During the 2020 ACR State-of-the-Art Clinical Symposium, Zoltán Szekanecz, MD, PhD, addressed the risks of vascular disease and how to manage them in patients with rheumatic diseases.
Case Report: Too Many Activated Immune Cells in a 9-Month-Old Boy
Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disease of immune dysregulation characterized by unchecked inflammatory responses leading to end-organ dysfunction. Primary HLH results from inherited mutations that impair the capacity for immune regulation; secondary HLH arises from the inappropriate response to an immune stimulus, such as infection, malignancy or autoimmunity. What is less well known is…
Case Report: Diagnosing a Lupus-Flare Mimic
The diagnosis of rheumatic diseases requires the exclusion of other systemic disorders. Infection, hematologic conditions, malignancies and some drugs may all lead to syndromes that closely mimic rheumatic diseases, which may lead to diagnostic delays. Idiopathic multicentric Castleman disease (iMCD) is a heterogeneous group of lymphoproliferative diseases (LPDs) characterized by systemic inflammatory manifestations.1,2 As with…
Case Report: What’s Causing This Severe Case of Rhabdomyolysis?
Rhabdomyolysis is a clinical syndrome characterized by muscle tissue necrosis and release of intramuscular components into the circulation. Typical manifestations include muscle pain and myoglobinuria, causing dark urine. Serum creatinine kinase (CK) enzyme levels are usually markedly elevated. Severity can range from muscle enzyme elevation in the serum of an otherwise asymptomatic patient to extremely…
Recurrent Medial Elbow Pain Following Successful Tommy John Surgery
A 27-year-old, left-handed man was referred to our ultrasound clinic for left elbow pain. History The patient had been a pitcher on a Minor League Baseball team. Two years before, he developed sudden, severe medial elbow pain while pitching in a game. The pain was associated with some tingling down the left medial forearm. The…
ACR Releases COVID-19 & MIS-C Clinical Guidance for Kids with Rheumatic Disease
The ACR has released clinical guidance documents for pediatric patients with rheumatic disease in the context of the COVID-19 pandemic, including one for multi-system inflammatory syndrome in children (MIS-C). Jay Mehta, MD, MS, an attending physician in the Division of Rheumatology and director of the Pediatric Rheumatology Fellowship at the Children’s Hospital of Philadelphia (CHOP),…
Bisphosphonates Reduce Bone Toughness Over Time
NEW YORK (Reuters Health)—Using bisphosphonates for several years is associated with increasing brittleness and decreasing toughness of bone, according to a new review. “Long-term treatment with bisphosphonates can have negative side effects in some people because of their effects on bone toughness [toughness = the energy that bone tissue can absorb before cracking],” David B….
Abaloparatide vs. Alendronate for Osteoporosis
In a clinical trial, researchers compared the efficacy of abaloparatide with alendronate in reducing the risk of fracture among postmenopausal women with osteoporosis. The findings suggest initial treatment with abaloparatide may result in greater vertebral fracture reduction than alendronate…
Study Finds Increased Risk of Cancer in Psoriasis Patients
Recent research reinforces the finding that psoriasis patients have a slightly increased risk of cancer, specifically keratinocyte cancer and lymphomas. However, the study found no association between cancer and the use of biologic treatments in this patient population…
U.S. Hip Fracture Incidence Declines with Reductions in Smoking & Drinking
(Reuters Health)—Age-adjusted hip fracture incidence has declined in the U.S. over the past four decades, aided by a decline in smoking and alcohol consumption, a new study suggests. Researchers examined data on 4,918 men and 5,634 women who participated in the prospective Framingham Heart Study from 1970 to 2010. Overall, the age-adjusted incidence of hip…
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