We report a case of a 27-year-old woman who was initially diagnosed with systemic lupus erythematosus (SLE), had features of scleroderma and was subsequently found to have lymph node biopsy consistent with multicentric Castleman disease (MCD). She also had serologic evidence of acute Epstein-Barr virus (EBV) infection (vs. reactivation of EBV). The occurrence of MCD…
When I began my tenure as ACR president this past November, I posited that it “takes a village” to grow and succeed in rheumatology’s rapidly changing environment. The ACR village includes volunteers who represent a diverse leadership pipeline reflecting the demographics of our younger members. It also includes the international rheumatology community that accounts for…
I read with interest the Diagnostic View (TR, April), which, according to the authors, represented a case of rhupus, an overlap syndrome of RA and SLE. I challenge this view. My arguments: In the case of erosive RA, typically erosive changes are seen at MTP joints other than MTP1 (e.g., MTP5). In addition, the erosive…
Spotting the signs of autoimmunity as early as possible is often viewed as a positive goal for rheumatologic research. The premise: Patients may begin treatment years before their disease is active and destroying joints and tissue. Although much progress has been made in identifying early stages of rheumatoid arthritis pathogenesis, the clues are not as…
The serine-threonine protein phosphatase 2A (PP2A) enzyme is critical for regulatory T cells to function—without it, they don’t have the ability to suppress effector T cells and can’t protect against autoimmunity, according to new research published in Nature Immunology. Researchers found that conditional knockout mice—in which PP2A expression is knocked out only in regulatory T cells—developed…
New research investigates the role of autophagy, specifically the cell digestion process called LC3-associated phagocytosis (LAP), in inflammation and the pathology of systemic lupus erythematosus (SLE). Researchers found that defects in this process result in failure to digest dying cells, which increases inflammatory cytokine production and results in SLE-like disease in mice. Further exposure to dying cells accelerated disease development…
New research has found that the amyloid protein curli triggers immune activation and autoantibody production in lupus-prone and wild-type mice. Stefania Gallucci, MD, says these results provide insight into the mechanisms of bacterial infection that may result in lupus…
A recent case study revealed that an infant from a donor egg developed neonatal lupus erythematosus (NLE) and a congenital heart block, which may have been due to the presence of antibodies to Ro and La in the birth mother—not the genetic mother. The results suggest that a gestational mother with a history of autoimmune disease is sufficient to trigger the pathology of NLE…
LONDON (Reuters)—Britain’s healthcare cost watchdog has finally approved GlaxoSmithKline’s lupus drug Benlysta (belimumab) for limited use, after rejecting it since 2011 on the grounds that it failed to offer good value for money. The National Institute for Health and Care Excellence (NICE) said on Tuesday that the drug would be made available under a managed…
A recent study found that plasmacytoid dentricitic cells (pDCs) control the differentiation of immature B cells into regulatory B (Breg) cells or plasmablast, depending on the concentration of IFNα. For patients with SLE, researchers found that immune regulatory feedback between pDCs and Breg cells is dysfunctional, with the exception of patients who respond to rituximab…