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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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EULAR/ACR Classification in MDA5+ Myositis Patients
The diagnosis of idiopathic inflammatory myopathies (IIMs) can be informed by the 2017 EULAR/ACR classification criteria, but their utility in patients with clinically amyopathic dermatomyositis (CADM) and anti–melanoma differentiation–associated protein 5 (anti–MDA-5)–positive IIM
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Study of 497 pts referred by general practitioners to rheumatologist (2018-19) showed:
- GP Dx changed by Rheum in 58%
- Low complexity Dx (FM, OA) acct for 50% referrals
- 46% of referrals inappropriate
- GP correlations w/ Rheum Dx poor (κ < 0.5) https://t.co/q592iHQZbq https://t.co/XyPdtpHQGK
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Dr. John Cush RheumNow ( View Tweet)
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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Dr. John Cush RheumNow ( View Tweet)
NICE Guidelines on Gout Diagnosis and Management
NICE (UK) has systematically reviewed current medical evidence and delivered a set of recommendations with consideration of cost effectiveness.
https://t.co/ckDrfVAynN https://t.co/jzBviwpxGL
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Dr. John Cush RheumNow ( View Tweet)
Risk of TNFi-related psoriasis in 5088 TNFi Rx children w/ IBD, JIA, or CNO. Compared to non-TNFi exposed, kids on TNFi had an increased PSO risk w/ ADA (IRR 2.70; 1.53-4.75), infliximab (2.34) or etanercept (2.21) & not incr w/ DMARD use https://t.co/MyjLfeoChq https://t.co/A3JJUA1AaM
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Dr. John Cush RheumNow ( View Tweet)
Cranial nerves exam (unknown source) #BJHM #Neurotwitter #Medtwitter #MedEd #medstudents https://t.co/NnUx6tGERn
Brown Journal of Hospital Medicine BrownJHM ( View Tweet)
New data at today's CDC/ACIP meeting on vaccine effectiveness vs BA.5 wave hospitalizations, all adults
https://t.co/64b9g7HW1h
Less protection for both 3rd and 4th dose vaccines compared with the prior wave (BA.2, BA.2.12) https://t.co/JTichjw2I3
Eric Topol EricTopol ( View Tweet)
Calling All Rheumatology Fellows! Join the ACR Fellows-in-Training Subcommittee https://t.co/FSyMjVieAD
Dr. John Cush RheumNow ( View Tweet)
Gout: diagnosis and management—summary of NICE guidance https://t.co/zOdPzGtqg7 https://t.co/N7CJ23vLND
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Dr. John Cush RheumNow ( View Tweet)
OPTION-DM study of 140 diabetic neuropathy pts Rx for 16 weeks w/ one agent (& if no response) an add-on agent. At wk 16, all 3 regimens lowered nerve pain score from 6.6 to 3.3 w/ no difference between Elavil+Lyrica, Lyrica+Elavil, o Cymbalta+Lyrica) https://t.co/rijJyq1DYL https://t.co/NwHF6xuF0j
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Dr. John Cush RheumNow ( View Tweet)
Have you registered for RheumNow yet? With registration you'll be able to sign up for our daily email, as well as our topic specific emails.
RheumNow is where rheumatologists come to learn.
https://t.co/NuN8JL37tk https://t.co/urJGorSzxo
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Dr. John Cush RheumNow ( View Tweet)
Prevalent Sleep Problems in Rheumatoid Arthritis
Data from Data FORWARD (The National Databank for Rheumatic Diseases) reveals that nearly two-thirds of rheumatoid arthritis (RA) patients have self-reported sleep problems.
https://t.co/WHv3BBeI8T https://t.co/awSy2VqBIn
Links:
Dr. John Cush RheumNow ( View Tweet)
Disease Activity Scoring in AOSD
AOSD or sJIA can have dramatic symptom severity, making it easy to gauge disease activity and response to therapy, especially at the outset. However, a validated measure of disease activity has not been agreed upon.
https://t.co/oD6uDD6W8m https://t.co/KxNJeJ31h8
Links:
Dr. John Cush RheumNow ( View Tweet)
ANA Increasing? Part of the NHANES survey, ANA (IIF on HEp-2 cells) was performed on 13,519 in 3 periods: 1988-1991, 1999-2004, and 2011-2012. ANA+ was
11% 1988-1991
11.4% 1999-2004
16.1% 2011-2012 (P <0.0001)
Meaning ~22.3, ~26.6, &~41.5 mil had +ANAs https://t.co/vWYJci3uDV https://t.co/SEIbrYRoRJ
Links:
Dr. John Cush RheumNow ( View Tweet)
SURPRISED? Psoriasis pts have a known increased risk of CV disease. But did you know several papers & metanalyses show increased risk of abdominal aortic aneurysm in PSO (HR 1.30), worse w/ dz activity; lost w/ age, female, DM? https://t.co/UssLZsBJle https://t.co/ESGK8fjjJk https://t.co/CBBYZRCjCA
Dr. John Cush RheumNow ( View Tweet)
Anti-PM-Scl connective tissue diseases - By Paul Breillat (Fellow in Internal Medicine, Paris, France) #connective #scleroderma #myositis #PMScl #InternistAcademy https://t.co/P727E4ddzz
Benjamin Terrier TerrierBen ( View Tweet)
✅ Probably one of my most important slides ⬇️
WHY IS MY #TREATMENT NOT WORKING (or not working enough) 😭 This is really a question we're dealing with everyday in #rheumatology when taking care of patients with #autoimmune and other rheumatic diseases 👍 https://t.co/osUPYSvuWf
Laurent ARNAUD Lupusreference ( View Tweet)
This precipitous drop and current level is substantially worse than 21 peer countries
https://t.co/NAEMjhs4j3 https://t.co/QhrZ1Xnwcr
Eric Topol EricTopol ( View Tweet)
In a nutshell, reducing glucocorticoids in #SLE patients is associated with a number of important clinical benefits and may impact risk of other comorbidities such as BP and infection risk. https://t.co/YBoIU6aK8p
Ian N Bruce Lupusdoc ( View Tweet)