I’m writing in regard to the article, “Fever of Unknown Origin” (TR, March 2016), by Charles Radis, DO. In regard to the non-caseating granulomas, there was no mention of epithelioid or giant cells. In addition, it was mainly [complement] C4 in the center of the granulomas, which is often found in sarcoidosis. Moreover, whether these…
Rheumatoid Arthritis & Autoimmune Glomerulonephritis
Rheumatoid arthritis (RA) is rarely associated with renal manifestations, but secondary amyloidosis due to chronic inflammation is reported to be the etiology of renal dysfunction in many cases of RA.1,2 The discovery of biologic therapy, with TNF-alpha inhibitors in particular, made a huge difference in the disease course and prognosis of RA patients. However, TNF-alpha…
Rheumatology Drug Updates: Etanercept for Pediatric Plaque Psoriasis
Etanercept Submitted for Chronic, Severe Plaque Psoriasis in Children The U.S. Food and Drug Administration (FDA) has accepted the supplemental Biologics License Application for etanercept (Enbrel) for treating pediatric patients with chronic, severe plaque psoriasis.1 The application was submitted in early January 2016 and is based on results of a one-year Phase 3 study with…
Diagnostic Tests, Tips for Gluten-Induced Celiac Disease
CHICAGO—Celiac disease—the gluten-induced illness that can be seen alongside rheumatic diseases—has been seen much more commonly over the past 20 years than it was previously, but the illness can come with questions that are not always straightforward, an expert said at the ACR’s State-of-the-Art Clinical Symposium. The disease, in which the small intestine becomes inflamed…
Treatments for Scleroderma with Gastrointestinal Involvement Address Symptoms
CHICAGO—Nine out of 10 scleroderma cases include clinical signs of gastrointestinal (GI) involvement, with severe involvement associated with high mortality rates, but the pathology of this is not very well understood, a GI expert said at the ACR’s State-of-the-Art Clinical Symposium. That has left clinicians with a slate of treatments—anti-reflux, antimicrobials and prokinetics—that address only…
Tips on Vaccinating Patients with Rheumatic Diseases
CHICAGO—In October of last year, a 52-year-old woman came to see Kevin Winthrop, MD, MPH, associate professor in infectious diseases, public health and preventive medicine at the Oregon Health & Sciences University. She had rheumatoid arthritis and was taking methotrexate and prednisone. She had had little change in her RA disease severity and was considering…
University of Alabama at Birmingham’s Division of Clinical Immunology & Rheumatology Recognized for Excellence
An interdisciplinary and collaborative environment is a critical factor for the advancement of basic science and clinical research in the academic environment, says William J. Koopman, MD, former director of the University of Alabama at Birmingham’s (UAB’s) Division of Clinical Immunology and Rheumatology. And in 1977, when he was being recruited by Division Director J….
Pitfalls of Potential Lupus Diagnosis
Spotting the signs of autoimmunity as early as possible is often viewed as a positive goal for rheumatologic research. The premise: Patients may begin treatment years before their disease is active and destroying joints and tissue. Although much progress has been made in identifying early stages of rheumatoid arthritis pathogenesis, the clues are not as…
Protein Phosphatase 2A and Regulatory T Cell Function Researched
The serine-threonine protein phosphatase 2A (PP2A) enzyme is critical for regulatory T cells to function—without it, they don’t have the ability to suppress effector T cells and can’t protect against autoimmunity, according to new research published in Nature Immunology. Researchers found that conditional knockout mice—in which PP2A expression is knocked out only in regulatory T cells—developed…
Researchers Hone in on Defect in Autophagy that May Underlie Lupus
New research investigates the role of autophagy, specifically the cell digestion process called LC3-associated phagocytosis (LAP), in inflammation and the pathology of systemic lupus erythematosus (SLE). Researchers found that defects in this process result in failure to digest dying cells, which increases inflammatory cytokine production and results in SLE-like disease in mice. Further exposure to dying cells accelerated disease development…
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