Mevalonate kinase deficiency (AKA hyper-IgD syndr-HIDS) is a rare autosomal recessive autoinflammatory dz of the MVK gene w/ exaggerated innate immunity & incr IL-1β production. Usually Dx in kids, milder forms of periodic fever syndrome have been seen in adults. https://t.co/0hAIz4JgY3

Machine learning predicts macrophage activation syndrome in adult Still’s disease – 312 AOSD – XGBoost model had 5 predictors: ferritin, splenomegaly, Plt#, cholesterol, & ESR (AUC 0.839, sensit 0.824, specificity 0.710. https://t.co/QrogaCYPCT https://t.co/Z6WgCnFTfx

19 yr old male is Dx w/ Stills Dz (Fever 104F, pleuritis, organomegaly, WBC 24k, ESR 98, CRP 11 mg/L) – what drug do you prescribe first?