Dr. R Puligari: 55 yo female w/arthritis, rash, DOE, fever, weight loss, CT abnormal +MDA5 dermatomyositis: Rx RTX, IV steroids, CYP, TAC and Ofev. Disease progressed; IVIG,steroids, PLEX added w/benefits. 6 months later had CMV retinitis. What to do next? #ACR22 @rheumnow https://t.co/A1m8HMtCob