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Vasculitis

There have been many cases of Kawasaki vasculitis in kids ith COVID-19; now Lg vessel vasculitis in 79 yo Japanese man w/ COVID-19 pneumonia, CRP 17.7 mg/dL, spiking fevers and CTA and FDG-PET evid of aortic and LVV, neg ANCA, nl IgG4, but was HLA-DR4+.

Dr. John Cush RheumNow ( View Tweet)

Oct 14, 2020
In elderly AAV, initial steroid dose should be rapidly reduced be required to safe outcomes. Study of 179 AAV pts 80yrs old w/ high Birmingham Vasculitis Score 16.1. 94% MPO+, 6% PR3+, Serious infections seen in high-dose Pred vs low dose (43% vs.

Dr. John Cush RheumNow ( View Tweet)

Oct 13, 2020

Biologics Beneficial in Eosinophilic Vasculitis

Oct 08, 2020

Two biologic therapies showed promise in the treatment of refractory or relapsing eosinophilic granulomatosis with polyangiitis (EGPA) in a retrospective European study.



Among 63 patients who were treated with rituximab (Rituxan), remission or partial responses at 1 year were observed

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Sustained Remission Off Therapy Unlikely in GPA

Oct 08, 2020

A French Vasculitis Study Group analysis of their granulomatosis with polyangiitis (GPA) reveals that after 10 years, only 7% of GPA patients achieved sustained remission off therapy (SROT) and have never relapsed.

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European collaborative study of eosinophilic granulomatosis with polyangiitis (EGPA) Rx w/ RTX, mepolizumab or omalizumab (OMA). MEP > RTX > OMA. Mepolizumab was highly effective in GC‐dependent asthma. https://t.co/fi8pjnJO03

Dr. John Cush RheumNow ( View Tweet)

Oct 06, 2020
"Prednisone >30 mg/day for > 4 weeks, patients should be on PJP prophylaxis." Image shows when to start/stop PJP prophylaxis Dr. Kevin Winthrop on Risks/Prevention of OI @UTSWRheum Grand Rounds @rheumnow https://t.co/nXuWYRxbgy
Oct 05, 2020

Livedo, Purpura and Coagulopathy in Severe COVID-19

Sep 23, 2020

JAMA Dermatology expands the spectrum of complications seen with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection describing cutaneous purpura and livedo lesions in patients with severe COVID-19.



A flurry of recent reports have described livedoid and necrotic

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Case series compared 247 pregnancies in IgA Vasculitis patients vs 556 control pregnancies showing IgA Vasculitis had no effect on fertility and did not induce flares. But IgAV had more spont. abortions, gestational HTN, preterm delivery.

Dr. John Cush RheumNow ( View Tweet)

Sep 09, 2020

RheumNow Podcast – To Celiac Test or Not? (9.4.20)

Sep 04, 2020

Dr Jack Cush reviews the news, journal articles and takes a few Back Talk questions this week:

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COVID and the Multisystem Inflammatory Syndrome in Children

Aug 31, 2020

Lancet Infectious Disease has reviewed the epidemiology, causes, clinical features, and current treatment for the multisystem inflammatory syndrome in children (MIS-C) and adolescents associated with COVID-19, noting severe organ damage can occur pediatric COVID-19 patients who are severely

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Update on Polymyalgia Rheumatica and Giant Cell Arteritis

Aug 24, 2020

JAMA has published a clinical update of recent studies on GCA. While PET/CT scanning are novel means of demonstrating activity, they have not changed the diagnostic approach to GCA or PMR and although there are no new proven treatment strategies for PMR beyond glucocorticoids, the FDA has

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Diagnostic Accuracy of Symptoms, Signs and Labs in GCA

Aug 23, 2020

A systematic review and meta-analysis of 68 diagnostic cohort studies (14 037 patients) suggests that no one feature is more impactful that the combination of symptoms, signs, and laboratory tests to diagnose the presence giant cell arteritis (GCA).



From these analyses findings

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@RheumNow its time we stopped “seroneg RA” which are many diseases, like ANCA pos Vasculitis we should have ACPA pos RA and others - how many viral arthritides in our country “doing great” on SZP, PLAQ, or low dose MTX and reluctant to stop? #RA #Seronegative

Peter Nash drpnash ( View Tweet)

Aug 20, 2020

RheumNow Podcast - The SARS-CoV-2 Update (8-14-20)

Aug 14, 2020

Dr. Jack Cush updates the news and journal articles from the past week on RheumNow.com, with information on enthesitis, nr-Ax-SpA, UAB, Blockbuster Rheum Drugs and use of ACE inhibitors.

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Thromboembolic Risk with Tofacitinib in RA, PsA and UC

Aug 06, 2020

An analysis of the tofacitinib (Xeljanz) drug development program in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ulcerative colitis suggests a low level risk for venous (VTE) and arterial thromboembolism (ATE).  



In the last 2 years, observational data has

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Study of 662 temporal artery Bx shows that when diagnosing #GCA, the TAB length should be at least 5 mm and should analyze at least 3 further sections at deeper levels for maximal yield. https://t.co/6zM9hBUsXy

Dr. John Cush RheumNow ( View Tweet)

Aug 06, 2020

Long-Term Rituximab in ANCA-Associated Vasculitis

Aug 06, 2020

The Annals of Internal Medicine reports that biannual rituximab infusions over 18 months was effective at maintaining remission in patients with antineutrophil cytoplasmic antibody–associated vasculitis (AAV).

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RheumNow Podcast – COVID-19 Responds to Steroids (7.24.20)

Jul 24, 2020

Dr. Jack Cush reviews the News and Journal Reports from the past week on RheumNow.com.

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Registry of COVID CNS complications reports 125 pts; 77 (62%) w/ Cerbrovascular event (57 ischemic CVA), 9 intracerebral hemorrhage, 1 CNS vasculitis. 39 w/ AMS, 9 encephalopathy & 7 encephalitis.

Dr. John Cush RheumNow ( View Tweet)

Jul 17, 2020
Skin is often involved w/ ANCA+ vasculitis - 1184 AAV pt study shows skin involvement in 34% GPA; 28% MPA & 47% EGPA. Common are petechiae/purpura pruritus, urticaria, and maculopapular rash.

Dr. John Cush RheumNow ( View Tweet)

Jul 10, 2020
Avacopan is as effective as steroids in ANCA Assoc Vasculitis – 330 pt RCT AAV Rx w/ RTX or CTX but randomized to p… https://t.co/mxm5NAjZtL

Dr. John Cush RheumNow ( View Tweet)

Jul 09, 2020
PRES - Posterior reversible encephalopathy syndrome. Review of US hosp records finds 3125 cases.

Dr. John Cush RheumNow ( View Tweet)

Jul 02, 2020

ACR Outlines Best Practices for Kids With MIS-C

Jun 25, 2020

Multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19 infection has both similarities and differences with Kawasaki disease, and requires distinct clinical management, according to draft guidance from the American College of Rheumatology (ACR).



Age, symptoms,

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Serum calprotectin: a better biomarker in ANCA-associated vasculitis?

Jun 10, 2020

Flares in ANCA-associated vasculitis are difficult to predict, but serum calprotectin may help predict relapse and renal failure, according to data presented at the EULAR 2020 virtual meeting this week.

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#EULAR2020 #op0143 a nationwide study concludes GCA pts at higher risk for sarcoma (HR 2.14), kidney cancer (1.6), hematological malignancies (HL2.42&non-HL1.66). Overall cancer HR 1.29.
Olga Petryna DrPetryna ( View Tweet)
Jun 07, 2020
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