Reza

This prompted me to think about other autoinflammatory syndromes.

And autoinflammatory syndromes are different than autoimmune.

In autoimmune, you're responding to a specific antigen.

And a prototypical example is lupus, where there's immune dysregulation to self, leading to

to this complex clinical syndrome.

And autoinflammatory, it's actually the innate immune system.

There is no antigen.

And a prototypical example of an autoinflammatory disease is adult-onset stills.

Nothing about this sounds like adult-onset stills, but that whole family, you can just start naming like papuloaptis, this, that, and end up with an acronym that defines one of the autoinflammatory syndromes.

So for me, my focus right now is the ulcers, the joint, the skin.

And I'm like, is there some kind of disseminated infection?

It's subacute, it's progressive, but it waxes and wanes.

Or is this in reality some kind of autoinflammatory syndrome that has an acronym that I'm just not familiar with?

And does this patient...

need infectious rule out?

And it seems like they had some mild anemia, which is probably the underlying inflammation.

And then do they need something like

anakinra, or the fact that they improve with ibuprofen because some of these diseases, autoinflammatory like FMF, familial Mediterranean fever, though that classically presents with abdominal pain, is quite sensitive to things like colchicine.

That's a diagnostic test.

So I will pass the mic to Robbie because, again, I think he does so great with the pattern recognition.