Infectious Rheumatology (5.15.2026)
Dr. Jack Cush discusses his favorite journal articles from the past week on RheumNow.com.
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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
Dr. John Cush @RheumNow( View Tweet )
Does RTX work in CNS lupus? Japanese experience in 17 refractory NP-SLE pts Rx w/ RTX - 16/17 had significant improve. & 1 partial improvement -- none had NP-SLE relapse. Two died during COVID> https://t.co/GpCgpSxn37 https://t.co/PMz05MHBhj
Dr. John Cush @RheumNow( View Tweet )
Infectious Rheumatology (5.15.2026)
Dr. Jack Cush discusses his favorite journal articles from the past week on RheumNow.
https://t.co/MzqDykG78w https://t.co/z7BsADXo4x
Dr. John Cush @RheumNow( View Tweet )
10yr retrosp. study of 110 Still’s dz pts. MAS occurred in 37% (1/2 @onset; assoc w/ serositis) and ILD observed in 82% (also assoc w/ MAS, polycyclic course) https://t.co/SNa0KiWfgY https://t.co/xbpCuHdJka
Dr. John Cush @RheumNow( View Tweet )
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
Dr. John Cush @RheumNow( View Tweet )
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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Dr. John Cush @RheumNow( View Tweet )
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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Dr. John Cush @RheumNow( View Tweet )
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
Dr. John Cush @RheumNow( View Tweet )
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
Dr. John Cush @RheumNow( View Tweet )
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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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
Dr. John Cush @RheumNow( View Tweet )
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
Dr. John Cush @RheumNow( View Tweet )
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
Dr. John Cush @RheumNow( View Tweet )
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
Dr. John Cush @RheumNow( View Tweet )
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
Dr. John Cush @RheumNow( View Tweet )
Top Four and More (4.10.2026)
Dr. Jack Cush reviews the news and journal reports from RheumNow.com this week - including his top four favorite subjects.
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5 yr Italian study of hospitalized autoimmune pts(2018-23) 4,896 IMID pts compared to 301,126 non-IMIM. IMID had signif higher risk cancer (adj OR 1.32) highest 1st yr. Decreased from 1.83 @ yr 1 to 1.2 @5+ yrs. IMID had more lung & bladder CA, leukemia lymphoma & melanoma https://t.co/UXqDHQtzv0
Dr. John Cush @RheumNow( View Tweet )
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/Ljr5maHZcr
Dr. John Cush @RheumNow( View Tweet )
Recent Blogs
Imagine that 100 years from now, your great granddaughter, an eminent rheumatologist, reviews the history of rheumatoid arthritis mimics.
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A beloved childhood game I enjoyed was Freeze Tag. Players would run to avoid being tagged by the person who was “It”. If you were tagged, you had to “freeze” in your spot until someone was brave enough to come un-tag you. The game ends when everyone is frozen or if people quit. For over 2 years, I have been living in a real-life “Freeze Tag” game and able to dodge COVID19, until now. Sitting in my room symptomatic and frozen in isolation, I ruminated about my patients who had COVID19 and their experiences. I wanted to share with you three stories of three variants.
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