SAN FRANCISCO—Rheumatologists have to look no further than the American College of Rheumatology guidelines to know that the options for patients with lupus nephritis are sometimes not very appealing. The first-line choices are either mycophenolate mofetil (MMF) plus glucocorticoids or cyclophosphamide (CYC), also with glucocorticoids—and all of their attendant side effects. The problem: evidence, said…
SAN FRANCISCO—A 40-year-old woman shows up in the clinic with scarring alopecia, with an area of hyperpigmentation on the rim of her scalp, extending from just behind the temple to behind her ears. An examination with a dermatoscope shows hyperkeratotic follicular plugging. The case—in this example, the discoid form of cutaneous lupus erythematosus (DLE)—is one…
New research examines how the generation of reactive oxygen species and neutrophil extracellular traps may break down the protective mechanisms of mitochondrial DNA, resulting in NETosis in people with autoimmune disease. They found oxidized mitochondrial DNA may contribute to inflammation in such diseases as systemic lupus erythematosus by upregulating type I interferon signatures…
SAN FRANCISCO—A 40-year-old woman shows up in the clinic with scarring alopecia, with an area of hyperpigmentation on the rim of her scalp, extending from just behind the temple to behind her ears. An examination with a dermatoscope shows hyperkeratotic follicular plugging. The case—in this example, the discoid form of cutaneous lupus erythematosus (DLE)—is one…
A recent study on systemic lupus erythematosus examined the effects of metabolic modulators on the disease’s abnormal T cell metabolism. Using a combination therapy of metformin and 2-deoxy-D-glucose, researchers were able to normalize CD4+ T cell functions and restore defective IL-2 production in mice…
View the question. Findings/Diagnosis An anteroposterior (AP) radiograph of the right foot shows hallux valgus of the first metatarsal phalangeal (MTP) joint, erosive changes at the first and fifth metatarsal bones and degenerative changes at the fourth and fifth metatarsal-cuboid joints. An AP radiograph of the left foot shows extensive erosive and degenerative changes at…
Editor’s note: In this recurring feature, we first present a series of images (this page) for your review, and then a brief discussion of the findings and diagnosis. Before you turn to the discussion, examine these images carefully and draw your own conclusions. History A 33-year-old woman with a 16-year history of systemic lupus erythematosus…
The Lupus Initiative (TLI) of the American College of Rheumatology (ACR) continues its work to reduce the health disparities for people with lupus through multiple, national-level, grant-funded projects, targeting primary care physicians with lupus education to increase appropriate rheumatology referrals and—when necessary, appropriate and effective—distance-managed care. Since 2009, the ACR has received funding through the…
Interactions between an individual’s genetic background and their exposure to environmental factors are thought to result in a cascade of immune reactions, ultimately leading to the development of autoimmune diseases such as rheumatoid arthritis (RA), juvenile idiopathic arthritis (JIA), systemic lupus erythematosus (SLE) and juvenile dermatomyositis.1,2 For example, an environmental factor that conclusively affects susceptibility…
Researchers used T cell transcriptome analysis in a small-scale study, identifying gene expression of specific patient subtypes and finding that expression alteration of T cells may correlate with severity of SLE rather than its presentation…