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Pediatric Rheum

Review of HLA-B27

Jack Cush, MD

HLA-B27 remains the dominant genetic link to spondyloarthritis (SpA) across the age spectrum, but B27 related clinical expression diverges between children and adults. New mechanistic data on autoreactive T cells, HLA-B27 misfolding, and gut-joint trafficking point to new plausible, targetable

Dr. John Cush
@RheumNow
Epic Cosmos study of GLP-1RA Rxs in 3.5 million children (8–11 yrs) - very few 0.6% recv a GLP-1RA (20,282 kids) - Rx went from 0.03% (2019) to 9.3% (2026-310-fold incr). More likely in older, girls, obese kids. Most GLP-1 kids had severe obesity (93.7 percent) https://t.co/JW6SXxJjA0
Dr. John Cush
@RheumNow
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/PYuvyaPdxA
Dr. John Cush
@RheumNow
Japanese study of 101 864 children shows fertility treatments (ovulation induction, intrauterine insemination, invitro fertilization) increases the risk of Kawasaki Dz. Incidence rates per 100K PYs - 274 for spont conception vs 391 for assisted conception (adj HR 1.42; https://t.co/Ro0beSXAAq
Dr. John Cush
@RheumNow
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

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.

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
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
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
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

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

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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