4.09 Rheumatologic Emergencies

Rheumatology review for USMLE Step 1 Exam

Giant Cell Arteritis (GCA)

• A large vessel vasculitis, mainly in older individuals.
• Symptoms: headache, jaw claudication, vision loss.
• Ischemia from granulomas in large vessels causes vision loss.
• Immediate high-dose corticosteroids are crucial.

Scleroderma Renal Crisis

• A complication of scleroderma.
• Symptoms: finger edema, skin tightening, sudden hypertension, rising creatinine.
• Renal artery fibrosis leads to high blood pressure.
• Treat with IV ACE inhibitor, not steroids.

Acute Transverse Myelitis in SLE

• Inflammation of the spinal cord in lupus.
• Symptoms: bilateral numbness, tingling, weakness.
• Treat with corticosteroids.

Catastrophic Antiphospholipid Syndrome (CAPS)

• A rare, life-threatening form of APS.
• Symptoms: unexplained miscarriages, unexplained clots, multiorgan failure.
• Treat with anticoagulation followed by immune suppression