib Shows Early Potential for Treating Dermatomyositis
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…
Intensive Patient Education May Not Be Helpful for Acute Low Back Pain
Education with recommended first-line care may not improve pain outcomes in patients with acute low back pain. When comparing patients who received education with those who received professional consultation without information or advice, researchers found patient education was no more effective than placebo at reducing depression or incidence of chronic low back pain…
Intronic Polymorphism Associated with Risk of Neurological Disorders in SLE
Patients who develop neuropsychiatric symptoms of SLE have a small nucleotide polymorphism (SNP) in an intron in a Ca++ ion channel gene that influences some, but not all, events regulated by Ca++. The SNP appears to influence activation induced apoptosis rates and cytokine production, specifically IL-4, in a disease- and genotype-specific manner…
SLE Patients May Not Receive Enough Cardiovascular Disease Assessment & Treatment
Systemic lupus erythematosus (SLE) is associated with high rates of cardiovascular disease. However, research has shown that aggressive risk assessment with lipid screenings and treatment with statins may be suboptimal for these patients. A new study compared the rates of screening and treatment between SLE patients, diabetes mellitus patients and the general Medicaid population. The results: Despite having an elevated risk of CVD, SLE patients received less lipid testing and fewer statin prescriptions than other patients…
Moderate Liver Enzyme Elevation Found in Patients With & Without Hepatic Steatosis
Limited data are available on liver enzyme elevation in patients with RA, PsA and psoriasis being treated with tofacitinib and methotrexate. But early study findings are shedding light on the nature and risks of liver enzyme levels in these patients…
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