- N Engl J Med 2022; 387:167-167
A 30-year-old man presented with a morbilliform rash and fever after taking an antimicrobial agent. Facial edema, eosinophilia, and elevated liver-enzyme levels developed later.
- N Engl J Med 2022; 386:2036-2048
A 55-year-old man was evaluated for a mediastinal mass, which was identified during an evaluation for waxing and waning fevers, night sweats, and fatigue. He had mediastinal lymphadenopathy with low FDG uptake, splenomegaly, anasarca, elevated inflammatory marker levels, hypoalbuminemia, anemia, and thrombocytopenia. A diagnosis was made.
- N Engl J Med 2022; 386:1560-1570
A 41-year-old woman with transient dysarthria and facial droop was evaluated for mitral valve masses. Three weeks earlier, she had heavy vaginal bleeding with crampy abdominal pain, fatigue, and lightheadedness. CT imaging was notable for small chronic cerebral infarcts and uterine fibroids. Diagnostic test results were received, and management decisions...
- N Engl J Med 2022; 386:1034-1045
In a phase 2 trial of iberdomide in patients with moderate-to-severe SLE, a composite response (on the Systemic Lupus Erythematosus Responder Index–4) occurred in 54% of those who received iberdomide (0.45 mg), as compared with 35% in the placebo group, but this between-group difference was not significant at lower doses....
- N Engl J Med 2022; 386:1071-1079
A 54-year-old woman was evaluated in the emergency department because of abdominal pain, nausea, and vomiting. Computed tomography of the abdomen and pelvis revealed circumferential jejunal-wall thickening. Medical history was notable for episodic swelling of the arms, hands, and feet. Diagnostic tests were performed, and treatment decisions were made.
- N Engl J Med 2022; 386:157-171
Patients with severe asthma are at increased risk for a decreased quality of life, fixed airway obstruction, hospitalization, and death. Biologics may be required to reduce the disease burden. This review discusses the mechanisms, efficacy, and safety of biologics for severe asthma.
- N Engl J Med 2021; 385:2451-2462
Dramatic advancements in the use of synthetic and mechanical devices to replace tissues have been made, but restoring tissue and organ structure and function remains challenging. This review discusses the origins, innovations, and future of regenerative medicine and transplantation, which are closely intertwined.
- N Engl J Med 2021; 385:1543-1545
As the new school year approaches, an immunocompromised mother faces a different risk–benefit calculus from most moms in sending her son off to kindergarten during a pandemic. But having saved up her “risk dollars,” she is ready to spend some on a return to normalcy.
- N Engl J Med 2021; 385:1302-1315
There is still no cure for inflammatory bowel disease. This review covers newer treatments that reflect our understanding of the complex pathogenesis of IBD, with a focus on clinical and endoscopic remission and more precise molecular targeting of inflammatory cascades.
- N Engl J Med 2021; 385:1246-1248
A female adolescent being treated for Hodgkin’s lymphoma had febrile neutropenia, diffuse abdominal pain, varicella–zoster infection, recurrent rash, and respiratory distress. She had received MMR vaccination 2 months before lymphoma was diagnosed. Her illness progressed, and she died. Postmortem studies showed that her fatal illness was caused by the vaccine...
- N Engl J Med 2021; 385:885-895
In a multicenter, open-label, randomized trial in patients with immune thrombocytopenia, 91.5% of patients who received mycophenolate mofetil plus glucocorticoids had platelet levels above 100,000 per microliter, as compared with 63.9% of patients who received glucocorticoids only. Quality-of-life measures of physical function and fatigue were worse in the mycophenolate mofetil...
- N Engl J Med 2021; 385:921-929
A young man with a germline mutation in IL2RG had a history of herpes-related encephalitis and multiple skin and mucosal lesions caused by human papillomavirus, including a recurrent refractory nasal squamous-cell carcinoma. Allogeneic hematopoietic-cell transplantation resulted in clearing of the HPV lesions, including the nasal carcinoma.
- N Engl J Med 2021; 385:628-639
The ability to block specific cytokine pathways has revealed pathophysiological differences among autoimmune diseases (e.g., the efficacy of TNF inhibitors in arthritides and inflammatory bowel disorders and their inefficacy in giant-cell arteritis and multiple sclerosis), providing a framework for reclassification.
- N Engl J Med 2021; 385:562-566
In this article, the authors discuss the challenges of SARS-CoV-2 infection in patients with a weakened immune system, including the potential implications regarding viral evolution and transmission.
- N Engl J Med 2021; 385:76-77
Celiac disease is a T-cell–mediated enteropathy induced by dietary gluten that shares many features with organ-specific autoimmune disorders.1 Celiac disease requires the presence of autoantibodies directed against the endogenous enzyme tissue transglutaminase 2 and occurs selectively in persons in whom the HLA-DQ2 or HLA-DQ8 molecules, which harbor positively...
- N Engl J Med 2021; 385:35-45
In a phase 2 proof-of-concept trial, patients with celiac disease controlled on a gluten-free diet were assigned to one of three dose levels of ZED1227 (a selective transglutaminase 2 inhibitor) or placebo. Patients were challenged with 3 g of gluten daily for 6 weeks. Comparison of duodenal-biopsy samples between baseline...
- N Engl J Med 2021; 385:74-75
Since the sudden emergence of multisystem inflammatory disease in children (MIS-C) in April 2020 as a novel and severe presentation of coronavirus disease 2019 (Covid-19), nearly 4000 cases of MIS-C and 35 deaths have been reported in the United States and many more internationally.1-4 A steep learning curve...
- N Engl J Med 2021; 385:23-34
An analysis of surveillance data on inpatients younger than 21 years of age who had multisystem inflammatory syndrome in children and were hospitalized between March 15 and October 31, 2020, showed that initial treatment with IVIG plus glucocorticoids was associated with a lower risk of cardiovascular dysfunction and a lower...
- N Engl J Med 2021; 385:11-22
An observational cohort study evaluated immunomodulatory therapy of multisystem inflammatory syndrome in children by comparing IVIG, IVIG plus glucocorticoids, or glucocorticoids alone. The investigators found no evidence of the superiority of any of the three therapies, although significant differences may emerge as more data accrue.