Background Autoimmune diseases, such as rheumatoid arthritis (RA) and systemic lupus erythematous, occur when the body attacks its own tissue because it cannot differentiate between self and non-self. This is mainly through deregulation of the immune system. Vitamin D has been known to play a critical role in bone mineralization and bone health. Activated vitamin…
Rheumatology Case Report: When Moyamoya Disease Mimicks Primary Central Nervous System Vasculitis
Case report: A 60-year-old Hispanic male with poorly controlled hypertension was sent from the primary care clinic for evaluation of malignant hypertension with a systolic blood pressure above 200 mmHg. His symptoms at the time of presentation included episodic confusion, worsening vision and an unsteady gait. A head computed tomography (CT) scan showed a subacute…
Diagnostic Criteria Released for Neuromyelitis Optica Spectrum Disorders
Recent updates to criteria used for diagnosing neuromyelitis optica (NMO) are aimed at helping physicians make the differential diagnosis of this disorder differentiating it from other inflammatory disorders—a diagnosis that can be difficult given the presenting symptoms that can mimic a number of other conditions, such as multiple sclerosis. Published in July 2015, the new…
Fellows’ Forum Case Report: Palmar Fasciitis & Polyarthritis Syndrome
Case report: A 78-year-old Caucasian female presented to our outpatient rheumatology clinic with pain in her bilateral shoulders, hands and knees that began suddenly one month earlier. She admitted to stiffness in her hands lasting several hours, and expressed an inability to extend her fingers. She denied fever, rashes, jaw claudication, headache or visual changes….
Research in Temporal Arteritis Suggests Link with Infection, Autoimmune Disease
Temporal arteritis was first described by Sir Jonathan Hutchinson in 1890 in an elderly retired gentleman’s servant who developed red, painful streaks on his temples and was found to have bilaterally swollen temporal arteries with feeble pulses.1 Sir Hutchinson disputed the suggestion that the red streaks were caused by the man’s hat and, instead, called…
Higher Tocilizumab Dose Plus Methotrexate Best for Early RA
NEW YORK (Reuters Health)—Tocilizumab improves remission rates and slows disease progression in patients with early rheumatoid arthritis (RA), a new randomized controlled trial demonstrates. Tocilizumab was effective both on its own and when combined with methotrexate, Dr. Gerd R. Burmester of Charite Medical University of Berlin and his colleagues found. Tocilizumab, an interleukin-6 (IL-6) blocker,…
Expert Q&A: Dr. Michael Lockshin on APS
Michael Lockshin, MD, reminds medical professionals that patients suffering from antiphospholipid syndrome (APS) don’t respond to medications in the same way as patients with other clotting-related diseases. Insufficient evidence exists to determine whether the new wave of anticoagulant medications is safe for use in patients with APS…
Early Probiotics Supplementation Tied to Lower Risk of Islet Autoimmunity
NEW YORK (Reuters Health)—Exposure to probiotics in the first few weeks of life is associated with a reduced risk of islet autoimmunity, according to results from the TEDDY study. “Early supplementation of probiotics may be important but we need more research on this,” Dr. Ulla Uusitalo from University of South Florida in Tampa told Reuters…
Bone Turnover Markers Show Link to Iliac Histomorphometry in Older Women
NEW YORK (Reuters Health)—Although histomorphometry of iliac bone gives precise results, bone turnover markers provide a better reflection of the overall skeleton in untreated postmenopausal osteoporotic women, according to French researchers. Bone histomorphometry allows study of bone remodeling at the basic structural unit level, Dr. Pascale Chavassieux and colleagues at the University of Lyon note…
Bariatric Surgery Tied to Improvement in Psoriasis, Psoriatic Arthritis
NEW YORK (Reuters Health)—Obese patients with psoriasis or psoriatic arthritis are apt to experience significant symptomatic relief following bariatric surgery, according to a new chart review. Specifically, the study found that more than half of the patients with psoriasis or psoriatic arthritis reported improvements in their disease following surgery. Dr. Soumya Reddy, assistant professor of…
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