Clinical Pearl at #ACR21 from Dr. J. Stone: ⭐️Ferritin:ESR ratio helps distinguishes systemic JIA flares from macrophage activation syndrome (MAS). ⭐️During MAS: *️⃣Ferritin rapidly rises as an acute phase reactant *️⃣ESR declines as fibrinogen is consumed. #ACRBest @RheumNow

Treatment for VEXAS syndrome. It is steroid responsive. Avoid IL-1 inhibitors severe skin reactions at injection site, bone marrow transplant may be curative @RheumNow #ACR21 Session6S410 L Wilson, DO Cordona https://t.co/eQ1KVDiKKV

VEXAS a new genetic disorder, (V) Vacuoles, (E) E1-enzyme, (X) X-linked, (A) Autoinflammatory, (S) Somatic. These are the important clinical features to be looking out for in clinic @RheumNow #ACR21 Session6S410 L Wilson, DO Cordona https://t.co/dBBLox6vVg

IL-18 in autoinflammatory Disorders session talk by Raphaela Goldbach-Mansky - Discovered in 1995 - IL18 expressed in epithelial cells, keratinocyts, macrophages - IL-18R neg regulated by IL-18 binding protein https://t.co/U6TTDqEb7L https://t.co/R2lIo188ac

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It is always difficult to distinguish infection and disease flares in autoinflammatory syndromes = 25 pt sJIA study at #ACR21 showing serum procalcitonin levels are useful when >0.95ng/ml @StillsDis_411 @rheumnow #abst0252