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IL-18 is a proinflammatory cytokine involved in innate &adaptive immune responses. IL-18 is a key mediator in autoinflammatory diseases, MAS, Still’s disease. Serum IL-18 levels may be useful in diagnosis and monitoring of disease activity https://t.co/P8ecLAtNx5 https://t.co/3mo1vcYKUr
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Great and Not So Great (9.30.2022)
This week it's the great and not-so-great on gout, chondrocalcinosis, osteoporosis and misdiagnosis. We are good at many of those things - what's not so great? Let's review the news and journal reports from the past week on RheumNow.
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ASBMR 2022 study shows Patients w/ serum ferritin > 1000 µg/L or Dx hemochromatosis or thalassemia — were 60% more likely to have an osteoporotic fracture (2X risk vertebral Fx) during an up to 10-year follow-up https://t.co/uLf8zTiMml https://t.co/9KnApUxxTF
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Heavy Metal Rheumatology (9.23.2022)
Below are this week’s highlights from RheumNow, as discussed by Dr. Jack Cush. Thanks to all of you for your kind comments and great reviews of our weekly podcast. Please let us know how we can improve by emailing me or recording your suggestion using the "Ask Cush Anything" link on our website.
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Dr. John Cush RheumNow ( View Tweet)
Retrospective study of PFAPA < 18yrs, 336 pts, Boys=Girls, peak onset ~age 1 yrs (less w/ yrs); 90% 1st Sxs under 5 yrs & <3% after age 10 yrs, Common Sxs: pharyngitis w fever, Cx adenitis, aphthous stomatitis, atyp skin rash. Incidence 0.86/10K/Yr https://t.co/1Mrp9bMnuE
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Dr. John Cush RheumNow ( View Tweet)
NIH: 27 pts w/ ROSAH (retinal dystrophy, optic N. edema, splenomegaly, anhidrosis, headache) syndrome, due to dominant mutation ALPK1 - an autoinflammatory Dz w fevers, HA, Abnl CNS MRI, deforming arthritis, AA amyloidosis . https://t.co/Pyb3QNrPnB https://t.co/wxtwOGpKFr
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Colchicine vs cimetidine in PFAPA (Periodic fever, aphthous stomatitis, pharyngitis, adenitis) syndrome. 72 pts given COL vs CIM x 3 mos: # of febrile attacks was significantly decreased by both Rx (noninferior to each other) https://t.co/MO7IQ0e8gf
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Dr. John Cush RheumNow ( View Tweet)
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ACR Questions Medicare Proposed Cuts to Critical Services Reimbursement by Cognitive Specialists
In comments submitted to the Centers for Medicare and Medicaid Services (CMS) in response to the CY 2023 Medicare Physician Fee Schedule and Quality Payment Program proposed rule, the American College of Rheumatology applauded proposals that would provide more flexibility and improve care coordination, while raising concerns about proposed cuts to reimbursement for critical services provided by rheumatologists and other cognitive specialists.
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Review of IL-1 inhibitors in recurrent idiopathic pericarditis. While Rilonacept is FDA approved (320 mg x1 then 160 mg sc/wk), anakinra (2 mg/kg/d or 100 mg/d), canakinumab and colchicine are used https://t.co/j00yWpBbq3 https://t.co/7BK2mopssc
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Goofy But True
Dr. Jack Cush discusses declining survival rates in the USA, FDA approvals of new COVID subvariant boosters and other odd and possibly true new research reports from the past week on RheumNow.com.
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Genetic Testing for Autoinflammatory Disease
Not all patients with periodic fevers fit neatly into diagnostic categories. Some can be diagnosed as Still’s disease (based on criteria) while others can be classified as autoinflammatory diseases (AID) and some may be unclassifiable, clinically or genetically.
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Recent review of AOSD suggests: - AOSD & SJIA are the same - Classify dz as systemic or articular - #MAS occurs in up to 23% - Yamaguchi & Fautrel criteria are widely used - Cytokines important: IL-1, IL-6, IL-18, IL-37 - only Canakinumab is FDA-approved https://t.co/4ERA56Wqcb https://t.co/FkIWxIrwxX
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