The etiology of psoriatic arthritis (PsA) is poorly understood but current evidence supports an interaction between genetic and environmental factors that coalesce to promote local tissue inflammation.1-3 The pivotal cytokines that underlie the local inflammatory response in a wide range of tissues are interleukin (IL) 23, IL-17 and tumor necrosis factor (TNF).4 The central contribution…
Two new ACR Clinical Practice Guidelines provide recommendations on the pharmacologic management of JIA, focusing on treatment of oligoarthritis, temporomandibular arthritis & systemic JIA, as well as nonpharmacologic therapies, medication monitoring, immunizations & imaging.
Sarcoidosis is a multisystem disease characterized by noncaseating granulomas in affected tissues, mostly involving the lungs and lymph nodes.1,2 The etiology of sarcoidosis remains unknown but is thought to be due to an inflammatory response to an antigen exposure in genetically predisposed individuals.1 Tumor necrosis factor-α (TNF‑α), a pro-inflammatory cytokine, plays an essential role in…
A 26-year-old woman presented to our emergency department (ED) with intermittent fevers, nausea and vomiting. She had a past medical history of well-controlled, anti-nuclear antibody positive and rheumatoid factor negative polyarticular juvenile idiopathic arthritis (pJIA) and Crohn’s disease. Her maintenance treatment consisted of monthly intravenous infliximab, 10 mg of oral methotrexate weekly and 20 mg…
At the 17th Annual Advances in the Diagnosis and Treatment of the Rheumatic Diseases meeting, Clifton Bingham, MD, delves into research into rheumatoid arthritis at the cellular level.
Pulmonary nodules are comÂmon; most are benign, but the differential diagnosis is broad and includes life-threatening possibilities.1 Our patient is a former smoker who has a history of a complex autoimmune disease and multiple pulmonary nodules. This case was challenging, but clinical, radiographic and histologic clues helped lead to the correct diagnosis. Case Presentation The…
COVID-19 vaccination, treatments for rheumatic disease and more—the Late-Breaking Abstracts session of ACR Convergence 2021 highlighted six studies with implications for rheumatology.
Patients in intensive care may experience dangerous manifestations of rheumatic disease, such as digital ischemia, multi-system organ failure and more. In a session at ACR Convergence 2021, experts addressed how to manage and treat these critically ill patients.
NEW YORK (Reuters Health)—Zinc supplementation may exacerbate rheumatoid arthritis (RA), new laboratory data suggest. In monocytes from patients with RA, researchers found high concentrations of intracellular zinc, which regulates immune responses by affecting signaling pathways, according to a report in Science Signaling.1 They also found increased expression of Zip8, a zinc-specific importer, in peripheral and…
Immune checkpoint inhibitors (ICIs), such as anti-programmed cell-death 1/programmed death-ligand 1 (anti-PD-1/PD-L1) or anti-CTL-associated protein (anti-CTLA-4), have dramatically changed the treatment of advanced cancers over the past decade. ICIs block T cell inhibition, thus increasing the anti-tumor immune response. ICIs are used not only for metastatic cancer, but also as adjuvant treatment for some stage…