Vitamin D Headlines (5.9.2025)
Dr. Jack Cush reviews the news, journal reports and lupus highlights from the past week on RheumNow.com. Triple positivity, the gut and CRPS, and hope for better outcomes with Vitamin D therapy.
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Managing CKD in Lupus Nephritis
Dr. Hans-Joachim Anders explores how to treat LN patients with chronic kidney disease, balancing disease control and renal preservation.
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👉 Full update on RheumNow: https://t.co/frHvcd1xMw
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Dr. John Cush @RheumNow( View Tweet )
Soluble CD13 (sCD13) has pro-inflammatory effects & is elevated in severe COVID-19. sCD13 is chemotactic, angiogenic, & arthritogenic. In COVID-19, sCD13 was assoc w/ sCD13 severity, ethnicity, inflammation markers, NETosis, & vascular injury/thrombosis. https://t.co/dTT9X49DIt
Dr. John Cush @RheumNow( View Tweet )
Metanalysis of ANCA-associated vasculitis with interstitial lung disease (8 studies, 654 pts shows the following significan mortality risk factors: age (HR 1.06), ever smoker (HR 1.61), UIP pattern (HR 2.07), acute exacerbation (HR 2.73) & microscopic polyangiitis (HR 4.03). https://t.co/Rf6c2gidpK
Dr. John Cush @RheumNow( View Tweet )
Arterial or venous thrombotic events (AVTEs) are common w/ new forms of monogenic vasculitis (DADA2 & VEXAS), resulting from pathogenetic mechanisms of endothelial dysfunction, immune complex deposition and pro-inflammatory cytokines. Reviewed here. https://t.co/Nw9wNYssg3 https://t.co/5V0yrctaFI
Dr. John Cush @RheumNow( View Tweet )
single-centre study of 469 consecutive RA pts - 15 had VTE (3%). Strongest risk factor of VTE was the history of previous VTE (OR 44.7), recent hospitalisation (OR 6.82), diabetes (OR 11.23), and JAKi (OR 5.54) (Other studies show inflammation incr VTE risk) https://t.co/JfaBtfvujU
Dr. John Cush @RheumNow( View Tweet )
Metanalysis of ANCA-associated vasculitis with interstitial lung disease (8 studies, 654 pts shows the following significan mortality risk factors: age (HR 1.06), ever smoker (HR 1.61), UIP pattern (HR 2.07), acute exacerbation (HR 2.73) & microscopic polyangiitis (HR 4.03). https://t.co/z4zfDq9Wf9
Dr. John Cush @RheumNow( View Tweet )
Arterial or venous thrombotic events (AVTEs) are common w/ new forms of monogenic vasculitis (DADA2 & VEXAS), resulting from pathogenetic mechanisms of endothelial dysfunction, immune complex deposition and pro-inflammatory cytokines. Reviewed here. https://t.co/Nw9wNYssg3 https://t.co/1PoPWPWNec
Dr. John Cush @RheumNow( View Tweet )
Study of 42 pts w/ long standing RA-LD undergoing Lung Transplant (LTx) betw 2004 -2020. Median survival was 5.3 yrs (1-yr survival 88%) - same survival as LTx in other CTD & non-CTD ILD LTx. Mortality was 43%, higher w/ UIP. RA/CTD is not a contraindication to LTx. https://t.co/JcTug1wsTZ
Dr. John Cush @RheumNow( View Tweet )
Prophylaxis Against PJP in SLE: I'll Pass with @EBRheum
https://t.co/tUGwziEYCg https://t.co/VqTa9jG8oj
Dr. John Cush @RheumNow( View Tweet )
single-centre study of 469 consecutive RA pts - 15 had VTE (3%). Strongest risk factor of VTE was the history of previous VTE (OR 44.7), recent hospitalisation (OR 6.82), diabetes (OR 11.23), and JAKi (OR 5.54) (Other studies show inflammation incr VTE risk) https://t.co/pBJDhXOgut
Dr. John Cush @RheumNow( View Tweet )
Prophylaxis Against PJP in SLE: I'll Pass
I think we're all somewhat familiar with PJP prophylaxis. This is the thing we do to stop the scary, opportunistic infection that affects people who are immunocompromised. I'm going to start by actually steelmanning the case for doing PJP prophylaxis before I explain why I think you probably
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67 systemic sclerosis pts w/ mod-to-severe lower GI Sxs were Rx in phase 2, RDBPCT of placebo or fecal transplants at wks 0 and 2, with no signif change in GI sxs by week 12 (bloating or diarrhoea). https://t.co/vWq2c8d4Kn https://t.co/PpPsAQbj5M
Dr. John Cush @RheumNow( View Tweet )
Procalcitonin > 0.9 ng/mL can be a critical marker for identifying bacterial infection in #SLE. Single center study of 116 juv. SLE pts dx bacterial infx in 17%. Procalcitonin was signif better than others: NLR, PLR, ESR, CRP, LC4R, ferritin (cut offs need to be defined) https://t.co/NAM8xopNW5
Dr. John Cush @RheumNow( View Tweet )
Complex Evolution of RA Management and Outcomes
FIRST is a Japanese longitudinal, real-world registry of rheumatoid arthritis (RA) management, and over the last 20 years has shown significantly improved outcomes, yet significant challenges and unmet needs remain.
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Post-treatment Lyme Syndrome
Symptoms that persist long after Lyme disease is treated are not uncommon — a 2022 study found that 14% of patients who were diagnosed and treated early with antibiotic therapy would still develop Post Treatment Lyme Disease (PTLD). https://t.co/mmwGCnARY8
Dr. John Cush @RheumNow( View Tweet )
Castleman disease (CD) is a rare, non-clonal lymphoproliferative disorder w/ systemic sxs & maybe linked w/ herpesvirus 8, POEMS or TAFRO syndrome. Mimickers include lymphoma, sarcoma, IgG4-RD, Infections (EBV, HHV8, HIV, CMV, TB), Autoimmune Dz (RA, SLE, Stills) https://t.co/29M0jePXHd
Dr. John Cush @RheumNow( View Tweet )
Piperacillin effectively treats Lyme disease at 100-times lower dose than doxycycline https://t.co/vbu78RbRys https://t.co/AqSkm7XtbB https://t.co/olTi8OWsQ6
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Dr. John Cush @RheumNow( View Tweet )
Castleman disease (CD) is a rare, non-clonal lymphoproliferative disorder w/ systemic sxs & maybe linked w/ herpesvirus 8, POEMS or TAFRO syndrome. Mimickers include lymphoma, sarcoma, IgG4-RD, Infections (EBV, HHV8, HIV, CMV, TB), Autoimmune Dz (RA, SLE, Stills) https://t.co/70sROoHusy
Dr. John Cush @RheumNow( View Tweet )
Piperacillin effectively treats Lyme disease at 100-times lower dose than doxycycline https://t.co/NQXG7FRtwh https://t.co/YcIYJqorKX https://t.co/e7UCG0z4wL
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Dr. John Cush @RheumNow( View Tweet )
Post-treatment Lyme Syndrome
EurekAlert!
Symptoms that persist long after Lyme disease is treated are not uncommon — a 2022 study found that 14% of patients who were diagnosed and treated early with antibiotic therapy would still develop Post Treatment Lyme Disease (PTLD). Yet doctors puzzle over the condition’s causes and how to
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Diabetes Prevention with Hydroxychloroquine in Sjogren’s
A Taiwanese insurance claims analysis looked at HCQ use in primary Sjögren syndrome (pSS) and showed that HCQ exposure significantly reduces the risk of new onset diabetes in pSS. Conversely, higher doses of https://t.co/WQD0RNfm5Z
Dr. John Cush @RheumNow( View Tweet )
CDC's Committee on Immunization (ACIP) met and recommended:
1. Expand strains for meningococcal vax
2. Lower age for RSV vax > 50y
3. Rec. chikungunya vax for certain travelers
- Flu & Covid Vax to be up next mtg 6/25 https://t.co/jInnR5JSxS https://t.co/PXg0HDLgnL https://t.co/Vro5mbjG9R
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Dr. John Cush @RheumNow( View Tweet )
Distinguishing Septic and Gouty Arthritis
A single center, retrospective review of patients undergoing knee joint fluid aspirations for presumed crystalline arthritis (CA) showed that synovial WBC may provide a useful diagnostic marker for SA with an optimal threshold of 50,000 https://t.co/ye69mRooSh
Dr. John Cush @RheumNow( View Tweet )
Is High Dose Aspirin Needed in Kawasaki Disease (KD)?
Does aspirin add any advantage to intravenous immunoglobulin (IVIG) alone in children with KD? A randomized clinical trial IVIG alone was not inferior to IVIG plus aspirin, suggesting that high-dose aspirin during initial https://t.co/uuCgDmgNif
Dr. John Cush @RheumNow( View Tweet )
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