Diana Girnita MD, PhD Founder of Rheumatologist Oncall

Case Report: Sternoclavicular Erosions in a Patient with Uncontrolled RA Sternoclavicular joint involvement has rarely been reported in the context of active  rheumatoid arthritis (RA). The sternoclavicular (SC) joint is not a typical joint assessed for RA. However, the fact that it is a diarthrodial synovial joint suggests that this joint may be vulnerable to inflammatory process and could potentially be used radiographically to monitor disease progression. In this article, we describe a patient with long-term, poorly controlled RA who presented at our hospital with complaints of chest pain that were due to SC joint arthritis. http://www.the-rheumatologist.org/article/case-report-sternoclavicualr-erosions-in-a-patient-with-uncontrolled-ra/3/

Treatment Options for Severe Refractory Gout When Pegloticase Fails  Pegloticase is a new alternative therapy for patients with severe, refractory  gout  unresponsive to other urate-lowering agents. The goal of this therapy is to reduce disease burden, tophi size and frequency of flares and to improve quality of life when other treatments have failed. Persistent lowering of plasma uric acid (PUA) to less than 6 mg/dL, while achieving the therapy’s goal, is considered successful treatment. Herein, we present a case of severe refractory gout in a patient unresponsive to all standard urate-lowering therapies, as well as treatment with pegloticase. http://www.the-rheumatologist.org/article/treatment-options-severe-refractory-gout-pegloticase-fails/5/

Rheumatoid Arthritis & Autoimmune Glomerulonephritis -case report about the effect of long term use of TNF inhibitors on kidneys Rheumatoid arthritis is rarely associated with renal manifestations, but secondary amyloidosis due to chronic inflammation is reported to be the etiology of renal dysfunction in many cases. Autoimmune glomerulonephritis is rarely described in the literature, but when it is, it’s mostly in close temporal relation with the use of TNF-alpha inhibitors. 5  It’s not known if the autoimmune process induced by the exposure continues after discontinuation of these drugs and is responsible for further damage in the following years. Here, we present a case of long-standing, poorly controlled RA in a patient previously exposed to multiple TNF-alpha inhibitors who developed immune-mediated membrano-proliferative glomerulonephritis (MPGN). http://www.the-rheumatologist.org/article/rheumatoid-arthritis-autoimmune-glomerulonephritis/?singlepage=1