(Reuters)—Medications that suppress the immune system—necessary for many chronic diseases—do not worsen outcomes of COVID-19 cases, new data suggest. Researchers looked back at 2,121 adults hospitalized for COVID-19 between March and August, including 108 who were taking immunosuppressive drugs (primarily prednisone, tacrolimus or mycophenolate mofetil). After accounting for patients’ general baseline health status, researchers found…
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The Effects of IL-17A Inhibitors on the Microbiota
The use of an interleukin (IL) 17A inhibitor resulted in gut microbial dysbiosis and features of subclinical intestinal inflammation in a subgroup of psoriatic arthritis (PsA) and spondyloarthritis (SpA) patients, according to a multidisciplinary, collaborative study across several institutions published in Arthritis & Rheumatology.1 Understanding the downstream effects of these perturbations is an important step…
Rheum After 5: Dr. Angus Worthing, the Singing Rheumatologist
Every Christmas Eve, Angus Worthing, MD, FACP, FACR, his wife, Margaret, and two young children, engage in a sing-off over the phone, competing against a professional quartet comprising his best friend, Doug, Doug’s sister and their parents. Dr. Worthing, a partner at Arthritis & Rheumatism Associates in Washington, D.C., demonstrated his musical talent as a…
The ACR’s 2020 Advocacy Year in Review
To say it has been an interesting (the science and the memes), tumultuous (the politics) and heartbreaking (the pandemic and social injustice) year is an understatement. There have been moments of grace and inspiration that we hope have kept everyone going. As we look to 2021, we take lessons from our experiences in 2020. Washington,…
Case Report: Drug-Induced Lupus & ANCA-Associated Vasculitis Overlap
Drug-induced lupus erythematosus and ANCA-associated vasculitis (AAV) are both autoimmune conditions associated with the use of hydralazine, a commonly prescribed drug for hypertension and congestive heart failure. Although the pathogenesis is unknown, it is believed that hydralazine alters neutrophil and lymphocyte function and promotes exposure of antigens, leading to the development of anti-neutrophil antibodies (ANCA)…
Study Finds Renal Arteriosclerosis Is Common in Lupus Nephritis Patients
Renal arteriosclerosis is common in lupus patients with nephritis and occurs two decades earlier than it does in people without lupus nephritis (LN), report investigators in a study that examined the prevalence of renal arteriosclerosis in LN patients compared with healthy controls.1 The finding suggests that renal arteriosclerosis could be used as a biomarker for…
Case Report: Hydralazine-Induced ANCA-Associated Vasculitis
Hydralazine has been in use as a treatment for hypertension, most notably in heart failure patients, since 1951.1 The drug is a known cause of autoimmune disease, most specifically hydralazine-induced lupus. Hydralazine-induced lupus occurs in 7–13% of those taking the medication.2-4 It often presents with constitutional symptoms, arthritis/arthralgias, cutaneous lesions, serositis, myalgias and/or hepatomegaly. Features…
The History of ACE Inhibitors in Scleroderma Renal Crisis
Scleroderma renal crisis is a true medical emergency in rheumatology, one that requires prompt diagnosis and treatment. Here, we review the historic introduction of the angiotensin-converting enzyme inhibitors in this context, and highlight management and key questions moving forward. Background Awareness of renal disease in scleroderma dates back many years. The revered physician William Osler…
The Character of Rheumatology Has Changed Over the Past 50 Years
Camelot allegedly existed once upon a time in South Wales. The name was evoked again in the 1960s, but perhaps it is also applicable to the character of rheumatology in the halcyon days of the 1970s and 80s. That’s not to belittle the world we now live in, with so many treatment options for our…
Point-of-Care Testing for COVID-19
Ethan Craig was not pleased. As a reader of this column, you know that Dr. Craig is an assistant professor of clinical medicine in the Division of Rheumatology at the University of Pennsylvania and an associate editor of The Rheumatologist. On this particular morning, however, he was the father of a 5-year-old who woke up…
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