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Recent Updates in Juvenile Spondyloarthritis
Spondyloarthritis represents a group of disorders characterized by enthesitis and axial skeletal involvement. Juvenile spondyloarthritis begins before age 16. Joint involvement is usually asymmetric. Bone marrow edema on noncontrast MRI of the sacroiliac joints can facilitate diagnosis. The most significant risk factor for axial disease is HLA-B27. Most patients have active disease into adulthood. Enthesitis and sacroiliitis correlate with greater pain intensity and poor quality-of-life measures. Tumor necrosis factor inhibitors are the mainstay of biologic therapy. Although other biologics such as IL-17 blockers have show...
Source: Rheumatic Disease Clinics of North America - August 21, 2021 Category: Rheumatology Authors: Hemalatha Srinivasalu, Keith A. Sikora, Robert A. Colbert Source Type: research

Juvenile Fibromyalgia
Juvenile fibromyalgia is a common referral in pediatric rheumatology settings. Providing a clear diagnosis and explanation of altered pain processing offers reassurance that pain has a biologic basis and the symptoms are part of a recognized pain syndrome. Physicians should acknowledge the impact of chronic pain and associated symptoms on patient ’s lives and take time to understand contributing factors including stress, mood, inactivity, and lifestyle factors. The optimal treatment for juvenile fibromyalgia is multidisciplinary, focusing on education about juvenile fibromyalgia, along with physical therapy, cognitive be...
Source: Rheumatic Disease Clinics of North America - August 21, 2021 Category: Rheumatology Authors: Jennifer E. Weiss, Susmita Kashikar-Zuck Source Type: research

COVID-19 in Pediatrics
This chapter reviews the diagnosis and treatment of infection with coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), as well as a new inflammatory syndrome following SARS CoV-2 infection, called Multisystem Inflammatory Syndrome in Children (MIS-C). (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - July 20, 2021 Category: Rheumatology Authors: Siobhan Mary Case, Mary Beth Son Source Type: research

Abnormal Mitochondrial Physiology in the Pathogenesis of Systemic Lupus Erythematosus
This article highlights how abnormal mitochondrial function may occur in SLE and focuses on how energy metabolism, oxidative stress, and impaired mitochondrial repair play a role in the pathogenesis of the disease. How this may represent an appealing novel therapeutic target for future drug therapy in SLE also is discussed. (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - June 30, 2021 Category: Rheumatology Authors: Chris Wincup, Anna Radziszewska Source Type: research

Systemic Lupus Erythematosus: The Next Generation of Ideas and Scientists
Systemic lupus erythematosus (SLE) remains one of the most challenging diseases to diagnose and treat. Yet, numerous recent advances have been made in the study and understanding of SLE, moving our collective understanding of SLE into a new realm. In this issue, the authors provide their expertise and reflect on these important advances. (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - June 30, 2021 Category: Rheumatology Authors: Alfred H.J. Kim, Zahi Touma Tags: Preface Source Type: research

Lupus
Drs Kim and Touma have done a remarkable job in this issue keeping us informed about the latest information on diagnosis, treatment, pathobiologic mechanisms, and outlook for our lupus patients. Michelle Kahlenberg and her colleagues discuss the complexities of the relationships among the interferons themselves and between interferon signaling and lupus disease pathologic mechanisms. They correctly emphasize the genetic and environmental connections to the interferon story, leading us to be hopeful that further research in this area will permit greater understanding of the basic biology of lupus as well as the possibility ...
Source: Rheumatic Disease Clinics of North America - June 30, 2021 Category: Rheumatology Authors: Michael H. Weisman Tags: Foreword Source Type: research

Lupus
RHEUMATIC DISEASE CLINICS OF NORTH AMERICA (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - June 30, 2021 Category: Rheumatology Authors: Alfred H.J. Kim, Zahi Touma Source Type: research

Copyright
ELSEVIER (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - June 30, 2021 Category: Rheumatology Source Type: research

Contributors
MICHAEL H. WEISMAN, MD (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - June 30, 2021 Category: Rheumatology Source Type: research

Contents
Michael H. Weisman (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - June 30, 2021 Category: Rheumatology Source Type: research

Forthcoming Issues
Pediatric Rheumatology Part I (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - June 30, 2021 Category: Rheumatology Source Type: research

The Power of Systems Biology
This article summarizes approaches and results from phase 1 of AMP SLE Network effort, including single cell RNA-seq analysis of LN kidney biopsies, cellular and proteomic studies of LN urine, and mass cytometry immunophenotyping of blood cells. This work provides a framework to guide studies of the clinical implications of active cellular/molecular pathways in LN. (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - June 15, 2021 Category: Rheumatology Authors: Andrea Fava, Soumya Raychaudhuri, Deepak A. Rao Source Type: research

Patient-Reported Outcomes in Lupus
Patient-reported outcome (PRO) was identified as a core systemic lupus erythematosus (SLE) outcome in 1999. More than 20  years later, however, generic PRO measures evaluating impact in SLE are used mainly for research. Generic and disease-targeted PRO tools have unique advantages. Significant progress in identification of patient disease–relevant PRO concepts and development of new PRO tools for SLE has occurred o ver the past 20 years. Further research needs to focus on responsiveness and minimally important differences of existing, promising PRO tools to facilitate their use in SLE patient care and research. (Source...
Source: Rheumatic Disease Clinics of North America - June 15, 2021 Category: Rheumatology Authors: Narender Annapureddy, Meenakshi Jolly Source Type: research

T Cells in Systemic Lupus Erythematosus
T-cell dysregulation has been implicated in the loss of tolerance and overactivation of B cells in systemic lupus erythematosus (SLE). Recent studies have identified T-cell subsets and genetic, epigenetic, and environmental factors that contribute to pathogenic T-cell differentiation, as well as disease pathogenesis and clinical phenotypes in SLE. Many therapeutics targeting T-cell pathways are under development, and although many have not progressed in clinical trials, the recent approval of the calcineurin inhibitor voclosporin is encouraging. Further study of T-cell subsets and biomarkers of T-cell action may pave the w...
Source: Rheumatic Disease Clinics of North America - June 15, 2021 Category: Rheumatology Authors: Jacqueline L. Paredes, Ruth Fernandez-Ruiz, Timothy B. Niewold Source Type: research

B Cells in Systemic Lupus Erythematosus
B cells exert a prominent contribution to the pathogenesis of systemic lupus erythematosus (SLE). Here, we review the immune mechanisms underlying autoreactive B cell activation in SLE, focusing on how B cell receptor and Toll-like receptor signals integrate to drive breaks in tolerance to nuclear antigens. In addition, we discuss autoantibody-dependent and autoantibody-independent B cell effector functions during lupus pathogenesis. Finally, we address efforts to target B cells therapeutically in human SLE. Despite initial disappointing clinical trials testing B cell depletion in lupus, more recent studies show promise, e...
Source: Rheumatic Disease Clinics of North America - June 15, 2021 Category: Rheumatology Authors: Susan P. Canny, Shaun W. Jackson Source Type: research