A recent study is the first to examine pragmatic language skills in patients with systemic lupus erythematosus (SLE), finding that approximately half of SLE patients have pragmatic language dysfunction…
Clinical Pearls for Diagnosing & Treating Sjögren’s Syndrome
ATLANTA—Dry eyes and mouth are common symptoms in the general population. When patients report these symptoms to their primary care provider and other consultants, it may prompt a referral to a rheumatologist to rule out Sjögren’s syndrome. However, as discussed in the 2019 ACR/ARP Annual Meeting session, Sjögren’s Syndrome: Beyond the Dryness, evaluation of this…
Emerging Biomarkers for Lupus
ATLANTA—When it comes to identifying reliable biomarkers that can predict worsening illness or help point to proper treatment, it’s hard to imagine a more vexing disease than systemic lupus erythematosus (SLE), said Jill P. Buyon, MD, director of the Lupus Center at New York University Langone Medical Center, in the 2019 ACR/ARP Annual Meeting session…
Case Report: Obliterative Bronchiolitis in Rheumatoid Arthritis
A 59-year-old woman with rheumaÂtoid arthritis (RA) presented to our pulmonary clinic for progressively worsening dyspnea of five years’ duration. She described progressively worsening dyspnea after a few minutes of walking on level ground. In addition, she noted worsening pain and morning stiffness of the wrists, knees and metacarpophalangeal (MCP) joints, with subcutaneous nodules. She…
Sjögren’s Syndrome in Kids: Diagnostic Challenges & Treatment Options
A 14-year-old girl is referred to your office for fatigue and arthralgias. While you’re obtaining her past medical history, she divulges that she has had four episodes of bilateral parotitis, each lasting two weeks. An otolaryngologist evaluated her. She lacked sicca symptoms, had a normal complete blood count (CBC), normal inflammatory markers and a negative…
Case Report: Possible Overlapping Vasculitis & Ulcerative Colitis
A 42-year-old man with a history of ulcerative colitis (UC), primary sclerosing cholangitis (PSC) and chronic sinusitis was referred to a rheumatologist to evaluate for a possible diagnosis of systemic vasculitis. This patient had developed new skin lesions, gingival hypertrophy and ulcerating tracheobronchitis, concerning for possible granulomatosis with polyangiitis (GPA). Since 1994, the patient had…
PAD4 Antibodies May Help Predict Treatment Response in Rheumatoid Arthritis
A study published in Arthritis & Rheumatology highlights how the presence of autoantibodies to peptidylarginine deiminase (PAD) may eventually be used to influence treatment decisions in the management of rheumatoid arthritis (RA), sharpening our understanding of disease subtypes.1 Although follow-up prospective studies are needed, these findings underline some intriguing areas for future investigations in immunobiology….
ACR/EULAR Release New Classification Criteria for IgG4-Related Disease
Immunoglobulin G4-related disease (IgG4-RD) can cause fibroinflammatory lesions in nearly any organ, and diagnosis is challenging. ACR/EULAR classification criteria for IgG4-RD have been developed and validated in a large cohort of patients. These criteria have performed well in tests and should contribute substantially to future clinical, epidemiologic and basic science investigations.
Myositis-Specific Antibodies Identified
The idiopathic inflammatory myopathies (IIM) encompass eight categories: 1) dermatomyositis (DM) in adults, 2) juvenile dermatomyositis, 3) amyopathic DM, 4) cancer-associated DM, 5) polymyositis, 6) immune-mediated necrotizing myopathy, 7) inclusion body myositis, and 8) overlap myositis.1 These categories help classify the myopathies based on clinical and histologic features. The incidence of IIM is estimated at…
Denosumab Tied to Infection Risk
NEW YORK (Reuters Health)—The osteoporosis drug denosumab is associated with a higher incidence of serious infections compared with placebo, but the risk is similar to comparator drugs, a systematic review and meta-analysis reveals. Talia Diker-Cohen, MD, PhD, of Tel Aviv University, and colleagues searched the literature through May 2019 for randomized controlled trials of denosumab…
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