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Researchers Seek the Best Methods to Maintain Remission in Vasculitis

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MADRID—During the 2019 European Congress of Rheumatology (EULAR), held June 12–15, speakers addressed the complexity of vasculitis in a Challenges in Clinical Practice session titled, How to Maintain Remission in Vasculitis. Although vasculitis appears in many varieties, one commonality exists among these related yet distinct conditions: When there is vital organ or systemic involvement, disease…

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Why You Should Consider Adding a Dietitian to Your Team

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A patient with rheumatoid arthritis (RA) asks if diet can help ease their symptoms. Or maybe a patient with severe knee osteoarthritis (OA) seeks diet advice because they want to lose weight and relieve pressure on their joints. Although there’s no specific nutrition plan for patients with rheumatic diseases, research has shown many dietary factors…

Study Examines How Depression Subtypes May Stem from Osteoarthritis

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People with or at risk for sympto­matic knee osteoarthritis (OA) may be assigned to four depression subtypes with distinct clusters of depressive symptoms that may affect pain and disability over time, according to a new study in Arthritis Care & Research.1 Four depression subtypes were identified in the study using the Center for Epidemiologic Studies…

Study Implicates Epstein-Barr Virus in 7 Autoimmune Diseases

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The identification of specific transcription factors linked to the Epstein-Barr virus (EBV) provides new information on the molecular mechanisms underlying the link between EBV and autoimmune disease. A recently published study, “Transcrip­tion Factors Operate Across Disease Loci, with EBNA2 Implicated in Auto­immunity,” co-led by John B. Harley, MD, PhD; Leah C. Kottyan, PhD; and Matthew…

Case Report: A Patient Develops Scleroderma Renal Crisis

Adria Madera-Acosta, MD, Teresa Sosenko, MD, & Diana Girnita, MD, PhD  |  

Scleroderma renal crisis (SRC) is a life-threatening complication of systemic sclerosis. SRC occurs in 2–15% of patients with diffuse sclerosis and usually within the first five years from the time of diagnosis. Risk factors for SRC include, but are not limited to, early diagnosis, corticosteroid or cyclosporine use, and the presence of anti-RNA polymerase III…

Forging & Maintaining a Therapeutic Alliance with Difficult Patients

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When I first met Ms. Miller (name changed), quite frankly, I couldn’t wait to get out of the room. I’m sure she couldn’t either. A woman in her 40s with systemic lupus erythematosus, poorly controlled asthma and fibromyalgia, she seemed to have every conceivable symptom. And, worse than that, due to a long history of…

Lessons from Master Clinicians: An Interview with Dr. Michael Weisman

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Rheumatologists want to be the best clinicians possible, provide consistently exceptional care to patients and serve as role models for colleagues and trainees. In the Lessons from a Master Clinician series, we offer insights from clinicians who have achieved a level of distinction in the field of rheumatology. Michael H. Weisman, MD, is a professor…

Case Report: A Patient on Apremilast Develops Streptococcus Salivarius

Stephanie Kydd Dondero, DO, & Barry Waters, MD  |  

Apremilast was first marketed in March 2014 for the treatment of adults with psoriatic arthritis (PsA). An immuno­modulating drug, which is a small molecule inhibitor of phosphodiesterase 4 (PDE4) specific for cyclic adenosine mono­phosphate (cAMP), apremilast is administered orally. By inhibiting PDE4, intracellular cAMP levels are increased. Although the exact mechanism of action is not…