Other Rheumatic Conditions

The vicious cycle of macrophage activation syndrome. Antigen-presenting cells (macrophages and dendritic cells) and lymphocytes (primarily CD8+ T cells) form a cytokine-generating vicious cycle driven by multiple activation pathways (red ar-rows). Under normal conditions, this positive feedback loop is stopped by inhibito-ry pathways (blue), including killing of activated antigen-presenting cells and lym-phocytes, regulatory T cells and elimination of triggers, such as viruses (not shown). In MAS, factors leading to uncontrolled activation of this vicious cycle (gray boxes) include genetic and acquired defects in cell-cell killing, excess stimula-tion (Still’s disease activity, infection, malignancy) and IL-2 theft by highly activated CD8+ T cells expressing the high-affinity IL-2 receptor α chain CD25.

Weathering the Cytokine Storm: Macrophage Activation Syndrome in Adults & Children

Katie Robinson | December 18, 2024

Peter Nigrovic, MD, provides a practical guide to the diagnosis & treatment of macrophage activation syndrome (MAS) in children & adults.

The Identification & Management of Hypophosphatasia

Colin Ligon, MD, MHS | December 10, 2024

With the U.S. Food & Drug Administration’s approval in 2014 of asfotase alfa for replacement of tissue-non-specific alkaline phosphatase (TNSALP or TNAP) in juvenile-onset hypophosphatasia (HPP), rheumatologists have a responsibility to recognize the more subtle manifestations of this condition in adults to avoid missed treatment opportunities for fractures, dental loss and musculoskeletal pain. Hypophosphatasia is…

The 5 Ms: A Simple Framework to Care for Older Patients

Samantha C. Shapiro, MD | December 5, 2024

WASHINGTON, D.C.—For the first time in U.S. history, older adults are projected to outnumber children by 2034, and their care poses unique challenges to the rheumatologist.1 Normal physiologic changes of aging include but aren’t limited to falling renal function, changes in pharmacokinetics and bone density loss. At the ACR Convergence 2024 Review Course, Namrata Singh,…

Is It Behcet’s? Review Course Offers Diagnosis Tips

Samantha C. Shapiro, MD | December 5, 2024

WASHINGTON, D.C.—Behçet’s disease (BD) is not a common condition, but we frequently receive referrals to evaluate for it in rheumatology clinics because a patient has oral or genital ulcers. So what’s Behçet’s and what’s not? How can we tell the difference? At the ACR Convergence 2024 Review Course, Johannes Nowatzky, MD, director, New York University…

MCTD: Is It Just Letters?

Ruth Jessen Hickman, MD | December 4, 2024

At a Great Debate session, speakers discussed whether mixed connective tissue disease is a distinct disease entity in rheumatology.

Considerations for Lung Transplants in Patients with SARD-ILD

Ruth Jessen Hickman, MD | December 2, 2024

At this ACR Convergence 2024 session, Sonye Danoff, MD, PhD, discussed many factors that need to be considered before referring patients with SARD-ILD for lung transplantation.

Collaborative Care Essential for Diagnosis & Care of Neurosarcoidosis

Ruth Jessen Hickman, MD | November 26, 2024

At a ACR Convergence 2024 session, experts discussed key characteristics, diagnostic challenges & treatment considerations for neurosarcoidosis.

Fun in the Sun: The Benefits of Vitamin D

Samantha C. Shapiro, MD | November 23, 2024

Vitamin D has gotten a lot of press over the years. But is it actually worth the hype, especially when it comes to autoimmunity? Does it prevent the onset of autoimmune disease? Does it have a role in treatment? Experts in this ACR Convergence 2024 session helped decipher the role of vitamin D in bone health, immune regulation and infection reduction.

SURF’n Autoinflammation: Evaluation & Management of Syndrome of Undifferentiated Recurrent Fever

Samantha C. Shapiro, MD | November 23, 2024

At this ACR Convergence 2024 session, the focus was on the identification & treatment of a newly identified syndrome of undifferentiated recurrent fever (SURF).