Anti-HMGCR Autoantibodies in Juvenile Idiopathic Inflammatory Myopathies Identify a Rare but Clinically Important Subset of Patients

Objective.We aimed to establish the prevalence and clinical associations of anti-HMG-CoA-reductase (anti-HMGCR) in a large UK cohort with juvenile myositis.Methods.There were 381 patients investigated for anti-HMGCR using ELISA.Results.Anti-HMGCR autoantibodies were detected in 4 patients (1%). These children had no or minimal rash and significant muscle disease. Muscle biopsies were considered distinctive, with widespread variation in fiber size, necrotic fibers, and chronic inflammatory cell infiltrates; all had prolonged elevation of creatine kinase and all ultimately received biologic therapies.Conclusion.Anti-HMGCR in UK children with myositis are associated with severe disease that is poorly responsive to standard treatment.</jats:sec

The prescription and monitoring of conventional synthetic disease-modifying anti-rheumatic drugs: British Society for Rheumatology guideline scope

Lay Summary: What does this mean for patients? A revised guideline, produced by the British Society for Rheumatology (BSR), will provide up-to-date information about the safe prescribing and monitoring of the effects of non-biologic (or conventional synthetic) disease-modifying anti-rheumatic drugs (DMARDs). This guideline will be used by healthcare professionals, people living with autoimmune rheumatic diseases and other interested parties, such as patient groups and charities. DMARDs are a group of drugs prescribed to people with autoimmune rheumatic diseases. The main aims of these drugs are to control symptoms and reduce or prevent long-term progression of the disease. Biologic drugs and Janus kinase inhibitors—sometimes referred to as biologic DMARDs and targeted synthetic DMARDs, respectively—are excluded from this guideline. This article outlines the scope of the revised guideline for DMARD safety, which will be updated to include new information and is being extended to include children and young people. Guideline revisions will be undertaken by a working group of adult and paediatric and adolescent rheumatologists, other healthcare professionals and people living with autoimmune rheumatic disease. The guideline will be developed using the methods and processes outlined in the BSR document ‘Creating clinical guidelines: our protocol’

Periodontal plastic procedure for the management of the residual gingival defect after excision of an epulis

Dentinal hypersensitivity and unesthetic appearance are common findings after excision of an epulis due to exposure of root and underlying bone. The simultaneous placement of subepithelial connective tissue grafting after excision of the lesion seems to be viable surgical option in such cases. Furthermore, this will avoid second surgical procedure for the management of the residual gingival defect

Practical Guidance for the Evaluation and Management of Drug Hypersensitivity: Specific Drugs

International audienc