Lupus, Sjogren's Syndrome, Scleroderma, and Related Conditions

 
 
  • Ask the Experts - Thrombocytopenia Associated with Systemic Lupus... Please discuss the treatment options for thrombocytopenia associated with systemic lupus erythematosus (SLE), and the indications for splenectomy in these cases.
  • Ask the Experts - Suspected SLE What is appropriate management of a 58-year-old postmenopausal woman with suspected systemic lupus erythematosus (SLE), with anorexia (5- to 6-kg weight loss over 7-8 months), severe myalgia, antinuclear antibodies (ANA) strongly positive, ds-DNA negative, cardiac and renal profile normal, and cerebrospinal fluid (CSF) with 15% lymphocytes?
  • Ask the Experts - Advances in Lupus Cerebritis Could you describe recent advances in the treatment of lupus cerebritis?
  • Ask the Experts - Lupus and Cyclophosphamide A 21-year-old woman had grade IV lupus nephritis 5 years ago, with an excellent response to pulse cyclophosphamide and steroid. Now she has cerebritis and renal failure requiring hemodialysis. Is there any benefit to cyclophosphamide?
  • Ask the Experts - It's All in a Name We are familiar with the antibodies SS-A(Ro) and SS-B(La). Is there any more information on the origin of the names Ro and La.
  • Ask the Experts - Ligamentous Laxity What conditions are associated with ligamentous laxity first appearing in adulthood? Are there any specific treatments? Could use of nonsteroidal anti-inflammatory drugs (NSAIDs) aggravate the condition due to cartilaginous breakdown? Several of my active female patients have fibromyalgia-like symptoms seemingly triggered by exercise, associated with audible joint crepitance and demonstrable sacro
  • Ask the Experts - Sjögren's Syndrome and the Lasik Procedure A 30-year-old man presented with dry eyes; the condition has become worse since a Lasik procedure. He has no noted xerostomia. Antinuclear antibody (ANA) titer was 1:160 nucleolar; SGOT/AST, 47; lactate dehydrogenase, 148; SGPT/ALT, 71 (normal, 0-45); SS-A and SS-B were negative; and the remainder of the ANA panel is negative as well. Findings were also negative for hepatitis A, B, and C, and anti
  • Ask the Experts - Thalidomide for Discoid Lupus Does thalidomide have a role in the treatment of resistant cases of discoid lupus? If so, what is its appropriate dosing and monitoring?
  • Ask the Experts - Treatment for Linear Scleroderma Please discuss the treatment options for linear scleroderma.
  • Ask the Experts - Leflunomide for SLE Is it advisable to start leflunomide in a patient with systemic lupus erythematosus (SLE) in whom methotrexate had to be stopped because of liver enzyme elevations?
  • Ask the Experts - Complex Diagnosis Suggesting SLE The patient has undergone magnetic resonance angiography (MRA) of the aortic arch and branches, which yielded negative results. Takayasu's disease was considered. What are other possibilities?
  • Ask the Experts - Sjögren's Syndrome and Tongue Enlargement In Sjögren's syndrome, is there any enlargement of the lingual papillae? A 65-year-old woman has osteoporosis, severe xerostomy from Sjögren's syndrome, and dysphagia caused by enlargement of the papillae of the distal portion of the tongue. Corticosteroids were suggested but would not be appropriate, given the presence of osteoporosis.
  • Ask the Experts - Sarcoidosis Without Pulmonary Involvement We thought that the patient had sarcoidosis with renal involvement, and we started steroid therapy.
  • Ask the Experts - Treatment for Dermatomyositis with Concomitant... What is the best treatment for a 55-year-old woman with dermatomyositis with erythroderma, panniculitis, and extensive calcinosis?
  • Ask the Experts - A Case of "Localized Scleroderma" A parent is concerned because her 9-year-old daughter has been diagnosed with "localized scleroderma," after years of seeing physicians and not getting a diagnosis. A dermatologist told her to do nothing and to wait and see what happens. In contrast, a rheumatologist advised that her daugher be put on medications to prevent the scleroderma from getting worse. Who is right? What could be the downsi
  • Ask the Experts - Diagnosis of Sarcoidosis With an Increased ACE Level... How can a diagnosis of sarcoidosis be made in a patient with an elevated angiotensin-converting enzyme (ACE) level and a normal chest x-ray?
  • Ask the Experts - Is There a Risk of Thrombosis in a Patient With SLE... I have a 10-year-old female patient who has systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS). She presented with hematurea but never had a thrombotic event.