We report on a 77-year-old patient who was diagnosed with giant cell arteritis (GCA) on histopathology of the submandibular gland and eventually went on to develop classic signs and symptoms of GCA. This observation highlights neck swelling as a rare initial presentation of GCA. Case Presentation A 77-year-old previously healthy man presented to his primary…
Drug-induced lupus erythematosus and ANCA-associated vasculitis (AAV) are both autoimmune conditions associated with the use of hydralazine, a commonly prescribed drug for hypertension and congestive heart failure. Although the pathogenesis is unknown, it is believed that hydralazine alters neutrophil and lymphocyte function and promotes exposure of antigens, leading to the development of anti-neutrophil antibodies (ANCA)…
Hydralazine has been in use as a treatment for hypertension, most notably in heart failure patients, since 1951.1 The drug is a known cause of autoimmune disease, most specifically hydralazine-induced lupus. Hydralazine-induced lupus occurs in 7–13% of those taking the medication.2-4 It often presents with constitutional symptoms, arthritis/arthralgias, cutaneous lesions, serositis, myalgias and/or hepatomegaly. Features…
It is an exciting time in the world of vasculitis research. More clinical studies and trials are being conducted now than at any time in history. In the past ten years, four drugs have been approved by the U.S. Food & Drug Administration (FDA) and other regulatory agencies specifically for the treatment of vasculitis: Rituximab…
The ACR Review Course featured eight talks providing a practical review of issues encountered by rheumatologists.
In this ACR Convergence session, Jason R. Kolfenbach, MD, & John H. Stone, MD, MPH, shared clinical insights about rheumatic diseases.
New research on complement activation in anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis underscores its important role in the pathogenesis of this disease, an autoimmune condition defined by inflammation of small- and medium-caliber blood vessels.1 ANCA testing is commonly performed to help diagnose granulomatosis with polyangiitis and microscopic polyangiitis, both of which are forms of ANCA-associated…
Ironically, chronic exposure to minocycline has also been associated with a variety of autoimmune syndromes, including drug-induced lupus, autoimmune hepatitis, serum sickness and vasculitis.1 Minocycline is associated with an 8.5-fold increased risk of drug-induced lupus.2 Minocycline and nitrofurantoin are implicated in 90% of cases of drug-induced autoimmune hepatitis.3 Minocycline-induced vasculitis is much less common and,…
A 67–year-old white woman with primary Raynaud’s phenomenon presented following a week of progressively worsening shortness of breath, dry cough and generalized malaise. An avid tennis player, she first noticed dyspnea while playing, but a few days later grew short of breath even at rest. She went to an urgent care center, where a computed…
In a multicenter, prospective, open-label study, ustekinumab therapy was effective in treating oral ulcers resistant to colchicine in patients with Behçet’s disease, according to study author David Saadoun, MD, PhD, Department of Internal Medicine and Clinical Immunology, Sorbonne University, Paris, and fellow researchers.1 Researchers focused on the topic because oral ulcers are often disabling, have…