The patient was a 48-year-old woman who saw her primary care physician for a flu-like illness three months prior to admission. Her symptoms initially improved, but recurred one month later; she was treated symptomatically, and again symptoms resolved. Two months later, she presented to an outside facility’s emergency department with fever to 103ºF, with associated…
Fellows’ Forum Case Report: Tophaceous Bullae
As a manifestation of hyperuricemia, inflammatory bullous lesions have rarely been described in the past century. A more classic presentation of hyperuricemia is acute inflammatory gouty arthritis, characterized by the deposition of monosodium urate crystals. Other complications of chronic untreated hyperuricemia may include polyarticular arthritis, tophus formation and possible chronic destructive lesions of the bone,…
International Task Force Recommends Intra-articular Hyaluronic Acid for Knee OA
An international task force convened by the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) recommends systematic repeated intra-articular hyaluronic acid (HA) injections as second-line treatment for patients with knee osteoarthritis (OA). This is the first time a group of experts has made this recommendation, which is directed toward treatment of…
More Effective Antifibrotic Therapies for Systemic Sclerosis in Development; Adverse Events A Concern
Systemic sclerosis (SSc) is a rare disease affecting about 49,000 U.S. adults, and it is strongly associated with high levels of morbidity and mortality.1 Of the few available antifibrotic therapies, none is targeted for SSc. However, reason for optimism exists for antifibrotic treatments in early development and clinical trials, says Jörg H.W. Distler, MD, Heisenberg Professor…
Stem Cell Transplantation Shown to Improve Outcomes in Systemic Sclerosis
Rheumatologists now have another treatment option to offer their patients with one of, if not the most, difficult autoimmune diseases to treat. New data add to the growing evidence of the safety and benefit of stem cell transplantation for patients with systemic sclerosis with internal organ involvement. New results of the Scleroderma: Cyclophosphamide or Transplantation…
Plasma Complement Activation in Rheumatic Diseases May Accelerate Coronary Artery Disease
Complement can deposit in various tissues, and previous studies have associated complement deposition with an increased risk for all-cause mortality and stroke. Now, new research underscores the relationship between rheumatic disease, the complement system and cardiovascular disease. In particular, inflammatory rheumatic disease status appears to be uniquely associated with mononuclear cell infiltrates in the vascular…
Infection Rates for Patients with SLE on Immunosuppressive Drugs
A comparison study of the serious infection burden among patients with lupus found no major differences in patients treated with three separate immunosuppressive drug regimens. Given that serious infections are among the leading causes of hospitalizations and death in patients with systemic lupus erythematosus (SLE), researchers investigated whether the incident rates differed in patients who…
Rheumatology Case Report: Immune-Related Aortitis Associated with Ipilimumab
Ipilimumab (Yervoy) is a monoclonal antibody directed against cytotoxic T-lymphocyte antigen 4 (CTLA-4). It was the first drug to demonstrate a survival benefit in advanced melanoma and was approved by the FDA in 2011.1 By blocking the CTLA-4 receptor, ipilimumab enhances the immune response against tumors via cytotoxic T lymphocyte activation and proliferation.2 However, immunopotentiating…
Effectiveness of Novel Therapies for Cutaneous SLE Explored
WASHINGTON, D.C.—A new, humanized anti-BDCA2 monoclonal antibody can trigger inhibition of the production of interferon, cytokines and chemokines derived from plasmacytoid dendritic cells in patients with cutaneous systemic lupus erythematosus (SLE), according to research presented at the 2016 ACR/ARHP Annual Meeting. The findings were discussed during a session on SLE treatment, drug adherence and the…
Drug Reduction Strategies, Disease Control for Patients with RA in Remission
WASHINGTON, D.C.—Clinical aspects of managing patients with rheumatoid arthritis (RA) in remission were discussed by a panel of experts at the 2016 ACR/ARHP Annual Meeting during the session titled Rheumatoid Arthritis—Clinical Aspects IV: Managing Patients in Remission. Among the issues raised were strategies to taper or discontinue biologic therapies, as well as clinical predictors of…
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