Healthspan Immunology

10/04/2026

New hope for children with APDS 💙

On September 11, the FDA approved Joenja® (leniolisib) for children ages 4–11 who weigh at least 27 kg (about 60 lb) with activated PI3K-delta syndrome (APDS). It's the first treatment approved for children with this rare inherited immune disorder in the U.S. Until now, it was approved only for ages 12 and up.

Joenja is a pill that targets the overactive immune pathway causing APDS. In the pediatric trial, children had smaller lymph nodes and healthier B-cell counts within 12 weeks. A lower dose for smaller children (13–27 kg) is under priority FDA review, with a decision expected by January 30, 2027.

APDS is often missed for years. Signs include frequent sinus or lung infections, swollen lymph nodes, an enlarged spleen, and autoimmune problems. A simple genetic test can confirm it, and no-charge testing is available for eligible patients.

Questions about your child's immune health? Call us at 813-869-7111.

10/02/2026

An example of how subcutaneous immune globulin infusions work, with nice graphics:

09/30/2026

ARFID- when it's not just picky eating. Common in PANDAS. What are your thoughts? We love (on Instagram, not FB) for ARFID

Doctors are seeing more cases of avoidant/restrictive food intake disorder (ARFID) than ever before. Now they need to figure out how to treat it.

09/23/2026

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09/21/2026

"Paraben-free" isn't necessarily good...companies found a work-around with formadehyde-releasing preservatives. Joyous Health is my new favorite place to learn about skin health and nutrition! Joyous Health

Learn what they are, how they’re used, possible negative health impacts, and the body-loving swaps that are also kind to the planet so you can clean your beauty routine!

09/11/2026

As a specialist, I see zebras (complex rare disorders) every day. Many of my patients have insufficient workup if they come from the traditional medicine route, or irrelevant testing if they come from the functional medicine route. Not always. There are a few "unicorn" doctors in traditional medicine, and a few in functional medicine. 90% of the time, complex patients are underserved. I think the problem is a LACK OF CURIOSITY. And an inability to deal with uncertainty. And most of all, INSURANCE PRESSURE. I expect better. Even though I'm an Immunologist, I will order the DEXA scan. I will ask about hormones. Patients ask me, "Why didn't my P*P do this?" I shrug, but I know the answer.😖😠If you are a primary care doctor with a deep and insatiable CURIOSITY, if you enjoy complex cases, please reach out! Chronius Health is a great start. I am impressed with Chronius P*P workup of complex disorders. www.chroniushealth.com

09/08/2026

Great article by Dr. Kara Wada, a famous complex disorders specialist and highly regarded colleague.

Fragmented care leaves the sickest patients connecting their own dots. See why complex chronic illness needs a clinician holding the telescope, not a lens.

09/01/2026

Thanks to for this very cool tidbit of knowledge! How did I not know that the CLIFT test to confirm lupus uses a protozoan? ANA (anti-nuclear antibody) is best measured by immunofluoresence (IFA). When ANA immunofluorescence test comes back positive — especially with a homogeneous or peripheral/rim pattern, the patterns most associated with anti-dsDNA antibodies — many labs automatically reflex to the Crithidia luciliae immunofluorescence test (CLIFT) to confirm and characterize anti-double-stranded DNA (anti-dsDNA) antibodies.

Why Crithidia luciliae specifically?

Crithidia luciliae is a HEMOFLAGGELATE PROTOZOAN!!!! with a unique organelle called the KINETOPLAST— a mitochondrion-derived structure packed with a dense network of circular dsDNA, completely free of histones or other nuclear proteins.

That histone-free, pure-dsDNA structure is exactly what makes it such a good substrate:

It gives a clean, isolated dsDNA target with no other nuclear antigens (histones, RNP, Sm, etc.) around to cause cross-reactivity or confusion. https://www.euroimmunblog.com/excellent-performance-of-the-automated-clift-evaluation-by-the-europattern-suite/

08/29/2026