Team name: Origin of RA
Region: Origin Story
Authors: Duke Rheumatology Fellowship Program. Courtney Bair, BA, third year medical student, Benjamin D. Lueck, fourth year medical student, Ann Cameron Barr, MD, first year rheumatology fellow, Sonali Bracken, MD, PhD, second year rheumatology fellow, Dahima Cintron, MD, first year rheumatology fellow, Lena Eder, MD, second year rheumatology fellow, Jeffrey Shen, MD, first year rheumatology fellow, Catherine Sims, MD, third year rheumatology fellow, Lisa Criscione-Schreiber, MD, MEd, Professor of Medicine, David Leverenz, MD, MEd, Program Director.
Team Overview
Team ‘Origins of RA’ is led by medical student captain Augustin Jacob Landré-Beauvais, a rookie looking to make a splash. In describing and deliberating on gout, he publishes a case series of nine patients he thought did not present with “ordinary gout,” and in doing so, he provides what is generally acknowledged as the first description of Rheumatoid Arthritis (RA).1,2 Far ahead of his time in the year 1800, his distinction of RA from gout transforms the field.
But this team is far from all flash, they follow the fundamentals of the game. They not only clinically differentiate gout and RA, but go on to describe common pathologic findings of RA. In the face of adversity and with limited technology, they report autopsy findings clearly describing synovial involvement and bony erosions, defining hallmark pathologies of the disease. They even go further to recommend treatment strategies far ahead of their time, focusing on prevention of recurrent flares.
Impact on Rheumatology
What change had the biggest impact on modern basketball? Changing from 9 players on the court at a time to 5? Starting to use a regulated and standard sized ball? Introducing the three-point line? Like the game of basketball, the field of rheumatology and specifically the treatment of RA has drastically changed over time. In the management of RA, it is clear that nothing was more impactful than Augustin Jacob Landré-Beauvais first recognizing RA as its own disease process and not “ordinary gout”. Landré-Beauvais’s paper distinguished RA as a separate disease process and indicated the need for different and unique treatment options that didn’t include blood letting, astringent agents, and topical emollients, which were the standard treatment for gout at the time. Without this monumental discovery, we very well may still be treating RA with colchicine and allopurinol.
Chances in the Tournament
It is hard to overstate the contributions of team ‘Origins of RA’ as they totally changed the game and laid the foundation for those who come behind them. Given the all-around strength of the team, they must be considered a favorite in the tournament. They drew some tough early matchups against team “Origins of sJIA” and team “Cortisone,” but if they can make it out of their region, they look to be strong favorites against teams coming out of the TNF Takedown and RA Revamp regions.
Who is the most influential person to basketball? MJ? Chef Curry? The CEO of the NBA? How about James Naismith, who invented basketball in 1891, in graduate school as an assignment. Similarly, Landre-Beauvais, a medical student, was the first to distinguish gout from rheumatoid arthritis, serving as the foundation of our field and paving the way for description of other inflammatory arthritis subtypes. This distinction in causes of deforming arthritis had not been made for the past 2000 years. He noticed a pattern of patients with deforming arthritis that did not have the slam dunk features of gout and brought a new diagnosis to the game. ‘Nuff said.
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References:
- Landré-Beauvais AJ. The first description of rheumatoid arthritis. Unabridged text of the doctoral dissertation presented in 1800. Joint Bone Spine. 2001;68(2):130-143. doi:10.1016/s1297-319x(00)00247-5
- Tsoucalas G, Sgantzos M. Primary asthenic gout by augustin-jacob landre-beauvais in 1800: is this the first description of rheumatoid arthritis? Mediterr J Rheumatol. 2017;28(4):223-226.
