ACR on Air

In this episode, Dr. Randy Q. Cron discusses hyperinflammation and Macrophage Activation Syndrome (MAS), one of the most serious complications of Still's disease. Because MAS can mimic infection, sepsis, malignancy, or a disease flare, early recognition is critical—and treatment often must begin before every diagnostic criterion is met. We explore the clinical patterns and laboratory findings that matter most, how to interpret ferritin, and how to make timely decisions when multiple diagnoses may exist at once.

What if some patients who never quite fit their diagnosis actually have an underlying genetic disorder? In this episode, we explore Haploinsufficiency of A20 (HA20), a condition first described less than a decade ago that is already reshaping our understanding of autoinflammation, autoimmunity, and immune dysregulation. How many patients in our clinics have a genetic diagnosis we've never thought to consider? Join us as we discuss this emerging disease and its clinical implications with Dr. Daniella M. Schwartz.

Could chronic inflammatory calcium pyrophosphate deposition disease (CPPD) be hiding in plain sight? In this episode, we explore why CPPD may be far more common than previously recognized, how it can masquerade as conditions such as refractory inflammatory arthritis, polymyalgia rheumatica, and erosive osteoarthritis, and why it is so often overlooked in clinical practice. We discuss the growing role of musculoskeletal ultrasound in diagnosis and disease management, the structural damage associated with chronic CPPD, and where the field may be headed as researchers pursue more effective treatment strategies.

The 2026 ACR Guidelines for Juvenile Idiopathic Arthritis (JIA) are here, and lead author Dr. Karen Onel joins us to unpack the key updates shaping pediatric rheumatology care. From a biologics-first approach in systemic JIA to more individualized treatment pathways for non-systemic disease, the new recommendations emphasize earlier intervention, faster treatment tailoring, and risk-based decision-making. Dr. Onel also discusses the guidelines' broader focus on mental health, physical activity, rehabilitation, and the challenges of growing up with a chronic illness. More than an update to treatment algorithms, these guidelines reflect a fundamental shift in philosophy—one that puts the whole child, not just the diagnosis, at the center of care.

In the future, can autoimmune disease become curable? A groundbreaking study from Germany suggests there may be a pathway in some cases. Patients with severe, treatment-refractory lupus who received CD19 CAR-T cell therapy have remained in drug-free remission for up to five years without ongoing immunosuppression. In this episode, we discuss how these findings are shifting the conversation from disease control to the possibility of cure, and what they could mean for lupus, inflammatory myopathies, systemic sclerosis, vasculitis, rheumatoid arthritis, and autoimmune diseases more broadly. We also explore CAR-T therapy, immune resets, regulatory T cells, relapse risk, and the future of rheumatology with Dr. Georg Schett.