NEW YORK (Reuters Health)—Use of epidural steroid injections (ESIs) “should be approached with prudence,” particularly in patients who are at risk for osteoporotic fractures, such as women of postmenopausal age, according to authors of a systematic review. Although the literature presents a mixed picture, ESIs in doses as low as 80 mg methylprednisolone equivalents seem…

Social Media Campaign for Latin Lupus Sufferers
A person living with lupus may feel isolated. They receive information from their doctor, but it’s never enough to fully understand the disease. So where do they turn? Social media, where they can connect, share information and learn. A new social media initiative, Hablemos de Lupus—which translates to Let’s Talk About Lupus—focuses on sharing…

Fibromyalgia-Related Sleep Disorder Diagnosis & Treament Tips
When a patient has fibromyalgia, sleep troubles are the last thing they need. Unfortunately, sleep problems affect a large number of fibromyalgia patients, and those problems can turn into a vicious cycle that interplays with daytime pain and fatigue. “Pain and sleep disturbances are a double-edged sword,” says Elika Kormeili, MFT, a licensed clinical psychologist…
Fibrotic Diseases of the Retroperitoneum & Skin, & Rare Scleroderma Mimics
SAN DIEGO—Fibrosis affects all organ systems, but isn’t always systemic sclerosis. Experts on less common forms discussed patient presentations, diagnosis and treatment at the 2017 ACR/ARHP Annual Meeting in San Diego on Nov. 6. Retroperitoneal Fibrosis Formerly called Ormond’s disease, retroperitoneal fibrosis (RPF) is usually an IgG4-related disease, but has some unique characteristics, said John…

Can Rheumatologists Prescribe Exercise as Medicine?
SAN DIEGO—Exercise, within limits imposed by an individual’s circumstances, is an almost universally beneficial medical therapy. In fact, Teresa J. Brady, PhD, senior behavioral scientist with the federal Centers for Disease Control and Prevention’s Arthritis Program, labeled it “medicine” in a session on exercise at the 2017 ACR/ARHP Annual Meeting Nov. 3–8. Dr. Brady asked whether…

Tips for Treating Lupus-Related Renal Disease, Pain, Alopecia
SAN DIEGO—Rheumatologists who treat lupus patients gleaned tips on diagnosis and management of renal disease, painful neuropathies and alopecia at a “Curbside Consults” session held Nov. 6 at the ACR/ARHP Annual Meeting in San Diego. Membranous Lupus Nephritis Patients with refractory membranous lupus nephritis (MLN), or Class V lupus nephritis, face “significant morbidity, most of…

Lupus B Cell Research Points Toward Targeted Therapies
SAN DIEGO—B cell signaling goes awry in many patients with systemic lupus erythematosus (SLE), triggering pathogenic autoimmune responses and clinical disease. At the Rheumatology Research Foundation’s 2017 Evelyn V. Hess Memorial Lecture, held on Nov. 5 at the ACR/ARHP Annual Meeting, researcher Ignacio Sanz, MD, discussed B cells’ role in this complex disease. Because lupus…
New Lupus Classification Criteria Presented at ACR/ARHP Annual Meeting
SAN DIEGO—Proposed classification criteria for systemic lupus erythematosus (SLE), which are supported but not yet approved by the ACR and EULAR, debuted on Nov. 7 at the 2017 ACR/ARHP Annual Meeting. An international steering committee developed and validated the criteria, with patient input and the consensus of more than 150 global SLE experts. Researchers referred…

Autoimmune Inflammation Increases Risk of Heart Disease
SAN DIEGO—It’s no secret: Autoimmune, inflammatory rheumatic disease raises a patient’s risk of cardiovascular disease (CVD). “Inflammation may affect all aspects of the cardiac structure and function,” said Rekha Mankad, MD, FACC, director of the Women’s Heart Clinic at the Mayo Clinic in Rochester, Minn. Dr. Mankad also oversees a cardio-rheumatology clinic to assess and treat…

Case Review: Lupus Patient with Acute Disseminating Encephalomyelitis
Systemic lupus erythematosus (SLE) is an autoimmune-mediated rheumatic disease characterized by multisystem involvement that can cause significant morbidity and mortality. Acute disseminated encephalomyelitis (ADEM) is a rare, fulminant, autoimmune-mediated, demyelinating disease involving the white matter of the central nervous system (CNS), and is considered a manifestation of neuropsychiatric lupus. Few reported cases involve SLE and…
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