Locations
Washington University School of Medicine/Barnes-Jewish Hospital
Saint Louis, MO
About
Bio
I focus on the care of patients with moderate to severe lupus at Washington University School of Medicine/Barnes-Jewish Hospital. I also perform basic scientific research on how the immune system induces kidney injury using mouse models, and help perform clinical trials on novel therapies in lupus.
SpecialtiesDoctors may have more than one area of specialty interest. Board certification in a specialty area means the doctor has completed formal training and has practice experience in that specialty, and has passed the certification examination from the corresponding accredited medical specialty board.
Doctors may have more than one area of specialty interest. Board certification in a specialty area means the doctor has completed formal training and has practice experience in that specialty, and has passed the certification examination from the corresponding accredited medical specialty board.
Rheumatology
Internal Medicine
Doctor Q&A
84 Answers
75 Agrees
The number of answers this doctor has agreed with.
A 21-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
IL-6: Would look toward john stone's work at mgh (harvard) trying to determine which fraction of giant cell arteritis (which is seen in 50% of pmr cases and... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsAnswered >2 years ago
A 21-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
Yes: But how much of it is hereditary is unclear. From the limited genetic information that we have now (this is expanding as we speak), we think about 10%... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsReviewed >2 years ago
A 42-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
Usually not: Assuming this is orally given for muscle spasm (it can be given IV and also be used for tetanus), you can take up to 6 gms/day (split up 4x/day, there... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsAnswered >2 years ago
A 48-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
No: Dm is a treatable disease, and we attempt to restore the patient's quality of life back to pre-diagnosis. Only if the conventional treatments fail do ... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsAnswered >2 years ago
A 39-year-old female asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
Anything: Not enough information to answer this question. Rheumatologists need symptoms to assess for diseases like lupus. If you experience no symptoms consis... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsReviewed >2 years ago
A 29-year-old female asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
See rheum MD: These symptoms can be seen in autoimmune diseases such as rheumatoid arthritis. See a rheumatologist: they will help delineate whether your symptoms a... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsAnswered >2 years ago
A 48-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
Genes, environment: This answer will change as we know more about lupus. We believe that for a person to get lupus, from the limited genetic information we have now, abou... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsReviewed >2 years ago
A 44-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
Genes, environment: The complete answer is unknown, but this is certainly a genetic disease. We have known to quite some time that RA clusters within families. There are ... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsReviewed >2 years ago
A 44-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
Yes: While we understand that diseases like lupus is caused by antibodies in the blood that bind to your own tissues, it is still unclear if can be transfe... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsAnswered >2 years ago
A 35-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
Yes: So gout is a condition that tends to both recruit more joints with each flare (i.e. 1st flare: big toe, 2nd flare: big toe and knee, etc) and worsens ... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsReviewed >2 years ago
A 37-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
No: Takayasu's arteritis (it's not an arthritis) is a vasculitis, which is inflammation of the vessels. Etiology remains unclear, but the immune system is... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsReviewed Sep 19, 2022
A 33-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
Surgery, meds: The most common solution is joint replacement surgery, but bisphosphonate medications can be used first to try to slow the progression of bone death.
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsReviewed >2 years ago
A 39-year-old female asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
Again, symptoms key: Here, positive labs tests are not clinically important without symptoms. Your ESR would be consistent with age; i would ignore that along with the ANA... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsReviewed >2 years ago
A 62-year-old female asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
Fatty liver: Careful not to overinterpret lab tests, such as autoantibodies such as anti-smooth muscle antibodies. Positivity does not equal diagnosis: this appear... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsAnswered >2 years ago
A 39-year-old female asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
Depends on symptoms: ANA is a screen for lupus. The titer can be helpful in borderline lupus cases, but you must have symptoms c/w lupus. Dsdna, ENA panel needs to be orde... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.4k viewsReviewed >2 years ago
A 48-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
Fatigue, pain: As noted above, his is a difficult question to answer since lupus has been associated with virtually every organ system.
Of all the symptoms that a... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsReviewed >2 years ago
A 17-year-old male asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
Depends on "stop": There is a misunderstanding about when a defibrillator works. Defibrillators work when there is erratic electrical activity in the heart (ventricular ... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsAnswered >2 years ago
A 65-year-old female asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
Not sure: It is difficult to truly assess whether you have mctd or not. The presence of the rnp antibody in your blood does not mean anything by itself; you mus... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsReviewed >2 years ago
A 32-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
No: They will not cancel each other out. In fact, at least in people with hypertension, they will work together to reduce blood pressure. Interestingly, b... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsAnswered >2 years ago
A 35-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
None (except meds): So looking strictly at RA and pregnancy, there is no known risks between the two. In fact, for reasons that remain unclear, RA gets better during preg... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsReviewed >2 years ago
A 40-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
No: It's not legal to discriminate against anyone.
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsReviewed >2 years ago
A 33-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
Talk to MD: This is a difficult question to answer. If your symptoms are worse while on birth control, talk to your md to consider alternative contraception metho... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsAnswered >2 years ago
A 38-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
No link known: There is no known link between tetralogy of fallot and vasculitis that has been described.
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsAnswered >2 years ago
A 40-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
See derm, rheum MDs: There are several very effective medicines (anti-tnf meds or anti-p40 meds) that can really help with your symptoms. I would see both a dermatologist ... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsAnswered >2 years ago
A 44-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
Many genes: The previous answer is right with several genes associated with lupus, but no one knows how those genes cause disease.
I think it's important to re... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsReviewed >2 years ago
A 38-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
Genes, environment: This answer will change as we know more about lupus. We believe that for a person to get lupus, from the limited genetic information we have now, abou... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsReviewed >2 years ago
A member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
Talk to your MD: I agree that this is a very difficult question to answer. It would be dangerous for anyone of us to give any suggestions without physically talking an... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsReviewed >2 years ago
A 21-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
Vessel inflammation: Vasculitis is a basket term for numerous conditions that cause inflammatory damage to vessels. Vasculitis itself is not a diagnosis, but just a findin... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsAnswered >2 years agoMerged
A 32-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
Pain control, PT: Bouchard's nodes are an end result of degenerative arthritis of the middle knuckle of your fingers (pip joint). For unclear reasons, bone on bone dama... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsAnswered >2 years ago
1 comment
A 32-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
Avoid NSAIDS: So everyone has a very acidic stomach, but you probably feel symptoms like heartburn. In these cases, nsaids like Ibuprofen or Naproxen can enhance th... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsAnswered >2 years ago
A 41-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
X-rays, rest: The biggest thing to rule out is a fracture, and x-rays can pick up the obvious ones. If after several weeks of rest, it has not resolved, repeat x-ra... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsReviewed >2 years ago
A 36-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
# of joints affected: So rheumatologists can get diagnostic information based on the # of joints affected. Polyarthritis is having >4 joint affected, oligoarthritis is 2-4 ... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsAnswered >2 years ago
A 31-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
Joint, entheses dz: Reactive arthritis (formerly known as reiter's syndrome) is an uncommon (<0.01%) inflammatory arthritic condition preceded by an infection, usually in... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsReviewed >2 years ago
A 39-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
Joint, entheses dz: Reactive arthritis (formerly known as reiter's syndrome) is an uncommon (<0.01%) inflammatory arthritic condition preceded by an infection, usually in... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsReviewed >2 years ago
A 33-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
Morning stiffness: Rheumatoid arthritis (RA) is classically associated with stiffness of joints after long periods of rest, especially after waking up in the am. It can ... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsReviewed >2 years ago
A 48-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
Still unknown: Even though there is this very well-established connection between chronic Prednisone use and avascular necrosis, how this occurs remains unclear.
... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsAnswered >2 years ago
A 48-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
It can be: There is a much higher risk of solid organ cancers (lung, colon for example) in patients with dm. Why this is remains unclear.
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsAnswered >2 years ago
A 32-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
Tocilizumab: So for a fraction of people with temporal arthritis, they possess extremely elevated il-6 levels. Il-6 is a protein that increases with inflammation a... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsReviewed >2 years ago
A 37-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
Rheumatologist: See a rheumatologist or neuromuscular specialist. First to confirm that this indeed is the right diagnosis, and second, to evaluate the needs for medi... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsAnswered >2 years ago
A 36-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
Depends on duration: Let's assume that the infection that caused reactive arthritis has been treated (without this, very difficult to treat symptoms).
If joint symptoms... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsReviewed >2 years ago
A 37-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
Inflammed cartilage: Relapsing polychondritis (rpc) is an inflammatory condition where your cartilage, for reasons that remain unclear, are targeted by your immune system... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsReviewed >2 years ago
A 45-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
Estrogen effects: This is a highly disputed point currently, but there is a school of thought that Estrogens can worsen raynaud's. A definitive link remains elusive tho... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsAnswered >2 years ago
A 31-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
Yes: Immunosuppressive medications (prednisone, rituximab, azathioprine for example) are used with good success. Talk to a rheumatologist or neuromuscular ... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsAnswered >2 years ago
A 45-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
About 1 in 20 people: Typically affects people of northern european origin, less common in other ethnicities.
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsReviewed >2 years ago
A 54-year-old female asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
Not specifically: So it appears that you have bone lesions, but because it's in the marrow of your spine does not mean the nervous system is involved.
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsReviewed >2 years ago
A 35-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
Whatever works: That was a terse answer, but that is the truth. Everything from over the counter meds to narcotics need to be used, but most people will eventually ne... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsAnswered >2 years ago
A 48-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
Medicines, PT: Let's assume this is from osteoarthritis (wear & tear) and this advice (like all advice from this site) must be discussed with your md prior to starti... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsReviewed >2 years ago
A 43-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
Genes, environment: This answer will change as we know more about lupus. We believe that for a person to get lupus, from the limited genetic information we have now, abou... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsReviewed >2 years ago
A 36-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
Medication, PT: So degenerative arthritic pain is one of the most common and difficult conditions to treat. Pain control with medications is 1st: nsaids (oral or topi... Read More
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsAnswered >2 years ago
A 44-year-old member asked:
Dr. Alfred Kimanswered
Rheumatology 18 years experience
Joint replacement: Bisphosphonates (medications typically used for osteoporosis) can be used as a non-surgical approach, but most people need surgery.
Created for people with ongoing healthcare needs but benefits everyone.
5.5k viewsReviewed >2 years ago
TestimonialsRecommendations and Thank you notes are endorsements given from patients or other doctors.
Recommendations and Thank you notes are endorsements given from patients or other doctors.
2
Recommendations
196
Thank you notes
HealthTap member
Mar 30, 2015
Dr. Kim is an amazing doctor! #nationaldoctorsday2015 #virtualflower1
HealthTap member
Mar 31, 2015
Dr. Kim is an amazing doctor! #nationaldoctorsday2015 #virtualflower1
HealthTap member
Thank you for this information, but if you're not in the US then what other medicine can I take? I've had r.arthritis for 23 years now
HealthTap member
Thank you, your answer was very helpful! I never knew about this new medicine, thanks!
HealthTap member
Thank you, your answer was very helpful! Thanks,the answer was brief,clear .
Education & Training
Medical/Graduate school
Drexel University College of Medicine, PA
Graduated 2005MD
Residency
BARNES JEWISH HOSPITAL
Awards
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