Adult-onset Still’s disease (AOSD) is a systemic autoinflammatory disorder characterized by persistent fever at regular intervals, arthralgias or arthritis, rash, sore throat and neutrophilic leukocytosis.1,2 Significant elevation in ferritin levels is characteristic and tends to correlate with disease activity. Additional clinical features may include myalgias, lymphadenopathy, hepatosplenomegaly, serositis, myocarditis, abnormal liver function tests and development…
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When to Check Drug Levels & Why
Checking blood levels of commonly used disease-modifying anti-rheumatic drugs (DMARDs) has gained widespread attention in the rheumatology community, even resulting in a recent guidance document from EULAR for biologics.1 Although a highly useful tool, drug level measurement in rheumatology is not without challenges; many of our drugs violate the basic principles of pharmacology that we…
Curbside Consults: Experts Weigh in on Complex Rheumatic Conditions
In this ACR Convergence 2023 session, experts offered guidance on a selection of diagnostic & treatment challenges rheumatologists may encounter.
Management Updates for a Spectrum of Systemic Autoinflammatory Diseases
SAN DIEGO—As part of a panel on systemic autoinflammatory diseases (SAIDs) at a Nov. 15 scientific session of ACR Convergence 2023, Sivia Lapidus, MD, shared context and insights on the therapeutic management of patients with these conditions. The Spectrum of SAIDs SAIDs encompass a broad swath of individually rare disorders driven by innate immune responses…
Rheum in the Court, Law in the Clinic: Health Policy in Global Rheumatology
SAN DIEGO—At ACR Convergence 2023, panelists presented information concerning several policy issues that affect rheumatologists & their patients, including abortion access & the WHO’s Essential Medicine List.
Rheum in the Court, Law in the Clinic: Health Policy in Global Rheumatology
At ACR Convergence 2023, panelists presented information concerning several policy issues that affect rheumatologists & their patients, including abortion access & the WHO’s Essential Medicine List.
Case Report: Adult-Onset Still’s Disease with Complications
The following report outlines a case of newly diagnosed adult-onset Still’s disease (AOSD) complicated by macrophage activation syndrome (MAS) in a previously healthy and active 32-year-old man who had emigrated from Africa to the U.S. Case A man with no prior medical history presented with acute-onset polyarthritis, fevers and fatigue that began one month previously….
Highlights from the ACR Review Course 2022
PHILADELPHIA—At ACR Convergence 2022, the much-anticipated ACR Review Course featured talks from eight experts. Topics reflected the heterogeneity of our field and included Sjögren’s disease, spondyloarthritis (SpA), osteoarthritis (OA), paraneoplastic rheumatic syndromes, metabolic bone disease, statin myopathy, Raynaud’s phenomenon and autoinflammatory syndrome. Here, I share highlights from this comprehensive, six-hour session. Sjögren’s Disease Sara S….
Is Gout an Autoinflammatory Syndrome After All?
PHILADELPHIA—The term autoinflammatory syndrome was coined by Daniel L. Kastner, MD, PhD, National Institutes of Health (NIH), Bethesda, Md., not long after he discovered that mutations in the gene MEFV, which codes for the protein pyrin, are responsible for familial Mediterranean fever (FMF).1 Early on, the term was meant to signify monogenic conditions in which…
Case Report: CPPD Presenting as Pseudosepsis
Calcium pyrophosphate crystal deposition disease (CPPD) is an arthritis caused by the accumulation of calcium pyrophosphate crystals. Despite a prevalence of 4–7% among the adult population in Europe and the U.S., it has remained a relatively under-recognized disease owing to its many clinical presentations.1 CPPD may cause an acute mono/oligoarthritis, which may mimic gout or…
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