Pediatric Rheum

39 studies compared Juvenile systemic sclerosis (jSSc) & adult SSc. 935 jSSc vs 15,451 aSSc pts; jSSc had more diffuse cutaneous dz (70% vs 41%), more overlap myositis (33% vs. 5%), arthritis (33% vs 18%), digital ulcers (51% vs 20%), less renal crisis (0% vs 6%) & lower https://t.co/vflarmwSyv
Dr. John Cush @RheumNow( View Tweet )
purpura

Guidelines for Adult-Onset IgA Vasculitis

Jack Cush, MD

A EUVAS-sponsored expert panel of 37 specialists across rheumatology, nephrology, dermatology and pathology has published evidence-based guidelines for adult-onset IgA vasculitis (IgAV), which behaves very differently in adults compared to usually self-limited childhood form.

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Childhood vs Adult onset SLE? Retro Australian Lupus Registry study of 519 SLE pts (68/13% w/ cSLE) found childhood onset had signif more damage (SDI≥1 53 vs 40%; renal Dz 62 vs 37%), more Dz activity, less LLDAS-50 (36% vs 51%) https://t.co/ttBRtSVl5n https://t.co/hoN1t16Za3

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Dr. John Cush @RheumNow( View Tweet )
Fever,temp,man,HA,thermometer

Misdiagnosis of Still's Disease

Jack Cush, MD

High fever, strange rashes, scary labs often lead to a consideration of Still's disease (AOSD or systemic JIA). Yet the dramatic onset of a systemic disorder may overlap with another, and possibly as rare, systemic disorder that should not be misdiagnosed or mistreated. A current case review by

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In 2026 Abbvie granted 34 scholarships to students With Inflammatory Diseases. In the last 10 yrs, theyve granted $6 million to >350 students in the US for higher education. These awards up to $20,000 per student renewable up to 4 yrs. https://t.co/DFy5SukB6G https://t.co/9mVkrhL2lo

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Dr. John Cush @RheumNow( View Tweet )
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Doubting RS3PE (8.14.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles this week where RheumNow featured info on cancer, deadly viruses, AI rules, poetry and good moons rising.

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From 1975 -2025, incidence of Kawasaki dz (KD) increased 16.1-fold in Japan, KD cases 15 032 and& 14 809 in 2023 & 2024, but during COVID #s dropped to 10 333 in 2022. KD #s rebounded after the COVID-19: Infants showed minimal changes, but kids 5-9 had the greatest increase https://t.co/j0BL2ZELXn
Dr. John Cush @RheumNow( View Tweet )
Retrospective study, 41 pediatric Behcets Dz pts looked at Inflam. indices (NLR, SII, PIV, CRP/albumin) vs controls. BD systemic involvement in 68%, CNS dz in 10%, Vascular Dz in 12% & major organ dz 46%. Inflamm indices significantly higher in BD w/ systemic, CNS, & Vasc https://t.co/wHiBIaOWWU
Dr. John Cush @RheumNow( View Tweet )
pediatric.kid_.jpg

$2 Million in Research Grants for Juvenile Arthritis

Jack Cush, MD

July is Juvenile Arthritis Awareness Month, and while many people think of arthritis as a disease of aging, nearly 300,000 children in the U.S. are living with a rheumatic disease.

Equally important is that 2026 marks a 50 year anniversary for Pediatric

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Cochicine overdose still occurs & can be deadly. There is no antidote. From 2011-2021, there were 57 pediatric cases (median 7 yrs)(0.41 /million kids/year. 52% started w/ GI Sxs, 12% multiple organ failure &4 deaths (7%). Ingested doses ranged from 0.01 to 1.45 mg/kg. https://t.co/RULmdBX0Qj
Dr. John Cush @RheumNow( View Tweet )
morbidity,covid,heart,lung,brain

Spotlight on Comorbidities from EULAR 2026

EurekAlert!

Systemic autoimmune diseases are associated with increased cardiovascular morbidity and mortality – possibly through autonomic imbalance, myocardial inflammation, or fibrotic infiltration of the conduction system. A team in Colombia have been looking into the

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guidelines.recommendations.jpg

2026 Guidelines for the Treatment of Axial Spondyloarthritis

ACR

New and updated clinical guidelines released today provide comprehensive, evidence-based recommendations for the management of axial spondyloarthritis (axSpA) for both adults and children. The effort includes an update to the 2019 ACR/SAA/SPARTAN treatment guidelines focusing on adults,

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Blood labs

2-Gene Blood Test for Kawasaki Disease in Febrile Children

Jack Cush, MD

JAMA Network Open has publshed that a simple 2-gene blood test may aid the earlier diagnosis of Kawasaki disease in children with febrile illnesses. 

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Breckenridge Pharmaceutical received FDA approval for their generic version of tofacitinib on 6/4/26. 5 mg and 10 mg tablets are now available in the U.S. market, for both adult and pediatric use. Tofacitinib Tablets are manufactured in Martorelles, Spain. https://t.co/oAh0KQSFgs https://t.co/fNxEm31MAI

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Dr. John Cush @RheumNow( View Tweet )
A high proportion of juvenile-onset SpA progress toward a r-axSpA phenotype Results from the Spanish REGISPON-3 POS1352 #EULAR2026 @RheumNow https://t.co/XicguAdXJ1

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Nelly ZIADE 🍀 @Nellziade( View Tweet )
EULAR flags

Updates in SLE and APS

2026 EULAR Press Release

Systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) often overlap. While there have been some therapeutic advances, significant needs remain around diagnosis and monitoring, with a gap around definitions and biomarkers for refractory disease or specific subsets. EULAR – The

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Live vaccinations in infants antenatally exposed to bDMARDs ⬇️⬇️ #WIN session @lauraandreoli80 #EULAR2026 @RheumNow https://t.co/84MCwb2fbT

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Nelly ZIADE 🍀 @Nellziade( View Tweet )
A Field Whose Time Has Come: Launching the EULAR Study Group on Geriatric Rheumatology EULAR launches a Study Group on Geriatric Rheumatology — clinics increasingly serve older patients with multimorbidity, polypharmacy, frailty, cognitive and functional limits, yet research

Dr. John Cush @RheumNow( View Tweet )

Transitioning from pediatrics to adult rheumatology for patients with autoinflammatory disease such as #AOSD should be done with administrative support and the right hand off. @RheumNow #EULAR2026 plenary talk https://t.co/N8qB7jrZfM

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Bella Mehta @bella_mehta( View Tweet )
EULAR flags

Understanding Comorbidities in RMD

2026 EULAR Press Release

People with rheumatic and musculoskeletal diseases (RMD) are at risk of a number of comorbidities, from cardiovascular diseases to cognitive impairment and fractures. The 2026 EULAR Congress showcased new data and ideas around various comorbidities and drug safety issues in people with an RMD –

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Multisystem inflammatory syndrome in children (MIS-C) - analysis of cases 2023-2024 shows 99% were undervaccinated against COVID-19. OVer 2 yrs, 141 MIS-C 78%had no COVID-19 vaccine. All 4 children who died were unvaccinated https://t.co/iBcA4GIdDe https://t.co/IQLLaG55gm

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Dr. John Cush @RheumNow( View Tweet )
Review of Ruxolitinib in 7 pts w/ refractory systemic JIA complicated by macrophage activation (MAS) (ages 1.6-11 yrs; 3M: 4F). 5 achieved complete remission; 2 partial remission. 2 relapsed w/ GC tapering (remission after adding canakinumab). No deaths https://t.co/j4Cm3UYB9c https://t.co/pKoDwpSKII

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Dr. John Cush @RheumNow( View Tweet )
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Count Your Telangiectasias (5.29.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal articles and missed quiz questions.

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Review of Ruxolitinib in 7 pts w/ refractory systemic JIA complicated by macrophage activation (MAS) (ages 1.6-11 yrs; 3M: 4F). 5 achieved complete remission; 2 partial remission. 2 relapsed w/ GC tapering (remission after adding canakinumab). No deaths https://t.co/j4Cm3UYB9c https://t.co/YIupsBank5

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Dr. John Cush @RheumNow( View Tweet )
Immune-Mediated Inflammatory Diseases Following Uveitis A Korean insurance claims data study showed children and adolescents diagnosed with uveitis have a 7-fold increased risk of developing an immune-mediated inflammatory disorder (IMID). https://t.co/NJI4369ygL https://t.co/6mHK8hYMeG

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Dr. John Cush @RheumNow( View Tweet )

Therapeutic Updates

Advancing the Treatment Landscape for Pediatric Psoriatic Disease

J&J January 2026
Learn more about a treatment offering pediatric patients 6 years and older who also weigh at least 40 kg, and their physicians and adult caregivers, an option that may improve skin clearance for moderate to severe plaque psoriasis or treat active psoriatic arthritis, collectively known as psoriatic disease.
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Recent Blogs

Best of 2022: Five Mistakes When Diagnosing Still’s Disease

Jack Cush, MD
Thermometer
Adult-onset Still's presents an interesting and diagnostic challenge when encountered. Here are 5 tips to improve your diagnostic acumen for this febrile disorder.
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From the Archives: Rheumatology Dead Word Cemetery

Jack Cush, MD
CTD.jpg
I recently heard of a secondary school assignment wherein students were challenged to “bury” a word that was no longer useful or appropriate. Their exercise has now evolved into an unofficial RheumNow task force to retire diagnostic terms that have grown into misuse in rheumatology and medicine. How did we decide which words should perish? And by what criteria? Who has the final say?
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Still's disease: paediatrics to adults, a continuum or not?

Dr. Ilenia Di Cola and Dr. Piero Ruscitti
life,stage,age,lifespan
Still’s disease is a rare inflammatory disorder, affecting less than 1 person per 2000 people. This disease may occur in both children and adults, namely as systemic juvenile idiopathic arthritis (sJIA) and adult-onset Still’s disease (AOSD). The paediatric form was described by George Still in 1896, whereas the adult variant later by Eric Bywaters in 1971. However only the adult disease is identified by the name of Still.
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