Necrotizing autoimmune myopathy (NAM) is a relatively recently discovered subgroup of inflammatory myopathies. NAM is characterized by predominant muscle fiber necrosis and regeneration with little or no inflammation.1 One subgroup of NAM is 3-hydroxy-3-methylglutaryl-CoA reductase antibody (HMGCR Ab)-related immune-mediated necrotizing myopathy (IMNM), which occurs (rarely) after statin exposure, with a rough incidence of two per…
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Rheumatology Case Report: TINU Syndrome with Concomitant Synovitis
Tubulointerstitial nephritis and uveitis (TINU) syndrome, also known as Dobrin syndrome, is a rare oculo-renal inflammatory disease. It was first described in 1975 by American physician Robert Dobrin, MD.1 It manifests as acute interstitial nephritis and bilateral uveitis. In addition, patients often experience nonspecific systemic findings, such as fever, weight loss, malaise, myalgia and arthralgia. TINU…
How Global Geographic Disparities Affect Healthcare Outcomes
Your home & your health: Does geography impact medicine? Does it matter whether a region is surrounded by large bodies of water, encircled by towering mountain peaks or that its residents share a common ancestry? Consider Switzerland, a nation with a highly developed economy replete with advanced technological and medical infrastructure. Despite these advantages, less…
Rheumatologists Treating Patients with HIV Face Treatment, Diagnostic Challenges
Rheumatologists treating HIV patients in 2017 must think through many important factors as this population ages. As we continue to learn, rheumatologists must consider important drug–drug interactions, relatively uncommon rheumatological presentations of HIV, as well as specific diagnostic challenges. Working closely with infectious disease specialists is the best way to achieve optimum care for this…
Data Tool: How to Design an EHR Algorithm to Identify SLE Patients
Electronic health records enable researchers to access significant amounts of patient data, but identifying subjects with a specific condition can be difficult. In a recent study, researchers successfully designed three algorithms to identify patients with SLE, incorporating multiple counts of the ICD-9 code, laboratory testing, medication data and keywords. In the future, these algorithms may successfully transfer to other systems to aid research…
Rheumatology March Coding Corner Question: Pediatric Rheumatology Consult
A 13-year-old black male, described by his mother as a very active and energetic child, is referred to a pediatric rheumatologist. His chief complaint is muscle pain in both legs, which he has experienced for the past three weeks. His mother is a patient of an adult rheumatologist at this clinic and is quite concerned….
What Our Colleagues Should Know: Neurologists & Rheumatologists Must Communicate
Neurologists and rheumatologists focus on atypical diseases, and their treatments often require insights from both specialties. Philip Seo, MD, MHS, says communication between specialists is key to diagnosis and treatment…
What Rheumatologists Wish Their Colleagues Knew: Managing Skin Disease & Comorbidities
From treating rashes to uncovering a case of osteoarthritis, dermatologists and rheumatologists can work together in a variety of ways to improve patient care, says Joseph F. Merola, MD, MMSc…
Anti-Interleukin-6 Therapy for Erdheim-Chester Disease Warrants Study
Erdheim-Chester disease (ECD) is a rare, non-Langerhan’s cell histiocytosis characterized by tissue infiltration of CD68-positive and CD1a-negative foamy histiocytes.1 ECD was discovered as a lipid granulomatosis in 1930 by Jakob Erdheim and his pupil, William Chester, and approximately 500 cases have been described to date.1 ECD has a heterogeneous course and prognosis ranging from an…
UHC Expands Pilot Lab Benefit Management Program
UnitedHealthcare recently announced plans to expand its pilot Lab Benefit Management Program to Texas, as of March 1, 2017. The pilot program, which is administered by BeaconLBS, was first launched in Florida in October 2014. Under the pilot, providers are required to use a tool called Physician Decision Support to order certain labs for UHC…
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