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Infectious Rheumatology (5.15.2026)
Dr. Jack Cush discusses his favorite journal articles from the past week on RheumNow.com.
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Follow the Money (4.23.2026)
Dr. Jack Cush follows the money and all the news that fits the Rheumatology Gab for this past week.
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Parvovirus B19 Infection - Images from JAMA Dermatology. 40yoM 2-days asymptomatic rash w/ fever to 39°C, w/ arthralgias, Rash on BL cheeks, inguinal, flanks, axilla. WBC =2K, CRP 1.24 mg/dl. Dx by PCR for parvovirus B19 DNA https://t.co/LGGnabvFvA https://t.co/XzPlaWkIfz
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RA adds to mortality risk in nontuberculous mycobact. infx (NTM). Retro study 1420 NTM pts, 66 (4.6) had RA. RA was independent predictor of resp-death (HR 4.30) - partly explained by ILD & systemic inflammation https://t.co/S9bndHsXCE https://t.co/mC74Qve1LZ
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ArthritisPower Registry (now PatientSpot) survey study of 351 RA pts (age 60, F 84%); reported 439 nonserious infx. 27% total infx, 14%w/ MD visist & Abx. Infx incr w/ GC ≥10 mg/d (OR 1.94), but Biologics & JAKi not assoc. w/ greater NSIE risk vs cs DMARDs https://t.co/bHqFnoY0Ud
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JAMA Insights on Chikungunya (affects 35 million worldwide) - mosquito-borne alphavirus seen in tropics, also travelers. Dz char by fever, disabling polyarthritis; less rash, HA, myalgia, N/V, conjunctivitis; rarely myocarditis. https://t.co/Fa3cHygc4W https://t.co/jmh2WjOcI5
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PTPN22 1858C>T allele, seen in 5-15% NAmerica, often assoc. w/ autoimmune dz risk. BUT...PNAS shows Ptpn22 augments innate immunity and enhances NK activity against coronavirus infection https://t.co/1AMTuOXtoT https://t.co/9f3JdimJsG
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Parvovirus B19 Infection - Images from JAMA Dermatology. 40yoM 2-days asymptomatic rash w/ fever to 39°C, w/ arthralgias, Rash on BL cheeks, inguinal, flanks, axilla. WBC =2K, CRP 1.24 mg/dl. Dx by PCR for parvovirus B19 DNA https://t.co/LGGnabvFvA https://t.co/yyBF9pEGls
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JAMA Review of acute and chronic Hepatitis B infection. "All ...on immunosuppressive Rx should be tested for HBsAg, HBsAb, and HBc Ab. HBV DNA measured in HBsAg+ & those w/ isolated Ab HBcAg https://t.co/LTecQlSMX3 https://t.co/SgVyk9fSCd
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Supposedly there's a shortage of Infectious Dz specialists & Fellowship applic are down. Survey of 380 Int. Med residents (41 prgs) shows ID interest signif assoc w/ exposure to ID in Yr 1 & 2, outpt clinics, ID- research. https://t.co/AUkiIvsuaV https://t.co/pOqkBhy93U
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Full read review of Preclinical Rheumatoid Arthritis:
- Mucosal Origin Hypothesis
- Gut Microbiota
- Smoking & environment
- Periodontitis
- Immunosenescence
- T cell abnormalities
- Drug prevention https://t.co/UgqNBnKLMT https://t.co/2YZEiRCKNi
Dr. John Cush RheumNow ( View Tweet)
JAMA Review of acute and chronic Hepatitis B infection. "All ...on immunosuppressive Rx should be tested for HBsAg, HBsAb, and HBc Ab. HBV DNA measured in HBsAg+ & those w/ isolated Ab HBcAg https://t.co/LTecQlSMX3 https://t.co/cq3CuIuMKX
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COVID Virus Persistence with DMARD Use
Drugs commonly used to treat systemic autoimmune rheumatic diseases (SARDs) may prolong SARS-CoV-2 circulation after COVID-19 infection in patients with these conditions, with researchers documenting substantially increased viral antigen https://t.co/szeILIbmjF
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Smoking is most established environmental risk factor for RA- Dz risk, severity, & RA-ILD. Role of other airborne pollutants is mixed: particulate matter & nitrogen dioxide show inconsistent associations w/ RA https://t.co/Fkemc5hAUB
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Retrospective observational study of IPAF (ILD w/ autoimmune) pts - from Mt Sinai ILD registry 791 - 14 Rx w/ rituximab vs 19 not. Betw group outcomes same: PFTs, O2 use, Infx, Resp admissions, mortality. RTX group recv more immunosuppressives. https://t.co/sle4a0JOFL https://t.co/rS69epQiif
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Retrospective study of 374 newly diagnosed microscopic polyangiitis (MPA) pts - 97 (26%) had severe infections w/in 6 mos - signif higher risk w/ high dose prednisone & chronic lung Dz. most common: bacterial (43%) & lung infx https://t.co/XXAxUZw7kx https://t.co/atK8Ob9zyQ
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Retrospective clinicopathologic review of 170 AORTIC surgical pathology cases (2009-16) - showed 87% w/ atherosclerosis, 13% aortitis/periaortitis and 2.4% atherosclerosis w/ excessive inflammation. Lymphoplasmacytic inflammation was most common w/ aortitis/periaortitis. https://t.co/CuP30dqRQU
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Retrospective observational study of IPAF (ILD w/ autoimmune) pts - from Mt Sinai ILD registry 791 - 14 Rx w/ rituximab vs 19 not. Betw group outcomes same: PFTs, O2 use, Infx, Resp admissions, mortality. RTX group recv more immunosuppressives. https://t.co/sle4a0JOFL https://t.co/SyhK12KhHY
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Claims data 2,751 #AAV patients - 6.2% developed #PJP infx. w/ predictors: age, max GC dose, rituximab, CTX, & PJP prophylaxis had Good concordance (0.70) @2mos & 0.66@1yrs. W/ monthly risk of 1.0%, prophylaxis yielded 34 potentially preventable PJP cases https://t.co/c2ObDnmfYp https://t.co/0JRd1k0R2R
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