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Autoinflammatory

Don’t Hold the JAK (10.9.2026)

Jack Cush, MD

On this week's podcast, Dr. Jack Cush reviews the news: Steroids are easy to start and hard to stop; hold the MTX but not the biologic or JAK, weighing in on avacopan, and age-old messages for old-age patients. 

Dr. John Cush
@RheumNow
52 VEXAS pts Rx w/ IL‐1i, IL‐6i, or JAKi therapy judged as compl Resp (CR), partial (PR), Failure (TF). @ 6mos: 3/19 IL‐6i had CR, 4/19 PR, 7/19 TF. JAKi had 2/17 CR, 3/17 PR, 6/17 TF. No CR w/ IL‐1i or TNFαi, only 1/5 IL‐1i patients experienced PR. Only IL‐6i & JAKi had https://t.co/wqogmfeAru
Dr. John Cush
@RheumNow
Retrospective review of 33 referred pts w/ Recurrent fever w/ MSK & skin Sxs, assessed by NGS. NLRP1 had FMF-like Dz; NLRP recurrent fevers w/ mucocutaneous; NLRP12 periodic fevers w/ MP/EN rash; NLRC4 episodic systemic inflammation GI Sxs & atypical skin rash https://t.co/Ll2V0Uzfio
Dr. John Cush
@RheumNow
Retrospective review of 33 referred pts w/ Recurrent fever w/ MSK & skin Sxs, assessed by NGS. NLRP1 had FMF-like Dz; NLRP recurrent fevers w/ mucocutaneous; NLRP12 periodic fevers w/ MP/EN rash; NLRC4 episodic systemic inflammation GI Sxs & atypical skin rash https://t.co/IWafJVFoaJ
Dr. John Cush
@RheumNow
Misdiagnosis of Still's Disease 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 rarer, systemic disorder that should not be https://t.co/pSfSahO5Nw
Dr. John Cush
@RheumNow
Misdiagnosis of Still's Disease 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 https://t.co/mCbNBAt9T5

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

Dr. John Cush
@RheumNow
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

A Tribute to Daniel L. Kastner, MD, PhD (1951–2026)

Jack Cush, MD

The rheumatology, genetics and NIH communities mourn for Dr. Daniel L. Kastner, who died on July 28, 2026, in Bethesda, Maryland, at age 74. The following are declarations, tributes, and memories dedicated to this mensch of a man, titan of science, memorable mentor and humble physician.

Dr. John Cush
@RheumNow
Chinese cohort of 209 AOSD pts identifed 49 (23%) w/ lung dz (by CXR), yet 69% were asymptomatic. Significcant risk factors for AOSD-LD were pleuritis, MAS (HR 2.62), & Dz relapse (HR 2.6). Imaging patterns: acute exudative pattern most prevalent, followed by interstitial and https://t.co/2IPJWRJicP
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