Paget’s Disease of the Bone – AZIV Infusion Therapy Center

Paget’s disease of the bone interferes with the process in which your body replaces old bone with new. It speeds up the process of rebuilding bones, leaving them softer than usual or enlarged and abnormally shaped. It affects the pelvis, low back, hips, thighs, skull and arms, causing bone and joint pain or enlarged bones.

For more information on Paget’s disease, visit the American Academy of Orthopedic Surgeons at www.aaos.org, the American College of Rheumatology at www.rheumatology.org, or the National Osteoporosis Foundation at www.nof.org.

People who have Paget’s disease of bone typically have no symptoms. When symptoms do occur, the most common complaint is bone pain.

Because this disease causes your body to generate new bone faster than normal, the rapid remodeling produces bone that’s softer and weaker than normal bone, which can lead to bone pain, deformities and fractures.

The disease might affect only one or two areas of your body or might be widespread. Enlarged and misshapen bones can put extra stress on nearby joints, which may cause further pain and complications. Symptoms, depend on the affected part of your body.

Pelvis. Paget’s disease of bone in the pelvis can cause hip pain.
Skull. An overgrowth of bone in the skull can cause hearing loss or headaches.
Spine. When the spine is affected nerve roots can become compressed. This can cause pain, tingling and numbness in an arm or leg.
Leg. As the bones weaken, they may bend — causing you to become bowlegged.

The cause of Paget’s disease of bone is unknown. Scientists suspect a combination of environmental and genetic factors contribute to the disease. Several genes appear to be linked to getting the disease.

In addition to a physical exam, X-rays, and blood tests can help confirm the diagnosis of Paget’s disease of bone. X-rays and bone scan may reveal changes in the bones. While, those with Paget’s disease of bone usually have elevated levels of alkaline phosphatase in their blood, which can be discovered by a blood test.

AZIV Infusion provides the following biologic injections and infusions in a convenient and comfortable setting for patients seeking treatment for Paget’s disease:

Locations

Contact Information

Phone Number: 602.386.4968

Fax: 623-594-8533

Email: Info@AZIVinfusion.com

Dermatomyositis (dur-muh-toe-my-uh-SY-tis) is a genetic and rare disease that is marked by muscle weakness and a distinctive skin rash.

This condition can affect adults and children. In adults, dermatomyositis usually occurs from the late 40s to early 60s. In children, it most often appears between 5 and 15 years of age. Dermatomyositis affects more females than males.

There is currently no cure for dermatomyositis. Most individuals experience periods of symptom improvement or remission can occur. Treatment can clear the skin rash and help one regain muscle strength and function.

Dermatomyositis is in a group known as inflammatory myopathies (disorder of muscle tissue or muscles), which are characterized by chronic muscle inflammation accompanied by muscle weakness. The primary symptom is a skin rash that precedes or accompanies progressive muscle weakness.

The cause of dermatomyositis is unknown, but the disease has much in common with autoimmune disorders, in which your immune system mistakenly attacks your body tissues.

To learn more about Dermatomyositis and other autoimmune blistering conditions or related diseases visit the National Organization for Rare Disorders (NORD) website. The site provides a wide variety of educational information for patients, caregivers, clinicians and researchers to specific rare diseases.

The most common symptoms of Dermatomyositis include:

Skin changes.A violet-colored or dusky red rash develops, most commonly on your face and eyelids and on knuckles, elbows, knees, chest and back. The rash, which can be itchy and painful, is often the first sign of dermatomyositis.

Muscle weakness.Progressive muscle weakness involves the muscles closest to the trunk, such as those in your hips, thighs, shoulders, upper arms and neck. The weakness affects both the left and right sides of your body, and tends to gradually worsen.

If your doctor suspects dermatomyositis, they might suggest some of the following tests:

Blood analysis
Chest X-ray
Electromyography(Muscle is measured in a relax or tighten activity.)
MRI
Skin or muscle biopsy

There is currently no cure for Dermatomyositis, however, treatment can improve your skin and your muscle strength and function. The earlier treatment is started in the course of Dermatomyositis, the more effective it is.

If your medical provider orders biologic injections or infusions, AZIV can provide the following medications in a convenient and comfortable setting for patients seeking treatment for Dermatomyositis:

Immunoglobulin Infusion Therapy IVIG

Remicade

Infliximab (Remicade, Inflectra, Renflexis)

Hidradenitis Suppurativa (HS) (hi-drad-uh-NIE-tis sup-yoo-ruh-TIE-vuh) is a chronic skin disease. It can occur in one or multiple areas of your body. The condition causes small, painful lumps, boils or abscesses to form under the skin. The lesions can break open, or tunnels can form under the skin. The condition mostly affects areas where the skin rubs together, such as the armpits, groin, buttocks and breasts. It causes long-term skin inflammation and can be painful.
Hidradenitis suppurativa most commonly occurs in women between the ages of 18 and 29. It can persist for many years and worsen over time. This condition has serious effects on your daily life and emotional well-being. Early detection is key to getting effective treatment. There are treatment options that can help manage symptoms and prevent complications.The exact cause of hidradenitis suppurativa is unknown. It develops when hair follicles in the skin become blocked. It is not caused by an infection or being unclean, and it can’t be spread to others.

Symptoms of Hidradenitis Suppurativa include:

Blackheads
Painful pea-sized lumps
Foul smelling drainage from site
Tunnels

Some people with this condition experience only mild symptoms.

There are no laboratory tests used to diagnosis this condition. Typically, a diagnosis is obtained with a thorough patient history and physical exam. If there is pus or drainage present, a culture of the fluid may be done to rule out other conditions, such as an infection.

There are a variety of medications available to help manage your symptoms depending on the severity of the condition.

AZIV Infusion provides the following biological therapies and infusions in a convenient and comfortable setting for patients seeking treatment for Hidradenitis Suppurativa:

Multiple Sclerosis (MS) is a disease of the central nervous system in which your immune system attacks the coating, called myelin, of the nerve cells. MS predominantly affects young adults during their most productive years. Genetic and environmental factors are known to contribute to Multiple Sclerosis, but a specific cause for this disease is unknown.

Disease begins most commonly with acute display of neurologic abnormalities. Symptoms vary dramatically from person to person and over the course of the disease depending on the location of affected nerve fibers.

For more information on Multiple Sclerosis, visit the National Multiple Sclerosis Society at www.nationalmssociety.org.

Multiple sclerosis symptoms differ greatly and often affect movement:

Numbness or muscle weakness in one or more limbs that typically occurs on one side of your body at a time, or the hands, legs and trunk
Tingling and burning sensations, numbness, and chronic pain with certain neck movements, especially bending the neck forward
Tremor, lack of coordination or unsteady balance
Problems with sexual, bowel and bladder function
Slurred speech
Fatigue
Dizziness

Vision problems are also common, including:

Partial or complete loss of vision, usually in one eye at a time, often with pain during eye movement
Prolonged double vision
Blurry vision

There are no specific tests for MS. Instead, a diagnosis of multiple sclerosis often relies on ruling out other conditions that might produce similar signs and symptoms. The assessment includes neurological findings, clinical observation, results of Magnetic Resonance Imaging (presence of areas of demyelination in the CNS), spinal fluid examination (presence of oligoclonal bands and/or elevated IgG index). Your doctor may include an evoked potential test which uses a visual stimuli or electrical stimuli, in which you watch a moving visual pattern, or short electrical impulses are applied to nerves in your legs or arms.

There is no cure for multiple sclerosis. Treatment typically focuses on speeding recovery from attacks, slowing the progression of the disease and managing MS symptoms. Some people have such mild symptoms that no treatment is necessary. However, a number of medications can be used to treat the disease symptoms, including but not limited to:

Corticosteroids

Plasma exchange (plasmapheresis)

Your doctor may order a more advanced therapy of biologic injections or infusions. AZIV Infusion provides the following biologic injections and infusions in a convenient and comfortable setting for patients seeking treatment for Multiple Sclerosis:

Ulcerative Colitis is a type of inflammatory bowel disease that causes inflammation and ulcers on the inner lining of the large intestine or colon and differs from Crohn’s Disease which can affect any section of the digestive tract. Ulcerative Colitis is the ulceration of only the lining of the colon which presents as tiny open sores that produce pus and mucous. Crohn’s Disease can affect all layers of the bowel. Both of these conditions fall under inflammatory bowel disease.

For those with either Ulcerative Colitis or Crohn’s Disease the body’s own immune system responds to food, bacteria, or other materials in the intestine as an invading substance. This triggers the inflammation process and ulcerations.

For more information on Ulcerative Colitis, visit the Crohn’s & Colitis Foundation at crohnscolitisfoundation.org.

Ulcerative colitis symptoms can vary, depending on the severity of inflammation and where it occurs. The most common symptoms are diarrhea with blood or pus, and abdominal discomfort. It often begins gradually and can become worse over time, though there may be periods of remission that can last for weeks or years.

Other symptoms include:

Rectal pain
Rectal bleeding — passing small amount of blood with stool
Urgency to defecate
Inability to defecate despite urgency
Weight loss
Fatigue
Fever

To confirm a diagnosis of Ulcerative Colitis, your medical professional may request one or more of the following tests and procedures:

Blood tests
Stool sample
Colonoscopy
Flexible sigmoidoscopy. To examine the last portion of your colon.
X-ray
CT scan
Computerized Tomography (CT) enterography and magnetic resonance imaging (MRI) enterography.Used to evaluate bowel wall features of both upper and lower gastro-intestinal tract

Most individuals with ulcerative colitis have mild to moderate symptoms. The course of ulcerative colitis may vary, with some people having long periods of remission. Treatment usually involves drug therapy including biologic injections and infusions or surgery.

The drugs that work well for some people may not work for others, so it may take time to find the medication that you are most respond.

AZIV Infusion provides the following biologic injections and infusions in a convenient and comfortable setting for patients seeking treatment for Ulcerative Colitis:

Rheumatoid Arthritis, or RA, is one of many types of arthritis. It is a chronic inflammatory autoimmune disease that can affect more than just your joints. For some, the condition can impact a wide variety of body systems, including the skin, eyes, lungs, heart and blood vessels.

For most, rheumatoid arthritis affects the lining of your joints, causing a painful swelling that can eventually result in bone erosion and joint deformity. RA often occurs in more than one joint and typically affects the hands, feet, wrists, elbow, knees and ankles.

For more information on Rheumatoid Arthritis, visit the Arthritis Foundation at www.arthritis.org.

Rheumatoid Arthritis is a chronic disease characterized by periods of disease flares and remissions. Early rheumatoid arthritis tends to affect your smaller joints first — particularly the joints that attach your fingers to your hands and your toes to your feet. Rheumatoid arthritis symptoms vary in severity and include:

Joint pain, such as in the joints of the feet, hands, and knees
Swollen joints
Fever
Loss of range of motion
Tender joints,
Loss of joint function,
Joint stiffness – worsens after inactivity
Fatigue
Rheumatoid nodules
Anemia
Joint warmth
Joint deformity

About 40 percent of the people who have rheumatoid arthritis also experience symptoms that don’t involve the joints. Rheumatoid arthritis can affect many body systems including:

Skin
Eyes
Lungs
Heart
Kidneys
Salivary glands
Nerve tissue
Bone marrow
Blood vessels

Rheumatoid Arthritis can be difficult to diagnose in its early stages because the early signs and symptoms mimic those of many other diseases. There is no one blood test or physical finding to confirm the diagnosis.

During the physical exam, your doctor will check your joints for swelling, redness and warmth. Reflexes and muscle strength are also evaluated.

The inflammation associated with rheumatoid arthritis is what can damage other parts of the body as well. While new types of medications have improved treatment options, severe rheumatoid arthritis can still cause physical disabilities. Treatment or medications selection will depend on the severity of your symptoms and how long you’ve had Rheumatoid Arthritis. Options might include

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
Steroids
Disease-modifying antirheumatic drugs (DMARDs).

AZIV Infusion provides the following biologic injections and infusions in a convenient and comfortable setting for patients seeking treatment for Rheumatoid Arthritis:

Ankylosing Spondylitis is a type of arthritis that affects the spine or back. It often begins in the lower back and moves up the spine, where joints and ligaments become inflamed, producing pain and stiffness. In advanced cases, the joints and vertebrae may fuse, making the spine rigid and inflexible.

AZIV Infusion Therapy Centers provides infusions to treat ankylosing spondylitis, including Remicade and Cimzia.

For more information on Ankylosing Spondylitis, visit the Arthritis Foundation at www.arthritis.org or the Spondylitis Association of America at www.spondylitis.org.

Early signs and symptoms of ankylosing spondylitis might include pain and stiffness in your lower back and hips and tends to be worse in the morning upon awakening and improves with activity. Neck pain and fatigue also are common. Symptoms are typcially inconsistent – worsen, improve or stop at irregular intervals.

Areas most commonly affected include:

The joint between the base of your spine and your pelvis (sacroiliac)
The vertebrae in your lower back
The places where your tendons and ligaments attach to bones (entheses), mainly in your spine, but sometimes along the back of your heel
The cartilage between your breastbone and ribs
Your hip and shoulder join
Inflammation of the eyes, skin, peripheral joints, soft tissue or gastrointestinal tract
For some, the pain occurs in the peripheral joint such as the hip, ankle, elbow, knee, heel, or shoulder.

Diagnosing disorders comparable to Ankylosing Spondylitis can prove especially challenging as there are limited blood tests and imaging studies that can effectively evaluate patients.

During a physical exam, your doctor might ask you to bend in different directions to test the range of motion in your spine. He or she might try to reproduce your pain by pressing on specific portions of your pelvis or by moving your legs into a particular position.

X-rays allow your medical professional to check for changes in your joints and bones, though the visible signs of Ankylosing Spondylitis might not be evident early in the disease.

An MRI uses radio waves and a strong magnetic field to provide more-detailed images of bones and soft tissues. MRI scans can reveal evidence of ankylosing spondylitis earlier in the disease process, but are much more expensive.

There are no specific lab tests to identify Ankylosing Spondylitis. Certain blood tests can check for markers of inflammation, but inflammation can be caused by many different health challenges.
Rheumatologists use a combination of blood tests, imaging studies, and your clinical history to arrive at a diagnosis of Ankylosing Spondylitis.
Testing for the HLA B27 gene can be helpful in identifying those patients with back pain who may be at an increased risk of developing Ankylosing Spondylitis Most people who have that gene don’t have Ankylosing Spondylitis, and fewer African American people with the disease have the gene than do causation people.

The goal of treatment for Ankylosing Spondylitis is to relieve your pain and stiffness, and prevent or delay complications and spinal deformity. Ankylosing Spondylitis treatment is most successful before the disease causes irreversible damage to your joints.
AZIV Infusion provides the following biologic injections and infusions in a convenient and comfortable setting for patients seeking treatment for Ankylosing Spondylitis:

Peripheral neuropathy (new-ROP-uh-thee) is damage or disease to your peripheral nerves — the nerves that carry information to and from your brain and spinal cord and the rest of your body, such as your arms and legs. The peripheral nerves make up an intricate network that connects the brain and spinal cord to the muscles, skin, and internal organs.

Peripheral neuropathy can result from traumatic injuries, infections, metabolic problems, inherited causes and exposure to toxins. One of the most common causes is diabetes.

To learn more about Neuropathy and other related diseases visit the National Organization for Rare Disorders (NORD) website. The site provides a wide variety of educational information for patients, caregivers, clinicians and researchers to specific rare diseases. Information may also be located at the American Diabetes Association.

Peripheral neuropathy can result from traumatic injuries, infections, metabolic problems, inherited causes and exposure to toxins. One of the most common causes is diabetes. Those with neuropathy often describe the pain as stabbing, burning or tingling. In many cases, symptoms improve, especially if caused by a treatable condition.

Every nerve in the peripheral system has a specific function; therefore, symptoms depend on the type of nerves affected. Nerves are classified as follows:

Sensory nerves that receive sensation, such as temperature, pain, vibration or touch, from the skin
Motor nerves that control muscle movement
Autonomic nerves that control functions such as blood pressure, heart rate, digestion and bladder

Symptoms of peripheral neuropathy include:

Gradual onset of numbness, prickling or tingling in your feet or hands, which can spread upward into your legs and arms
Sharp, jabbing, throbbing or burning pain
Extreme sensitivity to touch
Pain during activities that shouldn’t cause pain, such as pain in your feet when putting weight on them or when they’re under a blanket
Lack of coordination and falling
Muscle weakness
Feeling as if you’re wearing gloves or socks when you’re not

If autonomic nerves are affected, symptoms might include:

Heat intolerance
Excessive sweating or not being able to sweat
Bowel, bladder or digestive problems
Changes in blood pressure, causing dizziness or lightheadedness

Peripheral neuropathy has many potential causes, so doctors are sometimes unable to pinpoint the exact cause of an acquired neuropathy. The diagnosis of neuropathy may include a physical exam, blood tests, imaging tests, nerve function test and a nerve and/or skin biopsy.

The treatment goal of neuropathy is to manage the condition causing your neuropathy and to relieve symptoms.

Medications can reduce the pain of peripheral neuropathy.

Pain relievers
Anti-seizure medications
Topical treatments
Antidepressant

AZIV Infusion provides the following biologic injections and infusions in a convenient and comfortable setting for patients seeking treatment for Neuropathy:

Immunoglobulin Infusion Therapy IVIG

Guillain-Barré Syndrome [gee-YAH-buh-RAY] is a rare neurological disorder in which the body’s immune system mistakenly attacks part of its peripheral nervous system—the network of nerves located outside of the brain and spinal cord.

Weakness and tingling in extremities are the typical first symptoms. These sensations can quickly spread, eventually paralyzing the whole body. In its most severe form Guillain-Barre Syndrome is a medical emergency. Most people with the condition must be hospitalized to receive treatment. Fortunately, most people eventually recover from even the most severe cases of Guillain-Barré Syndrome (GBS).

Once thought to be a single disorder, Guillain-Barre Syndrome is now known to occur in several forms. The main types are:

Acute inflammatory demyelinating polyradiculoneuropathy (AIDP),the most common form in the U.S. The most common sign of AIDP is muscle weakness that starts in the lower part of your body and spreads upward.
Miller Fisher Syndrome (MFS),in which paralysis starts in the eyes. MFS is also associated with unsteady gait. MFS occurs in about 5 percent of people with Guillain-Barre Syndrome in the U.S. but is more common in Asia.

For more information visit the GBS | CIDP Foundation International is a global nonprofit organization supporting individuals and their families affected by Guillain-Barre’ Syndrome (GBS), chronic inflammatory demyelinating polyneuropathy (CIDP), and related conditions through a commitment to support, education, research and advocacy.

Guillain-Barre Syndrome often begins with tingling and weakness starting in your feet and legs and spreading to your upper body and arms. In nearly half of those with GBS symptoms begin in the arms or face.

Additional Guillain-Barre Syndrome symptoms may include:

Prickling, pins and needles sensations in your fingers, toes, ankles or wrists
Weakness in your legs that spreads to your upper body
Unsteady walking
Difficulty with eye or facial movements, including speaking, chewing or swallowing
Severe pain that may feel achy or cramp like
Difficulty with bladder control or bowel function
Rapid heart rate
Low or high blood pressure
Difficulty breathing

The exact cause of Guillain-Barre Syndrome is unknown. It is often preceded by an infectious illness such as a respiratory infection or the stomach flu. Guillain-Barre Syndrome can be difficult to diagnose in its earliest stages. Its signs and symptoms are similar to those of other neurological disorders and may vary from person to person.

In addition to reviewing medical history and completing a thorough physical examination. Your doctor may order the following tests:

Spinal tap (lumbar puncture)
Electromyography to measure nerve activity
Nerve conduction studies to measure the speed of nerve signals

There’s no known cure for Guillain-Barre Syndrome, but several treatments can ease symptoms and reduce the duration of the illness. Most people recover from Guillain-Barre Syndrome, though some may experience lingering effects.AZIV Infusion provides the following biologic injections and infusions in a convenient and comfortable setting for patients seeking treatment for Guillain-Barré Syndrome:
Immunoglobulin Infusion Therapy IVIG

Crohn’s disease is a type of inflammatory bowel disease that causes inflammation and irritation in your digestive tract.

For more information on Crohn’s disease, visit the Crohn’s & Colitis Foundation at crohnscolitisfoundation.org.

Symptoms of Crohn’s Disease vary depending on the severity of inflammation and where it occurs. Symptoms may range from mild to severe. You are likely to have periods of active illness followed by periods of remission.

The most common symptoms are diarrhea, cramping and pain in the abdomen, fatigue and blood in your stool. A reduced appetite typically leads to unplanned weight loss. Symptoms often begin gradually and worsen over time, though there may be periods of remission that last for weeks or years.

To help assist with a diagnosis of Crohn’s or Inflammatory Bowel Disease, you may have one or more of the following tests and procedures:

Blood tests

Tests for anemia or infection
Fecal occult blood test

Endoscopic procedures include:

View your entire colon or take small samples of tissue (biopsy) for laboratory analysis. Tissue samples can help confirm a diagnosis.
Flexible sigmoidoscopy. View the last portion of your colon.
Upper endoscopy. Examine the esophagus, stomach and first part of the small intestine (duodenum).
Capsule endoscopy. You swallow a capsule that has a camera in it and it transmits data.
Balloon-assisted enteroscopy. Allows a deeper view into the small bowel where standard endoscopes don’t reach.

Imaging procedures include:

X-ray
Computerized tomography (CT) scan
Magnetic resonance imaging (MRI)

The treatment goal of Inflammatory Bowel Disease is to reduce the inflammation that triggers your signs and symptoms. In the best cases, this may lead not only to symptom relief but also to long-term remission and reduced risks of complications. Although living with IBD can be discouraging, research is ongoing, and the outlook is improving.

Surgery for Crohn’s disease. Up to one-half of people with Crohn’s disease will require at least one surgery. However, surgery does not cure Crohn’s disease.

AZIV Infusion provides the following biologic injections and infusions in a convenient and comfortable setting for patients seeking treatment for Crohn’s Disease:

Psoriasis is a chronic skin condition caused by an overactive immune system. Symptoms include flaking, inflammation, and thick, white, silvery, or red patches of skin. Psoriasis treatments include steroid creams, occlusion, light therapy and oral medications, such as biologics.

Psoriasis starts as small, red bumps, which grow bigger and form scales. The skin appears thick but may bleed easily if you pick or rub off the scales.

Rashes may itch and skin may become cracked and painful. Nails may form pits, thicken, crack and become loose.

No one knows the exact cause of psoriasis, but experts believe that it’s a combination of things. Something wrong with the immune system causes inflammation, triggering new skin cells to form too quickly. Normally, skin cells are replaced every 10 to 30 days. With psoriasis, new cells grow every 3 to 4 days. The buildup of old cells being replaced by new ones creates those silver scales.

Some things that can trigger outbreaks are:

Cuts, scrapes, or surgery
Emotional stress
Strep infections

Some slow the growth of new skin cells, and others relieve itching and dry skin. Your doctor will select a treatment plan that is right for you based on the size of your rash, where it is on your body, your age, your overall health, and other things.
AZIV Infusion provides the following biologic injections and infusions in a convenient and comfortable setting for patients seeking treatment for Psoriasis:

Pemphigus vulgaris is a rare autoimmune disease that causes painful blistering on the skin and mucous membranes. If you have an autoimmune disease, your immune system mistakenly attacks your healthy tissues.

The most common areas including the:

Eyes
Genitals
lungs
Mouth
Throat
Nose

Can occur at any age, but it’s most often seen in people who are middle-aged or older. There is no known cause of the condition, but it is not contagious. Common symptoms include:

painful blisters that start in the mouth or skin areas
skin blisters near the surface of the skin that come and go
oozing, crusting, or peeling at the blister site

Your doctor may then take a biopsy of the blister, which involves removing a piece of tissue for analysis, and looking at it under a microscope to confirm the diagnosis. The biopsy may be treated in the laboratory with chemical substances that help your doctor find the abnormal antibodies. Your doctor can use this information to determine the type of pemphigus.

AZIV Infusion provides the following biologic injections and infusions in a convenient and comfortable setting for patients seeking treatment for Pemphigus Vulgaris:

For more information on Paget’s disease, visit the American Academy of Orthopaedic Surgeons at www.aaos.org, the American College of Rheumatology at www.rheumatology.org, or the National Osteoporosis Foundation at www.nof.org.

People who have Paget’s disease of bone typically have no symptoms. When symptoms do occur, the most common complaint is bone pain.

Pelvis. Paget’s disease of bone in the pelvis can cause hip pain.
Skull. An overgrowth of bone in the skull can cause hearing loss or headaches.
Spine. When the spine is affected nerve roots can become compressed. This can cause pain, tingling and numbness in an arm or leg.
Leg. As the bones weaken, they may bend — causing you to become bowlegged.

AZIV Infusion provides the following biologic injections and infusions in a convenient and comfortable setting for patients seeking treatment for Paget’s disease:

Psoriatic arthritis is an autoimmune disease in which your immune system attacks your joints and skin, causing pain, stiffness and swelling. It most commonly affects the fingers, toes, wrists, knees, ankles and lower back.

It occurs equally in males and females. About 30 percent of people who have psoriasis, another autoimmune disease that causes itchy, scaly rashes on the skin. In fact, the skin disease precedes the arthritis in nearly 80% of people. However, the arthritis may precede the psoriasis in up to 15% of patients.

For more information on Psoriatic Arthritis, visit the Arthritis Foundation at www.arthritis.org.

Psoriatic arthritis shares many symptoms with several other arthritic conditions, such as ankylosing spondylitis, reactive arthritis, and arthritis associated with Crohn’s disease and ulcerative colitis. Psoriatic arthritis presents as red patches of skin topped with silvery scales and additional symptoms include:

Low back pain
Conjunctivitis
Reduced range of motion
Swollen joints
Nail pitting
Joint pain and morning stiffness
Foot pain
Fatigue

Psoriatic arthritis is a diagnosis made mainly on clinical evaluation and based on the finding of psoriasis along with the typical inflammatory arthritis of the spine and/or other joints. There is no laboratory test to diagnose psoriatic arthritis. Some blood tests may confirm an abnormal elevated result and merely reflect presence of inflammation in the joints and other organs of the body. When one or two large joints (such a knees) are inflamed, arthrocentesis can be performed. This is an office procedure whereby a sterile needle is used to withdraw fluid from the inflamed joints. The fluid is then analyzed for inflammation. X-rays may show changes of cartilage or bone injury indicative of arthritis of the spine, sacroiliac joints, and/or joints of the hands. The blood test for the genetic marker HLA-B27, is often performed. This marker can be found in over 50% of patients with psoriatic arthritis who have spine inflammation.

AZIV Infusion provides the following biologic injections and infusions in a convenient and comfortable setting for patients seeking treatment for Psoriatic Arthritis:

Gout is a common and complex form of arthritis that can affect anyone. It’s characterized by sudden, severe attacks of pain, swelling, redness and tenderness in the joints, often the joint at the base of the big toe.

An attack of gout can occur suddenly, often waking you up in the middle of the night with the sensation that your big toe is on fire. The affected joint is hot, swollen and so tender that even the weight of the sheet on it may seem intolerable.

The pain of Gout is caused by deposits of crystals derived from uric acid. Additional information about gout can be found here at Rheumatology.org.

Gout signs and symptoms almost always occur suddenly, and often at night. Attacks often occur as severe flare-ups typically in the feet and ankles and include:

Intense joint pain
Lingering discomfort and selling
Inflammation and redness
Limited range of motion.

Early in the course of this disease, flare-ups occur infrequently, last a week or so, and resolve on their own or with the help of medications that fight inflammation.

Over time, attacks become more frequent, last longer and involve an increasing number of joints. Eventually, if not controlled, gout sufferers may develop persistent joint pain, swelling, deformity and disability. If Gout goes untreated it can lead to worsening pain and joint damage.

During symptom-free periods, dietary guidelines may help protect against future gout attacks:

Drink plenty of fluids
Limit or avoid alcohol
Get your protein from low-fat dairy products
Limit your intake of meat, fish and poultry
Maintain a desirable body weight
Joint fluid test
Blood test
X-ray imaging
Ultrasound

Tests to help diagnose gout include:

Joint fluid test
Blood test
X-ray imaging
Ultrasound
Dual energy CT scan

If you experience several gout attacks each year, or if your gout attacks are less frequent but particularly painful, your doctor may recommend medication to reduce your risk of gout-related complications. If you already have evidence of damage from gout on joint X-rays, or you have tophi, chronic kidney disease or kidney stones, medications to lower your body’s level of uric acid may be recommended. Options include:

Medications that block uric acid production.
Medication that improves uric acid removal.

AZIV Infusion provides the following biologic injections and infusions in a convenient and comfortable setting for patients seeking treatment for Gout:

Krystexxa

Lupus is an autoimmune disease in which your immune system mistakenly attacks your skin, joints and/or organs. Lupus is also known as systemic lupus erythematosus or SLE. It may flare up and go away for a time, but if it is chronic and can last for weeks or years.

Lupus occurs when your immune system attacks healthy tissue in your body (autoimmune disease). It’s likely that lupus results from a combination of your genetics and your environment. Lupus can cause pain in the joints or muscles; red rashes, most often on the face; and swelling in the legs or around the eyes. Inflammation caused by lupus may affect many different body systems — including your joints, skin, kidneys, blood cells, brain, heart and lungs.

Lupus is predominantly a disease of women. It may present at any age, although its peak incidence is during the childbearing years, between 15 and 45, at which time the female-to-male ratio climbs, reaching a peak ratio of approximately 12 :1. It occurs worldwide, although it is likely under-recognized and under-diagnosed in developing countries.

In the U.S., lupus is most prevalent among those of non-caucasian descent, with those of African heritage most affected.

For more information on Lupus, visit the Lupus Foundation of America at www.lupus.org.

No two cases of lupus are exactly alike. Signs and symptoms may come on suddenly or develop slowly, may be mild or severe, and may be temporary or permanent. Most people with lupus have mild disease characterized by episodes — called flares — when signs and symptoms get worse for a while, then improve or even disappear completely for a time.

The signs and symptoms of lupus will depend on which body systems are affected by the disease. The most common signs and symptoms include:

Fatigue
Fever
Joint pain, stiffness and swelling
Butterfly-shaped rash on the face that covers the cheeks and bridge of the nose or rashes elsewhere on the body
Skin lesions that appear or worsen with sun exposure (photosensitivity)
Fingers and toes that turn white or blue when exposed to cold or during stressful periods (Raynaud’s phenomenon)
Shortness of breath
Chest pain
Dry eyes
Headaches, confusion and memory loss

It appears that people with an inherited predisposition for lupus may develop the disease when they come into contact with something in the environment that can trigger it. The cause of lupus in most cases, however, is unknown. Some potential triggers include:

Sunlight
Infections
Medications Lupus can be triggered by certain types of blood pressure medications, anti-seizure medications and antibiotics.

Lupus can be difficult to diagnose because its signs and symptoms often mimic those of other ailments. The most distinctive sign of lupus — a facial rash that resembles the wings of a butterfly unfolding across both cheeks — occurs in many but not all cases of lupus.

Some people are born with a tendency toward developing lupus, which may be triggered by infections, certain drugs or even sunlight. While there’s no cure for lupus, treatments can help control symptoms.

No one test can diagnose lupus. The combination of blood and urine tests, signs and symptoms, and physical examination lead to the diagnosis.

Treatment for lupus depends on your signs and symptoms. Medications most commonly used to control lupus include:

Nonsteroidal anti-inflammatory drugs (NSAIDs)
Antimalarial drugs
Corticosteroids

If your physician or medical professional determine you would benefit from biologic injections and infusions, AZIV Infusion provides the following medications in a convenient and comfortable setting for patients seeking treatment for Lupus:

Behçet’s disease is a chronic inflammatory condition that damages blood vessels. Symptoms include mouth and genital sores, joint pain, and inflammation of the eye (uveitis). Vasculitis is a rare condition and can be a primary process, or secondary to another underlying disease or autoimmune condition. Vasculitis can affect people of any age, but some types occur more in certain age groups and ethnicities.

Behçet’s disease (or syndrome) is a chronic (long-term) inflammatory condition caused by vasculitis (an inflammation, or swelling, of the blood vessels) that results in damage to both arteries and veins. Where the disease strikes in the body is different for each person. The cause of Vasculitis and Behçet’s disease is unknown.

For more information on Vasculitis and Behçet’s disease, visit the Vasculitis Foundation at www.vasculitisfoundation.org/.

Sores in the mouth and/or genital area that keep coming back
Skin and joint pain
Inflammation in the eyes

The brain, nerves, intestinal tract, and kidneys can also be involved.

There is no single laboratory test that can diagnose Vasculitis and Behçet’s disease. The diagnosis is primarily based on signs and symptoms. Nearly everyone with this condition develops mouth sores that recur at least three times in 12 months.

In order to make a clear diagnosis, it is necessary to rule out other illnesses that may also produce mouth sores and imitate the disease, such as systemic lupus, Crohn’s disease (an inflammatory condition of the intestines) and other forms of vasculitis. HLA B 51 is a genetic marker that can sometime be present in patients with Behçet’s syndrome.

Additional testing can be directed by a rheumatologist, and depending on pretest probability might include:

ANA (Anti-nuclear antibodies)
Complement levels
ESR
CRP
ANCA
EMG/ NCS (electromyography/nerve conduction studies),
Imaging including MRI/MRA or ultrasound
Arteriography
Tissue biopsy

The goal of treatment is to induce remission, to minimize drug toxicity and to monitor for signs of recurrence.

Different drugs are used to treat Vasculitis and Behçet’s disease, depending on the severity of the illness as well as what organs are affected:

Topical or Oral medications might include:

Corticosteroids, such as prednisone, are the main treatment. These drugs suppress inflammation and immune function.
Colchicine (Colcrys) may help with mouth and genital sores.
Other drugs that suppress the immune system, such as: methotrexate (Trexall, Rasuvo), azathioprine (Imuran, Azasan), and cyclophosphamide (Cytoxan, Neosar); and anti-TNF biologics, such as infliximab (Remicade) and etanercept (Enbrel), are useful in more severe cases.
Recently, Apremilast (Otezla), an oral medication (taken by mouth), was found to be effective in controlling mouth ulcers in Behçet’s disease.

AZIV Infusion provides the following biologic injections and infusions in a convenient and comfortable setting for patients seeking treatment for Vasculitis and Behçet’s disease, including:

Inflammatory Myositis is a general term meaning inflammation of the muscles, myositis includes the following diseases:

Dermatomyositis
Inclusion Body Myositis
Juvenile Myositis
Polymyositis
Dermatomyositis
Necrotizing Autoimmune Myositis

The cause of these inflammatory myopathies stems from an autoimmune reaction to the muscle tissue in genetically susceptible people. Polymyositis, dermatomyositis, and juvenile myositis are all autoimmune diseases, meaning the body’s immune system is attacking the muscle. While the immune system may also cause muscle damage in inclusion body myositis, this may not be cause of this disease. Although myositis is often treatable, these diseases are poorly understood and do not always completely respond to current medications.

Precipitating factors that may be eliciting the event may include:

Viruses
Muscle injury
Cancer
Toxins
Inflammation
Infection
Hormonal imbalances and electrolyte imbalances

Inflammatory myositis is more common in African-Americans compared to Caucasians and in woman as compared to men. Polymyositis primarily affects adults in their 30’s to 50’s. Dermatomyositis commonly affects children ages 5-15 and adults ages 45-65. Myositis can occur in combination with other autoimmune diseases. The exact cause is unknown, but we do know that it is an autoimmune disease (the body’s own immune system attacks the muscles) and in some cases the skin. Inclusion body myositis is most common after age 50. General symptoms of chronic inflammatory myopathy. The inflammatory myopathies are a group of diseases, with no known cause, that involve chronic muscle inflammation accompanied by muscle weakness.

Additional information on inflammatory myositis can be found at https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Inflammatory-Myopathies

Symptoms of myositis may include:

Trouble rising from a chair
Difficulty climbing stairs or lifting arms
Tired feeling after standing or walking
Trouble swallowing or breathing
muscle pain and soreness that does not resolve after a few weeks
Known elevations in muscle enzymes by blood tests (CPK or aldolase)

Although the inflammatory myopathies affect about 50,000 Americans, often they are not diagnosed correctly. In part, because patients with autoimmune myopathies have many of the same symptoms as those with inclusion body myositis, toxic myopathy, or muscular dystrophies, which are inherited forms of muscle disease.

Diagnosis includes a skilled clinical assessment, evaluating symptoms already discussed (e.g. how fast are the symptoms progressing), physical exam; however, laboratory confirmation of the diagnosis is required in most cases. The benchmark confirmation is muscle biopsy. Electromyography, estimation of SCK, and detection of myositis specific antibodies may be helpful. Conceivably, a patient with all of the classical clinical features of DM, elevation of the SCK, and typical neurophysiological changes does not need a confirmatory muscle biopsy, but overall few cases of suspected myositis should escape biopsy. If management difficulties arise, there is often regret if a biopsy was not performed before initiation of treatment.

The initial treatment for inflammatory myositis is steroids taken by mouth and sometimes intravenously, depending on how severe symptoms are at diagnosis. No other medication works as quickly. The eventual goal is to taper the steroids slowly and substitute a medication that is safer to take in the long term such as mycophenolate mofetil or azathioprine.

In severe cases of myositis, especially when the muscles used for swallowing are impacted, we sometimes use intravenous immunoglobulin, or IVIG, a medication given monthly by infusion.

Physical therapy is also an important part of myositis treatment to help patients regain strength.

AZIV Infusion provides the following biologic injections and infusions in a convenient and comfortable setting for patients seeking treatment for Inflammatory Myositis: