Granulomatosis with polyangiitis (GPA) was first described in the British Medical Journal in 1897 by Scottish otolaryngologist Peter McBride.1 GPA is a relatively rare, systemic necrotizing vasculitis that can make diagnosis challenging. The incidence has been estimated anywhere between two and 12 cases per million.2 GPA mainly affects adults between the ages of 45 and…
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Neutrophil Extracellular Traps & Their Role in Autoimmunity
Certain medications have been associated for decades with the development of drug-induced autoimmunity. New research published in March 2018 in Arthritis & Rheumatology suggests that NETs (neutrophil extracellular traps) are potentially implicated in the mechanisms that lead to drug-induced autoimmunity.1 Peter Grayson, MD, MSc, head of the Vasculitis Translational Research Program at the National Institute…
6 Things Endocrinologists Want Rheumatologists to Know
In your daily contact with rheumatology patients, you likely come across several who have type 1 or 2 diabetes. Are you doing all you can to maximize their treatment? Most physicians know about the damaging health effects of uncontrolled diabetes. From vision loss to kidney failure to nerve damage, those with diabetes require regular vigilance…
Case Report: Refractory Calciphylaxis in Lupus
Calciphylaxis is a poorly understood and life-threatening ischemic vasculopathy characterized by calcification of the small- and medium-size arteries in the skin, subcutaneous tissue and internal organs, which leads to thrombosis, tissue necrosis and painful skin ulcerations that won’t heal. The disease has a 50–80% mortality rate. Although affected patients typically have end-stage renal disease (ESRD)…
Existing CT Scans as Good as DXA for Assessing Hip Fracture Risk
NEW YORK (Reuters Health)—A “biomechanical” analysis of a previously taken pelvic or abdominal computed tomography (CT) scan is at least as accurate in assessing an individual’s hip fracture risk as a dual-energy X-ray absorptiometry (DXA) scan, according to new research. This accuracy of the hip bone mineral density (BMD) T-score as measured by the biomechanical…
RA Patients May Not Receive Needed Osteoporosis Screening & Treatment
New research examined the frequency of osteoporosis screening and treatment for RA patients from 2003–2014, including four years following the release of the 2010 ACR guideline on glucocorticoid-induced osteoporosis prevention and treatment. The results: Approximately half of RA patients for whom treatment was indicated never received osteoporosis medication. Researchers also found that RA patients, despite their increased risk for developing osteoporosis, were not more likely to receive osteoporosis care than OA patients…
Using Ultrasound to Diagnose Carpal Tunnel Syndrome
Note: Updated May 2, 2018, to correct a link in the reference section. The error was introduced in editing. A 44-year-old Caucasian woman presented to the outpatient rheumatology clinic that had followed her for several years for rheumatoid arthritis. She was compliant with her regimen of hydroxychloroquine, etanercept and salsalate. Her chief complaint was worsening…
A Parathyroid Hormone Both Builds & Destroys Bone
SAN DIEGO—A hormone secreted by the parathyroid gland is both a builder and a destroyer of bone in humans, with important implications for a variety of conditions treated by rheumatologists. In the Oscar Gluck, MD, Memorial Lecture at the 2017 ACR/ARHP Annual Meeting Nov. 3–8, Henry Kronenberg, MD, chief of the Endocrine Division at Massachusetts…
Updates on Managing Lupus Complications
SAN DIEGO—To manage patients with systemic lupus erythematous (SLE), rheumatologists must be aware of potentially serious complications affecting many organ systems. On Nov. 7 at the 2017 ACR/ARHP Annual Meeting, two experts offered insights on cardiovascular and hematological complications of lupus. Myocardial Disease in Lupus Lupus patients are at increased risk for heart-related complications, especially…
Healthy Diet Linked to Lower Hip Fracture Risk in U.S. Women
(Reuters Health)—Eating an overall healthy diet is tied to a lower risk of hip fracture among women over age 50, a U.S. study suggests. Researchers analyzed decades’ worth of dietary and health data for more than 100,000 U.S. men and women. They found that women who scored highest on the American Healthy Eating Index-2010 (AHEI)…
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