In 1905, two pediatricians in Vienna, Austria, published Serum Sickness, a detailed 120-page monograph that was the first to carefully characterize the syndrome.1 The work would go on to become a classic, ultimately helping illuminate many important questions in immunology. Antitoxin Serum Treatments In the late 19th century, researchers were working to develop lifesaving antitoxins…
Case Presentation History of present illness A 66-year-old white woman presented with unexplained, recurrent episodes of high fever, abdominal pain, rash and arthralgias occurring over the previous three years. During typical episodes, the patient experienced flu-like symptoms, followed by fever, abdominal pain and non-bloody diarrhea without tenesmus. Her temperatures were 101–103ºF, with chills lasting up…
To the Members of the American College of Rheumatology, I had the honor and privilege of becoming the ACR’s 83rd president during the annual meeting in Atlanta in November 2019. My aspirations for the year were ambitious, filled with hopes of leading the ACR and the field of rheumatology forward in many new and bold…
Presidential Gold Medal The highest award the ACR can bestow, the Presidential Gold Medal is awarded in recognition of outstanding achievements in rheumatology over an entire career. This year’s award went to James O’Dell, MD, the Stokes-Shackleford Professor of Internal Medicine, vice chair of internal medicine and chief of the Division of Rheumatology at the…
Rheumatologists who are outstanding clinicians and provide consistent, exceptional care to patients are in the spotlight in our Lessons from a Master Clinician series. Here, we present insights from a clinician who has achieved distinction in the field of rheumatology, serving as a role model for colleagues and trainees. Alan Baer, MD, is currently a…
We have all been there when a patient with a systemic autoimmune disease needs sudden coordination of care. Your patient with Behçet’s disease nonchalantly mentions he hasn’t been able to see out of his right eye for two days. The spouse of one of your patients with sarcoidosis writes to you on the patient portal…
A strong association between Epstein-Barr virus (EBV) infections and systemic lupus erythematosus (SLE) has been known since the 1970s. Although the etiology of SLE is not fully established, multiple genetic factors and polymorphisms in genes involved in the immune system have been implicated, with environmental factors also contributing to the development of this complex condition….
Although systemic lupus erythematosus (SLE) affects both the central nervous system (CNS) and peripheral nervous system (PNS), past research has primarily focused on how lupus affects the CNS. Now, an international, inception cohort study, “Peripheral Nervous System Disease in Systemic Lupus Erythematosus,” published in Arthritis & Rheumatology, has examined different types of PNS disease to…
Uveitis is an umbrella term for intraocular inflammatory diseases that can lead to vision loss. It’s not just a concern for ophthalmologists. Uveitis occurs in approximately 2–5% of patients with inflammatory bowel disease, 6–9% of patients with psoriatic arthritis and 25% of patients with reactive arthritis. The prevalence may be as high as 33% in…
As practice administrator for the past nine years at Emerald Coast Rheumatology in Lynn Haven, Fla., Andre Smith has worked to expand what was a single-provider, three-employee practice into an 8,000-square foot rheumatology clinic and 18-chair infusion center with two additional providers. Although not all rheumatologists have a practice administrator on staff, those who do…
A recent article in Arthritis Care & Research supports the idea that the patient global assessment reflects primarily the patient’s experience of their functioning in daily life.1 Background The patient global assessment is a key measure used by clinicians and researchers to help evaluate disease status in rheumatoid arthritis (RA). Lead author Ethan T. Craig,…
It was a delight to read the comments in the May 2019 issue of The Rheumatologist on a paper by Hirsch and colleagues, discussing how health literacy affects the patient global assessment.1,2 Patient-driven outcome measures (PROs), patient global assessment on a visual analog scale (VAS) or a numeric rating scale (NRS), a segmented numeric version…
A study that focused on the detection and immunological characteristics of cryoglobulins provides insights for rheumatologists and other rheumatology providers, as well as lab professionals. Co-researchers Marie N. Kolopp-Sarda, PharmD, PhD, and Pierre Miossec, MD, PhD, Clinical Immunology Unit, Department of Immunology and Rheumatology, University of Lyon, France, included in their retrospective study, published in…
A recent paper in Arthritis & Rheumatology opens up the possibility of a new research avenue to treat systemic sclerosis: dipeptidyl peptidase 4 (DPP4) inhibitors, a previously approved therapy for type 2 diabetes.1 Work in mouse models and on skin samples from systemic sclerosis patients suggests these drugs pose a promising area of future translational…
The success of a physician-patient relationship encompasses several important factors, including mutual respect, trust and effective communication. But what can be done when this relationship becomes adversarial and communication breaks down? The American Medical Association has historically pointed out that poor physician-patient communication is directly related to malpractice or discrimination lawsuits. When providers end a…
The search for knowledge has shaped Western culture and is based on Greek philosophy, especially Aristotelian metaphysics. During the Middle Ages, this knowledge was matured by dialectical scholasticism, culminating, in its later stages, in the amalgam between Islamic science and the neo-Aristotelianism of St. Thomas Aquinas.1 In this way, the foundations of the future scientific…
After a busy day in rheumatology, Polly Ferguson, MD, gets creative at a local arts center, making beautiful pottery pieces, a skill she has wanted to develop for nearly 30 years.
The FDA has approved golimumab for the treatment of pediatric patients with active polyarticular juvenile idiopathic arthritis or active psoriatic arthritis…
Tofacitinib is now FDA approved to treat patients 2 years and older with active, polyarticular juvenile idiopathic arthritis.
The FDA is requiring all benzodiazepines to carry an updated boxed warning that addresses the risks of misuse, abuse and addiction associated with their use.
Content from ACR Convergence 2020, including scientific sessions, posters, exhibits, and community hubs, is available to All-Access Pass and COVID-19 Pass participants to view and access on-demand through March 11, 2021. View sessions you missed and related Q&As with the speakers, read and catch up on posters, interact with exhibits and industry events, and view…
Editor’s note Nov. 23, 2020: As of Nov. 12, 2020, UHC has delayed implementation of the policy discussed below. See “UnitedHealthcare Delays Copay Accumulator Policy.” UnitedHealthcare (UHC) announced that, as of Jan. 1, 2021, providers will be required to report the amount their patients receive in copay assistance for office-administered treatments. UHC will then use…
The ACR publishes multiple types of documents to provide guidance for its members, but some potentially beneficial topics have not fit neatly into existing production pathways. To answer the need, the ACR has formed a Guidance Subcommittee to the Quality of Care (QOC) Committee. This will allow the ACR to adapt more nimbly, when appropriate,…
The number of medications with rheumatologic indications has increased in parallel with expanding complexities of medication approval and delivery. Simply starting a patient on a biologic medication or new disease-modifying anti-rheumatic drug (DMARD) can be time consuming and frustrating for physicians, nurses and their support staff. In addition to educating the patient and obtaining prior…
