Tuesday, 16 Jul 2019

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RheumNow Podcast – Downside of Lupus (2.9.19)

Dr. Jack Cush reviews this past week's news and reports from RheumNow.com:

  1. Study of 497 rheumatology clinic pts shows 24% met fibromyalgia criteria, while 21% had a ICD-10 Dx of FM. Clinicians and criteria agreement was only fair (κ = 0.41). MD failed to Dx identify 60 criteria (+) pts & wrongly dx 43 criteria‐negative pts https://t.co/sZobOovOW4
  2. CDC Stats: In 2017, >2/3 of all drug overdose deaths in the United States involved opioids; From 2016 to 2017, opioid-related overdose deaths increased 12 percent overall (17.2% in elderly). https://t.co/O38uFIUcpd
  3. 17 yr review of records from Royal Adelaide Hospital studied the association of silicone breast implants (SBI) with rheumatic disease. SBI patients were more likely to have FM and Chr Fatigue syndrome compared to Scleroderma (but not SLE) patients https://t.co/XLbtY6kb0G 
  4. Cohort study from China compared 121 untreated IgG4-RD pts with and without dacryoadenitis and sialoadenitis (DS) and finds DS pts had more sinonasal involvement, eosinophils and higher serum IgG4 levels than those without DS. https://t.co/Mv6iFmPLI3
  5. Antiphospholipid syndrome incidence is 5 per 100k/Yr; aside from the triad lesser known complications valve dz, livedo reticularis, racemosa, skin ulcers/necrosis, GN & thrombotic microangiopathy, AVN, non-traumatic fractures https://t.co/ugjKR2gttU
  6. Study of 690 ambulatory patients examined RDW, ESR, CRP and showed RDW is increased in inflammatory disorders (RA, SpA) and elevated RDW has a 48–95% sensitivity and 66–95% specificity for inflammatory disease. https://t.co/P0QWh5NL3s
  7. French Study Group for Large Vessel Vasculitis shows in a small 49 pt GCA cohort study that GCA is not associated with a higher risk of cancer (compared 1:3 with age matched controls) https://t.co/o8z8D99aKn 
  8. Kaiser Permanente study of 1,956 adult #SLE patients shows that only 58% of lupus pts were ≥80% adherent to hydroxychloroquine. Only age and increasing visits were predictive. Not predictive were the rheumatologist, center or socioeconomic factors. https://t.co/2mpkaBK4YZ 
  9. Study of 3209 incident lupus pts in Sweden shows lung dz to be 6 fold more common than controls (IR 14/1000 Pt Yrs), including a 19 fold higher risk of interstitial lung disease. https://t.co/olLejMXv6j
  10. Elevated Fracture Risk in Lupus  
  11. Compounded Pain Creams - Expensive Placebos? 


The author has no conflicts of interest to disclose related to this subject

Rheumatologists' Comments

First time I saw Livedo Racemosa in clinic was as a Rheum trainee registrar. Send her to derm for biopsy- which was suggestive of PAN. No internal organ involvement was noted.

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