2023 Department of Pediatrics Academic Annual Report

Pediatric Rheumatology

PEDIATRIC FACULTY

Dr. Randy Cron............................................Director | Professor Dr. John Bridges..............................................Assistant Professor Dr. Melissa Mannion .....................................Associate Professor Dr. Emily Smitherman.....................................Assistant Professor Dr. Matthew Stoll .............................................................Professor

FEATURED RESEARCH

CYTOKINE STORM SYNDROME Members of the UAB Division of Pediatric Rheumatology excel in research of cytokine storm syndromes (CSS) in the pediatric population. Randy Cron, M.D., Ph.D., and Dr. Ed Behrens (University of Pennsylvania) published the first textbook devoted to CSS just months prior to the SARS-CoV-2 worldwide pandemic. Edition 2, including new chapters on COVID-19 and MIS-C, was published in late 2023. Additional investigations in the division have focused on the genetics and therapeutics for children and adults with COVID-19 pneumonia and the novel post-infectious entity of multisystemic inflammatory syndrome in children (MIS-C). Dr. Cron, along with UAB adult rheumatologist, Dr. Winn Chatham, conducted a randomized, double-blinded, placebo-controlled trial of the interleukin-1 (IL-1) receptor antagonist, anakinra, in treating adult COVID-19 patients at UAB. As part of this trial, in collaboration with Dr. Devin Absher (HudsonAlpha Institute for Biotechnology), genetic analysis of trial enrollees revealed mutations in known CSS genes in 50% of those sequenced. The division, including recently graduated fellow, Daniel Reiff, M.D., has published on clinical (diagnostic and therapeutic) and genetic aspects of pediatric SARS-CoV-2 and MIS-C. Dr. Cron published several editorials and invited review articles on the topic of CSS in 2023, including a review article for the Journal of Immunology and one for the Annual Review of Medicine. Dr. Cron also contributed to the 2023 points to consider publication on diagnosis and managing early stages of CSS. TEMPOROMANDIBULAR JOINT ARTHRITIS Dr. Cron and Matthew Stoll, M.D., Ph.D., MSCS, continue their long-standing clinical research in the arena of temporomandibular joint (TMJ) arthritis in children with juvenile idiopathic arthritis (JIA) from the perspectives of demographics, risk factors and radiologic diagnosis, as well as local and systemic anti-inflammatory therapeutic approaches. This work is in partnership with Children’s of Alabama Radiology Department and UAB Departments of Oral and Maxillofacial Surgery, and Orthodontics. Recent publications include TMJ condyle-fossa relationships and airway cephalometric values in children with JIA, as well as orthodontic and surgical approaches to treatment of dentofacial deformities in children with JIA and TMJ arthritis. JUVENILE IDIOPATHIC ARTHRITIS Several members of the UAB Division of Pediatric Rheumatology are adept at studying large data sets to explore treatment and outcomes of children with various rheumatic diseases, particularly JIA and pediatric systemic lupus erythematosus (SLE). Dr. Cron and Melissa Mannion, M.D., MSPH, recently contributed to the American College of Rheumatology Guidelines for the Treatment of Juvenile Idiopathic Arthritis: Therapeutic Approaches for Oligoarthritis, Temporomandibular Joint Arthritis and Systemic Juvenile Idiopathic Arthritis, as well as Recommendations for Non-Pharmacologic Therapies, Medication Monitoring, Immunizations and Imaging (both dually published in Arthritis & Rheumatology and in Arthritis Care & Research ). Drs. Cron and Stoll also contributed to the first interdisciplinary consensus-based recommendations for management of orofacial manifestations of JIA published in Arthritis & Rheumatology.

2023 Academic Annual Report

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