Sjögren’s syndrome is a chronic multi-system autoimmune disease characterized by inflammation and subsequent destruction of exocrine glands. Sjögren’s syndrome can present with glandular or extra-glandular manifestations. Neuromyelitis optica spectrum disorder (NMOSD) is a rare central nervous system (CNS) autoimmune disease that can present as the initial manifestation in less than 5% of patients with Sjögren’s….
I would like to tell you a story. Two, actually. I am just returning from the 19th International Vasculitis and ANCA Workshop, which is always a fascinating meeting. In its inception, it was a workshop, in the true sense of the word. Now, we discuss anti-neutrophil cytoplasmic antibody (ANCA) testing as casually as we discuss…
We have often heard it said that opportunity arises from challenges. Challenge, of course, is really just a polite way of saying problem—and for our patients, problems abound when it comes to obtaining timely and affordable access to the rheumatologic care they need. Access in this context has many meanings: There is access to life-changing…
A group led by Sarah Ringold, MD, MS, assistant professor of rheumatology at Seattle Children’s Hospital, has developed a new guideline intended to provide recommendations for the treatment and monitoring of children with juvenile idiopathic arthritis (JIA) manifesting as non-systemic polyarthritis, sacroiliitis or enthesitis.1,2 Key Updates The new recommendations appear in both Arthritis & Rheumatology…
As soon as pediatric patients are diagnosed with juvenile idiopathic arthritis (JIA), they should also be screened for uveitis, says ophthalmologist Gary Holland, MD. Otherwise, the University of California, Los Angeles, provider says, “Kids who are diagnosed with JIA may not come to an ophthalmologist until they have vision-limiting complications.” Uveitis is the most common…
On June 3, Steven C. Echard, IOM, CAE, relocated to Atlanta to begin his new role as executive vice president of the ACR, his third term with the organization over his distinguished career in association management. Since 2014, Mr. Echard has served as chief executive officer of the American Association for the Study of Liver…
Monosodium urate (MSU) crystal deposition commonly occurs within the distal appendicular skeleton. The peripheral nature of gout is a hallmark feature described in the ACR and the European League Against Rheumatism (EULAR) clinical practice guidelines.1 In this article, we report a rare presentation of a common disease: a case of axial gouty arthropathy masquerading as…
The Norman B. Gaylis, MD, Research Award for Rheumatologists in Community Practice is designed to encourage practicing clinicians to conduct their own research for the betterment of patients and rheumatology. The 2019 inaugural honoree is Sou-Pan Wu, MD, who will research gout in the Hmong population in Minnesota…
Eosinophilic gastroenteritis (EGE) is a rare condition caused by eosinophilic infiltration of the gastrointestinal (GI) tract. The condition is subdivided into the GI layers it affects: mucosal, muscular and subserosal.1 EGE usually presents with non-specific GI symptoms, such as impaired motility, intestinal obstruction and, rarely, ascites.2 Below, we report a rare case of EGE leading…
In a recent investigation of Swedish patients, environmental triggers of the immune system are a common factor for patients with primary Sjögren’s syndrome…
Kim Steinbarger, PT, MHS, knows how physical and occupational therapy can make a difference for patients with rheumatic diseases. Ms. Steinbarger was just two years into her career as a physical therapist (PT) when she was diagnosed with rheumatoid arthritis (RA) in 1991. “I’ve seen how regular exercise serves as an important tool in managing…
A recent analysis of retrospective clinical data on patients with systemic lupus erythematosus (SLE) at 14 Canadian centers found that a surprisingly high proportion—at least one-third—had active disease at any point over five years of data collection.1 It has been a longstanding belief among clinicians that SLE becomes less active over time, although its accumulation…
SAN FRANCISCO—The 13th International Congress on Systemic Lupus Erythematosus (SLE), held April 5–8, highlighted continuing advances in the fight against lupus, a chronic, inflammatory, autoimmune disease affecting multiple organ systems. The rheumatologist’s ability to control this incurable and life-threatening condition is limited both by its heterogeneous presentation and by the lack of successful treatment options,…
SAN FRANCISCO—The challenges of trying to solve the puzzle of lupus, in light of its broad heterogeneity of symptoms, manifestations in clinical involvement and treatment response, and the sheer complexities of the immune system, are driving researchers into ever more elaborate investigations of how the immune system functions in lupus patients. Genetic, transcriptomic and epigenetic…
If approved by the U.S. Food and Drug Administration (FDA), difficult-to-treat patients with axial spondyloarthritis who fail or are intolerant to standard treatment with tumor necrosis factor inhibitors (TNFi) may have a new treatment option. That new option is a high-affinity monoclonal antibody, called ixekizumab, which selectively targets an area linked to the immunopathology of…
I have worked as an advanced practice provider (APP) in pediatric rheumatology for nearly 16 years. My collaborating physicians have allowed me to function to the full extent of my scope of practice while allowing me to develop professionally within the subspecialty. My latest endeavor has been learning how to perform musculoskeletal ultrasound (MSUS) and…
Harold Edward Paulus, MD, professor of medicine (emeritus) at University of California, Los Angeles (UCLA), died April 5, 2019. During his nearly 90 years of life, he contributed hugely to clinical science and patient care in rheumatology. Hal was crazy smart. And if he had an idea, that idea had to be nurtured and expanded….
Some would call Guillermo J. Valenzuela, MD, a hunter of sorts. He has accompanied men and their dogs into the forests of Italy in search of white truffles, an underground fungus considered a European delicacy. “Years ago, when visiting my wife’s family in Italy, I walked into a very old restaurant in Parma,” says Dr….
Results from a Phase 3 study showed ixekizumab significantly improved the signs and symptoms of non-radiographic axial spondyloarthritis in patients…
In a second response letter, the FDA has cited the onset and duration of intravenous meloxicam, a non-opioid pain treatment, as concerns that it fails to meet prescriber expectations…
Recipient of a Rheumatology Research Foundation Scientist Development Award, Ashira Blazer, MD, focuses her research on racial and ethnic disparities in lupus. She looks beyond socioeconomic differences, differences in lifestyles and access to care to better understand the biologically determined differences behind disparate outcomes. With funding from the Foundation, she was able to investigate the…
RheumPAC, the ACR’s political action committee (PAC), is tasked with fundraising, vetting legislators, participating in Capitol Hill visits and developing important relationships for the College. During my interview with Gary Bryant, MD, the ACR’s inaugural RheumPAC chair, he shared his thoughts on the role of rheumatology advocacy in advancing clinical practice, research and education. ACR@Work: Have…
The Association of Rheumatology Professionals (ARP) and European League Against Rheumatism Health Professionals in Rheumatology (EULAR HPR) are, to a great extent, working toward addressing the same long-term goals and challenges. Despite differences in healthcare services, culture, organization and economical aspects across the Atlantic Ocean, we can help each other overcome these challenges and learn…
Join us in Atlanta Nov. 8–13 for the 2019 ACR/ARP Annual Meeting. Member registration is now open, including registration for the annual pre-meeting practice management workshop: Practice Matters—Navigating a Path to Success! The 2019 workshop will focus on key practice matters. The goal of the pre-meeting workshop is to address how best to manage your…
A private insurance carrier sends an audit request letter to a rheumatology practice to review its infusion medical records for the past 30 dates of service. What information should the practice send to the carrier? Only the infusion notes The complete notes for the requested dates of service only The complete notes for the requested…
Take the challenge. C—When an insurance carrier requests the medical record for a service performed, the practice should send all pertinent information to support the medical necessity of that service. For example, if the drug requires that a patient first be tested for tuberculosis and the patient should be on methotrexate or leflunomide, the note…