Systemic capillary leak syndrome (SCLS) is a very rare disorder, characterized by recurrent episodes of severe hypotension, hypoalbuminemia and hemoconcentration.1 Attacks of SCLS occur in three phases: 1) prodrome; 2) hypovolemia with weight gain; and 3) hypervolemia with fluid overload and polyuria often complicated by pulmonary edema. Often, compartment syndrome can lead to rhabdomyolysis as…
My nurse, Joanne, took me aside before I began my next consult. “Room No. 5, breast implant patient. Her lawyer organized the records.” She handed me a hefty three-ring notebook organized by color-coded tabs. “Her attorney called just now,” Joanne raised an eyebrow, “and told me to tell you that, to save time, he highlighted…
Glucocorticoids are widely prescribed by rheumatologists, and the effects of daily and cumulative doses of these drugs on bone mineral density (BMD) are important elements of a draft clinical guideline document presented on Nov. 13 at the 2016 ACR/ARHP Annual Meeting in Washington, D.C. Leaders of the ACR guideline project discussed their recommendations at the…
When treating adolescent patients who are making the important, sometimes bumpy crossing from a pediatric to an adult rheumatology practice, there’s no one-size-fits-all approach. “We have to be flexible on the receiving end when talking with these patients, and flexible with their families, too,” says Peter A. Nigrovic, MD, director of the Center for Adults…
NEW YORK (Reuters Health)—Geolocation and ethnicity exert a “strong influence” on the phenotype of primary Sjogren’s syndrome, researchers report. “The influence of ethnicity on the phenotypic expression of systemic autoimmune diseases has been suggested by various studies, especially in systemic lupus erythematosus, which has been reported as being more frequent and having less favorable outcomes…
Using metabolomic profiling of fecal samples of children with enthesitis-related arthritis (ERA), researchers found that children with ERA may have lower levels of tryptophan metabolites. This finding may be attributable to differences in the gut microbiota that contribute to their pro-inflammatory phenotype…
“Obesity is an inflammatory state, so it is in the landscape of the rheumatologist,” says Christopher Ritchlin, MD, MPH. And the more attention rheumatologists pay to obesity, the better…
NEW YORK (Reuters Health)—Compared with cyclophosphamide, rituximab treatment poses less malignancy risk in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), European researchers report. Dr. Emma E. van Daalen of Leiden University Medical Center in the Netherlands tells Reuters Health, “Previous studies reported an increased malignancy risk in patients with AAV, which has been associated…
A study of knee and hip articular cartilage found that thick fibers were bundles of thin fibrils—like a multi-thread rope in which each thread corresponds to a prototypic sub-fibril. The organization of the fibers also differed between the cartilages of distinct tissues, which may explain how a breakdown in the fiber pattern contributes to pathology…
The FDA is considering an application for subcutaneous rituximab and has approved an application for etanercept to treat pediatric patients with plaque psoriasis…