Immunoglobin G4-related disease (IgG4-RD) is a rare fibro-inflammatory disease of unknown etiology that has been recently recognized. It can cause fibro-inflammatory masses in almost every organ of the body and is associated with dense lymphoplasmacytic infiltration of IgG4-postitive plasma cells, storiform fibrosis and elevated levels of serum IgG4.1 IgG4-RD is a systemic disease that may…
Pulmonary arterial hypertension (PAH) in connective tissue disease (CTD) features significant morbidity and mortality. Standard therapies with endothelin receptor antagonists and phosphodiesterase-5 inhibitors have shown some clinical improvement in patients, but these clinical improvements have proved modest when compared with other types of PAH. As our case below suggests, rituximab may show promise as a…
No matter where you practice, rheumatology clinics are extremely busy. And in that hustle and bustle we find an uncomfortable jostling of priorities between delivering optimal care for as many patients as possible and upholding education for teachers and learners at all levels. Because salary usually comes from seeing more and more patients, teaching is…
In 1866, Adolf Kussmaul, an internist, and Rudolf Maier, a pathologist, published the classic characterization of what eventually became known as polyarteritis nodosa.1 It was the first scientific clinical characterization of a noninfectious vasculitis. As such, it became a paradigmatic point of contrast to other types of vasculitides that were later described. Their description also…
You see a patient for the first time to establish care for Sjögren’s disease. She complains of dry eyes, dry mouth and diffuse arthralgias. You do not appreciate any synovitis on physical exam. Of note, you are the fourth rheumatologist she has seen during the past year. Toward the end of the clinic visit, she…
A 58-year-old African American woman with a past medical history of hypertension (HTN), hyperlipidemia, severe gastroesophageal reflux disease (GERD) and limited cutaneous systemic sclerosis (lcSSc) presented to the emergency department with shortness of breath (SOB) and progressive bilateral lower extremity swelling for three weeks. She denied any chest pain, but endorsed generalized fatigue and dyspnea…
(Reuters)—Drugstore chain CVS Health Corp on Wednesday launched a new tool that will allow pharmacies help customers tackle the soaring cost of drugs by comparing prices of medicines. U.S. healthcare companies, ranging from insurers to drug retailers, are stepping up efforts to combat rising drug prices that has been widely criticized by regulators and has…
In March, the ACR released a white paper designed primarily to help rheumatologists and rheumatology health professionals gain an understanding of biosimilars.1 This research-based education piece examines the scientific, economic and prescribing issues related to the use of biosimilars. Now, the ACR has released an update to its official position statement on the use of…
While growing up in California’s capital city, Sacramento, Christina Downey, MD, learned early on that it’s important to speak up for what’s important to her. When she completed her fellowship and joined the ACR in 2015, she found her way to the ACR’s Advocacy 101 program, which trains rheumatologists to become advocates in Washington, D.C.,…
A recent study found that dermatology patients taking long-term steroids are not always evaluated for steroid-induced osteoporosis…