- N Engl J Med 2022; 387:737-737
A 61-year-old woman with primary biliary cholangitis and Raynaud’s phenomenon was referred to the rheumatology clinic. Tongue telangiectasias, puffy fingers, and nailfold capillary hemorrhage were present.
- N Engl J Med 2022; 387:631-639
Formerly known as Devic’s disease, this relapsing, demyelinating disorder of the central nervous system encompasses six syndromes and is associated with aquaporin-4 autoantibodies. Effective treatment prevents relapses.
- N Engl J Med 2022; 387:e14
A 74-year-old woman with psoriatic arthritis presented with swelling of the fifth finger. On examination, there were nontender, subcutaneous nodules in the hypothenar region and over the fifth finger.
- N Engl J Med 2022; 387:321-331
Litifilimab, a blood dendritic cell antigen 2 antibody, was superior to placebo with regard to a measure of disease activity in cutaneous lupus erythematosus at 16 weeks.
- N Engl J Med 2022; 387:168-176
A 17-year-old girl was admitted because of prolonged fever and cough. She had an elevated creatinine level and a low hemoglobin level. A diagnostic test was performed.
- N Engl J Med 2022; 386:2532-2534
In a prospective series of 17 children with Langerhans-cell histiocytosis of the skull, all the lesions resolved spontaneously by 1 year. This approach contrasts with the usual practice of surgery for these lesions.
- N Engl J Med 2022; 386:2359-2361
The rheumatologist had been drawn to her specialty by the diagnostic mysteries and long-term patient relationships, but faced with Mr. C., she found herself failing not only to diagnose his condition but also to keep him out of the hospital as his condition deteriorated.
- N Engl J Med 2022; 386:2315-2315
A 67-year-old man presented to the ophthalmology clinic with swollen eyelids and proptosis. Biopsy of the right lacrimal gland showed a lymphoplasmacytic infiltrate with IgG4-positive plasma cells.
- N Engl J Med 2022; 386:2222-2231
A 17-year-old boy was admitted to the pediatric ICU with chest pain, syncope, electrocardiographic abnormalities, and elevated creatine kinase and troponin T. He had been well until 5 days earlier, when fever, nausea, diarrhea, muscle aches, and chest pain developed.
- N Engl J Med 2022; 386:2221-2221
A 68-year-old man presented with a 2-month history of eye pain, redness, and blurry vision. He also had a 1-year history of dry cough, sinusitis, and unintentional weight loss. CT of the chest revealed lung nodules.
- N Engl J Med 2022; 386:2035-2035
A 40-year-old man presented with a foot rash, joint swelling, and low back pain after having recently had urethral discharge. Conjunctivitis, migratory glossitis, and circinate balanitis were also noted on examination.
- 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; 386:1933-1944
A 57-year-old man with polyarteritis nodosa was evaluated for cough and pulmonary opacities. Chest CT revealed multifocal clustered centrilobular nodules and opacities in a tree-in-bud pattern. A galactomannan test was positive. Diagnostic tests were performed.
- N Engl J Med 2022; 386:1732-1740
Nonspecific low back pain is diagnosed by ruling out other causes, usually by means of history taking and physical examination; imaging is not routinely indicated. Patients with acute nonspecific low back pain should receive education about the condition and advice to remain active; most recover within weeks. Exercise therapy and...
- N Engl J Med 2022; 386:1742-1749
An 82-year-old woman presented to the emergency department with a 3-week history of severe low back pain, rigors, anorexia, difficulty ambulating, and a sensation of incomplete urination. She had no numbness, tingling, weakness, saddle anesthesia, or fecal incontinence.
- 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....