- Multicentric reticulohistiocytosis in children: two case reports and a literature review. [Review]Clin Rheumatol. 2026 Oct 26. [Online ahead of print]CR
- Multicentric reticulohistiocytosis (MRH) is a disease of unknown etiology that predominantly affects middle-aged and elderly women. Although it can manifest with multi-organ involvement, characteristic skin rashes often aid in the diagnosis. MRH is rare in children and may be misdiagnosed as conditions such as juvenile idiopathic arthritis (JIA). We report two male pediatric cases: a 10.8-year-ol…
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- Safety profiles of tocilizumab and tofacitinib in rheumatoid arthritis: a propensity score-weighted comparative analysis. [Journal Article]Clin Rheumatol. 2026 Oct 26. [Online ahead of print]CR
- CONCLUSIONS: Although tocilizumab (an IL-6 receptor inhibitor) and tofacitinib (a JAK inhibitor) effectively modulate the immune response through distinct mechanisms, a lower herpes zoster incidence rate was observed in the tocilizumab group. No statistically significant differences were detected for the other evaluated safety outcomes and mortality rates between the two groups, although the relatively small number of events resulted in wide confidence intervals. Key Points • For moderate to severe RA patients concerned about herpes zoster risk, the tocilizumab group had a lower incidence rate than the tofacitinib group. • In real-world settings, RA patients with tocilizumab or tofacitinib had comparable incidence rates of other safety concerns and mortality.
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- High hazard ratios of fracture in gout. [Letter]Clin Rheumatol. 2026 Oct 26. [Online ahead of print]CR
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- Incidence and prevalence of connective tissue disease (CTD)-associated interstitial lung disease in the United States. [Journal Article]
- CONCLUSIONS: Consistent age- and sex-adjusted CTD-ILD incidence and prevalence estimates between two large, demographically distinct US databases provide contemporary population-level estimates of CTD-ILD frequency and distribution that can inform disease screening and patient care. Key points • US CTD-ILD incidence estimated at 7.6 and 10.0/100,000 person-years and prevalence estimated at 46.7 and 43.4/100,000 persons. • Incidence and prevalence rates were highest in female patients, patients aged ≥ 65 years, and patients of Black African ancestry. • Incidence and prevalence rates varied between CTD subtypes and were highest for RA-ILD and lowest for MCTD-ILD.
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- UACR as a clinical predictor of incident osteoarthritis: prospective evidence from the UK Biobank. [Journal Article]
- CONCLUSIONS: Elevated UACR is linked to increased OA in a nonlinear manner, remaining significant after adjustments, suggests that UACR, as a marker of systemic microvascular and endothelial health, could help identify individuals at higher risk for OA, potentially enabling earlier and more targeted preventive interventions. Key Points • Elevated urinary albumin-to-creatinine ratio (UACR) is independently associated with higher risk of incident osteoarthritis (OA) in a large population-based cohort. • The association follows a nonlinear dose-response pattern, with OA risk rising sharply after UACR exceeds 25 mg/g. • The predictive link between UACR and OA remains consistent across subgroups and is strongest in non-obese individuals. • UACR may serve as a novel, readily available biomarker for identifying individuals at increased OA risk(especially in lean non-obese individuals),and parallel increases in 18-year allcause mortality provide epidemiological evidence linking systemic endothelial damage to joint degeneration.
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- Clinical characteristics of persistent ısotretinoin-associated ınflammatory back pain: a retrospective cohort study. [Journal Article]
- CONCLUSIONS: Isotretinoin-associated IBP had a generally favorable course, with symptom improvement in most patients during follow-up, although symptoms persisted beyond three months in nearly one-quarter. Achilles enthesopathy at presentation was more frequent among patients with persistent IBP, suggesting that careful rheumatological follow-up may be particularly important in this subgroup.
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- Clinical characteristics of adult patients with autoimmune rheumatic diseases coexisting with persistent isolated low IgM: a retrospective study in China. [Journal Article]
- CONCLUSIONS: This study provided a comprehensive characterization of persistent isolated low IgM in Chinese adults with ARDs. Our findings suggest that this phenotype may not be solely attributable to immunosuppressive treatment and highlight the need for further studies to clarify its underlying mechanisms and clinical significance, particularly in relation to infection. Key Points • This is the first ARD-centered study to systematically characterize persistent isolated low IgM and represents the largest clinical cohort reported to date. • Persistent isolated low IgM was observed across multiple autoimmune rheumatic diseases and was identified before immunosuppressive therapy in a subset of patients. • Older age was independently associated with documented infection in patients with ARDs and persistent isolated low IgM.
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- Single-cell eQTL Mendelian randomization reveals the monocyte-associated PRKCB-CTSL axis as a candidate regulatory pathway and potential therapeutic target in rheumatoid arthritis. [Journal Article]
- CONCLUSIONS: Genetic, transcriptomic, single-cell, computational, and in vitro evidence supports monocyte-associated PRKCB-CTSL as a candidate regulatory pathway in RA. Further mechanistic and in vivo studies are required to establish its causal and pharmacological relevance. Key Points • Multi-omics analysis identified 11 key RA-associated targets. • RA was classified into two molecular subtypes with distinct immune features. • PRKCB was identified as the core target enriched in monocytes. • The PRKCB-CTSL axis may drive RA inflammation, and ursodiol showed therapeutic potential.
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- Increased risk of cancer in patients with mixed connective tissue disease: a population-based cohort study in Korea. [Journal Article]
- CONCLUSIONS: Patients with MCTD have an increased cancer risk, particularly haematologic cancer, compared with the general population. The cancer risk was particularly elevated in younger patients and during the first year after MCTD diagnosis. Key Points • Patients with MCTD have a higher overall risk of cancer, particularly haematologic cancer. • Cancer risk is particularly elevated during the first year after MCTD diagnosis, and clinicians should not overlook the possibility of cancer in younger patients with suggestive clinical features.
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- Hepatic steatosis and liver stiffness in patients with gout: a controlled cross-sectional elastography study. [Journal Article]
- CONCLUSIONS: Patients with gout exhibit a substantially higher burden of elastography-defined hepatic steatosis and increased liver stiffness than metabolically stringent controls. This excess was accounted for by adiposity and age rather than by gout status or urate levels, suggesting that non-invasive liver assessment in gout should be guided by cardiometabolic risk profile rather than by the diagnosis of gout itself. Key Points • In unadjusted analyses, patients with gout had more than twofold higher odds of both hepatic steatosis and increased liver stiffness on transient elastography compared with metabolically stringent controls. • BMI and ALT were the strongest independent determinants of CAP; BMI and age were the strongest determinants of continuous LSM. • After adjustment for age, BMI and cardiometabolic covariates, gout status was not independently associated with any elastographic outcome, including increased liver stiffness (LSM ≥ 7.0 kPa). • Serum uric acid, disease activity scores, and urate-lowering or anti-inflammatory therapies were not associated with elastographic liver measures, indicating that hepatic involvement in gout reflects adiposity-driven metabolic burden rather than urate-specific mechanisms.
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- Association between post-intravenous immunoglobulin hypothermia and lower receipt of second-line therapy in Kawasaki disease: a single-center retrospective cohort study. [Journal Article]
- CONCLUSIONS: Among patients with KD who achieved defervescence within 48 h after IVIG administration, second-line therapy was less frequently administered to those who developed post-IVIG hypothermia. Prospective studies are needed to clarify the clinical significance of this finding. Key Points • Among patients with Kawasaki disease who achieved defervescence within 48 h after IVIG administration, second-line therapy was less frequently administered to those who developed post-IVIG hypothermia (< 36.0 °C). • This association remained significant after adjustment for age, sex, Gunma score, and concomitant medications. • The clinical significance of post-IVIG temperature patterns requires further evaluation in prospective studies.
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- Clinical and sonographic enthesitis in psoriatic arthritis patients and its relation to serum calprotectin level. [Journal Article]
- CONCLUSIONS: PsA patients with entheseal disease might have higher disease activity. Serum CLP showed potential association with disease activity and entheseal involvement in PsA patients.
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- Higher APOB is associated with poor renal outcome in lupus nephritis. [Journal Article]
- CONCLUSIONS: Serum APOB level may be positively associated with the poor renal progression of LN. Key Points • Renal biopsy plays a key role in the evaluation and management of lupus nephritis (LN). However, some patients may not accept this detection for its invasive procedure. Therefore, it is quite meaningful to identify risk factors related to the progression of LN in some non-invasive method. • With the prolonged high-exposure duration of APOB, the risk of endpoint events in LN patients within the cohort gradually increased. • The impact of APOB on the renal prognosis of LN patients was not instantaneous, but results from long-term high-level cumulative exposure - a slow process of quantitative to qualitative change. • APOB was an independent risk factor for LN patients, with a cumulative effect.
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- Osteoporosis and fracture severity as independent risk factors for osteonecrosis of the jaw in rheumatoid arthritis: a TriNetX cohort study. [Journal Article]
- CONCLUSIONS: Osteoporosis and fracture history are independent risk factors for ONJ in patients with RA. These findings support a disease-driven paradigm where underlying bone fragility drives ONJ development beyond antiresorptive or glucocorticoid effects, highlighting the need for comprehensive bone health management in this population. Future prospective studies are needed to evaluate targeted screening interventions. Key points • Osteoporosis is a stronger independent risk factor for ONJ than antiresorptive medication. • Prior bone fractures significantly increase ONJ risk among patients with rheumatoid arthritis and osteoporosis. • Managing underlying bone fragility is crucial for ONJ prevention, beyond monitoring osteoporosis medication use.
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- Seizures as a marker of severe multi-organ involvement in neuropsychiatric systemic lupus erythematosus: a diagnostic risk stratification study. [Journal Article]
- CONCLUSIONS: Seizures in NPSLE are associated with poor renal prognosis. Our diagnostic model was developed to facilitate early risk assessment and may aid personalized seizure management; however, its clinical utility requires validation in larger, prospective cohorts. Key Points • A validated diagnostic model indentifies high-risk NPSLE patients for seizures. • 3 independent predictors of SE-NPSLE included anti-Rib-P antibodies, ESR and psychosis. • SE-NPSLE patients were youner, had higher SLEDAI, and exhibited more severe renal dysfunction than non-SE-NPSLE patients.
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