Click here for the case. Discussion Image 1 demonstrates two nodules in the right lung, one over the lateral costophrenic sulcus (2.4 x1.7 cm, not shown); and another in the middle lobe (3.1 x 2.6 cm), with lobulated and spiculated margins (red arrow). There was no lymphadenopathy or pleural effusion. Of note, a normal chest…
Editor’s note: In this occasional feature, we first present a series of images (this page) for your review, and then a brief discussion of the findings and diagnosis. Before you read the discussion, examine these images carefully and draw your own conclusions. History A 39-year-old white woman with a three-year history of seropositive rheumatoid arthritis…
In your daily contact with rheumatology patients, you likely come across several who have type 1 or 2 diabetes. Are you doing all you can to maximize their treatment? Most physicians know about the damaging health effects of uncontrolled diabetes. From vision loss to kidney failure to nerve damage, those with diabetes require regular vigilance…
Baltimore—Rheumatologists and meteorologists share more in common than you might suspect, said Dr. Rebecca Manno, assistant professor of medicine for the Division of Rheumatology at Johns Hopkins University, Baltimore, and assistant director of the Johns Hopkins Vasculitis Center. At a March 8 meeting of the Maryland Society for the Rheumatic Diseases, Dr. Manno used the…
Rheumatologists often rely on magnetic resonance imaging (MRI) in the evaluation of suspected muscular diseases. Here, we describe a case in which unexpected findings on MRI pointed to a diagnosis rarely considered as a mimicker of rheumatologic disease. The Case A 19-year-old man of Middle Eastern descent was admitted to our hospital for evaluation of…
Calciphylaxis is a poorly understood and life-threatening ischemic vasculopathy characterized by calcification of the small- and medium-size arteries in the skin, subcutaneous tissue and internal organs, which leads to thrombosis, tissue necrosis and painful skin ulcerations that won’t heal. The disease has a 50–80% mortality rate. Although affected patients typically have end-stage renal disease (ESRD)…
A yearlong pilot study that evaluated the safety and efficacy of belimumab in a small group of patients with early diffuse systemic sclerosis found no significant difference in the number of adverse events between those treated with the drug and those who received a placebo. Currently, no drugs are approved specifically for the treatment of…
Eosinophilia is usually defined as an eosinophil count of more than 500/microL in peripheral blood.1 An eosinophil count of more than 1,500 is referred to as hypereosinophilia (HE); hypereosinophilic syndrome (HES) is defined as HE associated with organ dysfunction attributable to eosinophilia.2 Eosinophilia can occur due to infectious, malignancy, autoimmune or allergic etiologies. However, a…
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…
Immunoglobin G4-related disease (IgG4-RD) is a rare fibro-inflammatory disease of unknown etiology that has been recently recognized. It can cause fibro-inflammatory masses in almost every organ of the body and is associated with dense lymphoplasmacytic infiltration of IgG4-postitive plasma cells, storiform fibrosis and elevated levels of serum IgG4.1 IgG4-RD is a systemic disease that may…