She had headaches for many years. She visited multiple doctors, including her primary care physician, a neurologist, a pain clinic, and even a headache specialist, but she was unable to find an effective treatment. Over time she developed additional symptoms, including unexplained rashes and abdominal pain. When a close family member was diagnosed with an autoinflammatory disease, she was referred to my clinic to see if she, too, had one of these rare illnesses. Continue reading Your headaches…are they autoinflammatory?
Fevers are tough. They make you feel lousy. They cause worry. They prevent kids from attending school and adults from going to work.
Dining with colleagues in the cafeteria of the Massachusetts General Hospital, Dr. Stephen Goldfinger expressed his frustration about the strange illness of a patient he had recently seen. She had attacks of fever and abdominal pain that seemed to come out of nowhere. Her attacks were brief, lasting 1-3 days, but were so severe that she became bed-ridden during these episodes. Although the woman was otherwise healthy, a severe depression ensued from the unpredictable, debilitating illness that plagued her life every few weeks.
We are not alone. Right now, there are over 500 species of bacteria living in your mouth. Each part of your gut (stomach, small intestine, large intestine) provides a home to 1000 unique bacterial species. There are many more bacteria living on your skin and in every orifice in your body. Microbes make up (at least half of) who we are. We are a walking ecosystem with an incredible diversity of organisms unique to us, and in more ways than one, they make up who we are and what we do. Continue reading The microbiome in autoinflammatory diseases: a missing link?
Autoinflammatory diseases are diverse: they are caused by different genes, present at various stages in life, and cause a variety of symptoms. Even in patients with the same disease, such as familial Mediterranean fever (FMF), attacks may differ widely; some can have severe abdominal pain while others develop headaches. As a result, measuring disease activity–how active the disease is and how severely the patient is affected–has been quite difficult.