Autoimmune rheumatic diseases (AIRDs) are known for their systemic presentations and multi-organ involvement. Numerous infectious diseases, particularly mycobacterial, fungal and indolent bacterial infections endemic to specific geographic regions, present with varied signs and symptoms of multi-system involvement and can mimic AIRDs. Thus, differentiating infection from an AIRD is critical to resolve competing treatment approaches. This…
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…
Intra-articular venous malformations of the knee are an uncommon cause of knee pain in children. Presenting symptoms of this rare subtype of venous malformation often include nonspecific pain and joint swelling, which may be episodic, and accompanied by limited range of motion. The signs and symptoms can mimic juvenile idiopathic arthritis (JIA). Timely diagnosis of…
ACR CONVERGENCE 2020—Tiphanie Phillips Vogel, MD, PhD, assistant professor of pediatrics and internal medicine at Baylor College of Medicine, Houston, moderated the session on COPA syndrome, which drew 324 attendees on a Sunday morning. This rare genetic cause of immune dysregulation can present like anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis, lupus, lupus nephritis or rheumatoid…
ATLANTA—Dry eyes and mouth are common symptoms in the general population. When patients report these symptoms to their primary care provider and other consultants, it may prompt a referral to a rheumatologist to rule out Sjögren’s syndrome. However, as discussed in the 2019 ACR/ARP Annual Meeting session, Sjögren’s Syndrome: Beyond the Dryness, evaluation of this…
Scleromyxedema is a rare, mucinous skin disorder of unknown origin, one of a number of conditions that mimic systemic sclerosis. Although cases of scleromyxedema remain rare, a better understanding of its mechanisms of action could have implications for the research and treatment of scleroderma and related autoimmune conditions, says Laura K. Hummers, MD, ScM, co-director…
CHICAGO—The 2018 ACR/ARHP Annual Meeting session on genetic mimics of rheumatic disease began with a description of a patient who presented with the symptoms of childhood-onset lupus but instead had a well-defined genetic disease: lysinuric protein intolerance (LPI). Lindsay Burrage, MD, PhD, assistant professor of molecular and human genetics at Baylor College of Medicine, Houston,…
A 43-year-old man with a past medical history of type 2 diabetes mellitus, bilateral inguinal hernia repair as a child and prior cholecystectomy woke from sleep with sudden-onset periumbilical abdominal pain. He was admitted to another hospital, but required transfer to our surgical intensive care unit after a recurrent episode of severe abdominal pain, during…
Rheumatoid arthritis (RA) is characterized by polyarthritis, especially involving hands and wrists. Without treatment, RA usually evolves to articular deformities. Unfortunately, although rheumatoid deformities are characteristic, they are not pathognomonic, and we should be aware of possible mimics.1 Neuropathic arthropathy (NA), similar to other diseases, such as hemochromatosis, psoriatic arthritis, calcium pyrophosphate deposition disease, Jaccoud…
CHICAGO—David Daikh, MD, PhD, professor of medicine at the University of California San Francisco and chief of the Rheumatology Division at the San Francisco VA Medical Center, said the overlap between malignant disease and rheumatic disease means rheumatologists should stay aware that more may be going on than just a rheumatic disorder. He made his…