Corticosteroids still represent the mainstay of treatment of patients with active disease. They have been used for more than 60 years, and although prolonged use is associated with organ damage, they have been shown to be lifesaving in various phases of the history of the disease. History of Use First introduced in the late 1960s…
Two previously unidentified cellular players in the pathogenesis of primary Sjogren’s syndrome (pSS) have been discovered: a regulatory T cell (Prdm1+eTreg) and a helper T cell (Il21+Th1). In the study, researchers also identified the transcriptional signatures of these cells and their differential dependency on the lymphotoxin/LIGHT signaling axis, which may guide future therapeutic interventions…
By examining the phenotypic plasticity of cartilage and tendon cells, researchers found that oxidative stress and P13K signaling pathways are key modulators of the phenotype of musculoskeletal cells. Using monolayer and three-dimensional cultures, the experiments confirmed that dedifferentiation occurs via reductions in expression of genes for cartilage (Col2a1, Agcn) and tendon (Tnmd, Serpinf1)…
A recent study found that the varicella zoster virus downregulates expression of programmed death ligand 1 and major histocompatibility complex 1 in brain fibroblasts, perineurial cells and lung fibroblasts. These effects may lead to persistent inflammation in the vessels and lungs, as well as promote subsequent infection of T cells and the spread of the virus…
In May, the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) published its recommendations for the treatment of psoriatic arthritis (PsA).1 The updated recommendations represent advances in drug development and availability since previous recommendations published in 2009, as well changes in treatment paradigms and the importance of associated aspects of the disease.2…
Depending on stage, severity and rate of progression of disease, systemic corticosteroids are commonly used to treat pulmonary sarcoidosis. However, a review of the literature suggests they have limited usefulness in advanced stage IV pulmonary sarcoidosis. Once sarcoidosis has advanced to this degree, steroid use may unnecessarily expose a patient to life-threatening complications, as demonstrated…
Oral health is not frequently considered within the sphere of a rheumatologist’s practice. However, recent results published by the Canadian Scleroderma Research Group (CSRG) point out the importance of assessing oral health in patients with systemic sclerosis (SSc). Result of 3-Year Grant Between 2008 and 2011, 163 patients with SSc and 231 controls were entered…
Otulipenia is a recently discovered autoinflammatory disease caused by germline mutations, which results in dysregulated ubiquitination in patients. In a small-scale study, researchers used exome sequencing and candidate gene screening to identify three different loss-of-function mutations in the OTULIN/FAM105B gene in patients…
We read the case report by Dr. Diana Girnita and colleagues (“Severe Refractory Gout: What options are left when pegloticase fails?” The Rheumatologist, August 2016) with interest. A case is reported of a subject with 20 years of chronic refractory gout who failed to respond to pegloticase therapy, and the potential roles of anti-drug antibodies or…
CPT: 99213, 89060 ICD-10: M10.072 Coding Rationale This is an established outpatient visit. The encounter is coded as 99213 because it included: History—Expanded problem-focused history. The history of present illness was brief, the review of systems was extended and the past medical and social history was documented. Examination—Detailed. There were seven organ systems examined. This…