Pesticide residues in bedroom dust: occurrence, determinants, and health risk assessment.

Modern ALL therapy aims to reduce toxicity, while maintaining and improving the current high cure rates. Acute and late sequelae of anthracyclines are of major concern. The AIEOP-BFM ALL 2009 trial aimed to clarify the need for anthracyclines in low-risk patients. After 2 weeks of induction therapy, which included two daunorubicin (DNR) doses once weekly (30 mg/m2 each) as part of a 4-drug therapy, patients age 1-17 years with newly diagnosed non-high-risk B-ALL either positive for ETV6::RUNX1 or with rapid treatment response, as assessed by induction day-15 evaluation, were randomly assigned to receive either two additional doses of DNR (control arm [CA]) or no further DNR during induction (experimental arm [EA]). Patients treated as randomly assigned were included in the primary analysis on noninferiority in event-free survival (EFS). Adverse reactions of special interest (ARSI) were analyzed in the as-treated population. Of 6,136 patients enrolled in AIEOP-BFM ALL 2009, 2,514 patients (41.0%) were eligible for this random assignment, with 82.7% actually randomly assigned (EA: n = 1,040 and CA: n = 1,039). The 5-year EFS was 92.5% (SE 0.8%) in CA and 92.2% (SE 0.9%) in EA. Accordingly, cumulative incidence of relapse was 5.8% (SE 0.7%) and 5.7% (SE 0.7%), and overall survival was 97.6% (SE 0.5%) and 97.4% (SE 0.5%) in CA and EA, respectively. Life-threatening and fatal ARSI were similar in the two arms, but there was a three times lower incidence of invasive fungal infections in the EA (0.5% v 1.5%, P = .02). A reduced DNR dose during induction did not compromise the outcome of patients with favorable prognostic factors but did diminish infectious toxicity indicated by the lower rate of invasive fungal infections.

Letrozole to prevent breast cancer in postmenopausal women with BRCA1/2 mutations (LIBER study).

Definitive and successful treatment of end-stage ankle arthritis is either total ankle replacement (TAR) or ankle fusion (AF). The long-term implications of both treatments remain unclear. AF may predispose patients to subsequent hindfoot joint fusion, and TAR potentially risks high rates of complex revision surgery. The study investigates the risks of further surgery, adjacent joint surgery, and rare but serious complications following AF and TAR. An England population cohort study was performed using the Hospital Episode Statistics database, linked to Office of National Statistics (ONS) mortality data (1998-2023). The primary outcome was Kaplan-Meier curve analysis of revision surgery-free survival of TAR vs AF. Secondary outcome measures were the rates of adjacent joint/hindfoot fusion, any further re-intervention to the ankle, peri-operative mortality, 90-day complications, and serious adverse events. A total of 10 335 TARs and 30 704 AFs were analyzed. The AF revision rate was significantly lower than TAR at all time points including 5 years (2% vs 6.1%, relative risk [RR] 0.12, 95% CI 0.10-0.16), 10 years (2.5% vs 10.2%, RR 0.12, 95% CI 0.08-0.18), and 20 years (3.1% vs 13.55%, RR 0.12, 95% CI 0.01-0.23). There was no significant difference in the 25-year risk of adjacent joint fusion following AF (8.64%, 95% CI 7.79%-9.58%) vs TAR (6.82%, 95% CI 5.36% to 8.66%). TAR was associated with higher risks of intra-operative fracture (0.42% vs 0.10%, RR=4.35) and re-intervention for wound infection (0.26% vs 0.15%, RR 1.74) but a lower observed 90-day pulmonary embolus rate than AF (0.23% vs 0.58% respectively). Both TAR and AF are definitive treatments of ankle arthritis with low peri-operative risk. In this England-wide registry cohort, TAR showed higher cumulative revision risk than AF over long-term follow-up. Estimates at the furthest time points have lower certainty. Furthermore, AF did not appear to pre-dispose patients to hindfoot fusion and was not associated with a higher 25-year rate of hindfoot fusion than TAR. These estimates do not capture joint degeneration managed non-operatively.

Patients with ulcerative colitis (UC) have an elevated thromboembolic risk. The comparative risks associated with advanced therapies (ADTs) remain unclear. In this retrospective cohort study, we utilized the Japanese Medical Data Vision claims database to assess patients with UC who initiated treatment with tumor necrosis factor (TNF) inhibitors, vedolizumab, or tofacitinib. We evaluated the cumulative incidence and hazard ratios (HRs) for venous thromboembolisms (VTEs), cardiovascular events (CVEs), and major adverse cardiovascular events (MACEs). The tofacitinib dose was modeled as a time-varying covariate. In total, 8125 TNF inhibitor users, 1218 tofacitinib users, and 2469 vedolizumab users were analyzed. Compared with TNF inhibitors, vedolizumab was associated with a lower risk of VTE (HR ,50, 95% CI 0.30-0.81) and CVE (HR 0.47, 95% CI, 0.27-0.81), with no difference in MACE. Tofacitinib 5 mg and 10 mg administration twice daily (BID) showed no significant differences vs TNF inhibitors, though point estimates were lower at 5 mg and higher at 10 mg. Concomitant 5-aminosalicylic acid was associated with a lower incidence of VTE. Vedolizumab demonstrated a favorable thromboembolic and cardiovascular safety profile compared with TNF inhibitors, whereas tofacitinib did not increase the risk at either dose. Concomitant 5-aminosalicylic acid may have a preventive effect against VTE. These findings may aid therapeutic decision-making for UC patients with elevated thrombotic risk.

HHV-6 encephalitis is a serious complication after allogeneic hematopoietic stem cell transplantation. Whether foscarnet prophylaxis improves outcomes after unrelated cord blood transplantation (UCBT), particularly under systemic steroid exposure, and the renal safety of foscarnet remain uncertain. This retrospective cohort consisted of 156 adult patients who received single-unit UCBT between 2005 and 2022. Foscarnet prophylaxis was defined as any use of foscarnet without encephalitis onset, including planned administration after transplantation, pre-emptive administration after HHV-6 DNAemia, or other indications. Primary endpoint was 60-day incidence of HHV-6 encephalitis, and secondary endpoints were overall survival and renal function up to 12 months. The 60-day cumulative incidence of HHV-6 encephalitis was 10.9%; 121/156 (77.6%) received prophylaxis. Incidence did not differ significantly by foscarnet exposure (9.9% vs. 14.3%; p=0.418) and this was not significant in the multivariable analysis. A high cumulative dose of corticosteroid was associated with higher incidence (28.6% vs. 7.1%; p=0.001). In patients with low corticosteroid exposure, the incidence of HHV-6 encephalitis was significantly lower with foscarnet prophylaxis (4.3% vs. 14.7%; p=0.040). Among patients who developed encephalitis, 1-year overall survival appeared higher with prior foscarnet exposure than in those without prior exposure (72.2% vs. 20%); renal function up to 12 months was similar. Foscarnet prophylaxis was not significantly associated with a reduced incidence of HHV-6 encephalitis after UCBT, whereas high-dose steroid exposure was a risk factor. Notably, a lower incidence of encephalitis with foscarnet prophylaxis was observed in the low-dose steroid subgroup, although this finding requires confirmation in larger cohorts.

The aim of this study was to investigate the value of early postoperative ctDNA dynamic monitoring (TP53/KRAS/PIK3CA gene mutations) combined with clinicopathologic factors in risk stratification of postoperative peritoneal metastasis in advanced gastric cancer. One hundred and twenty-eight patients with advanced gastric cancer (stage II/III) who underwent R0 resection were enrolled, of whom 32 developed peritoneal metastasis after surgery (peritoneal metastasis group) and 96 did not (non-peritoneal metastasis group). The study collected peripheral blood samples from patients at 7 days (T0) and 4 weeks (T1) after surgery, detected mutations in ctDNA at three loci, TP53 p.R248W, KRAS p.G12D, and PIK3CA p.H1047R, by ddPCR and simultaneously collected clinicopathological features such as Lauren classification and serosal invasion. The primary endpoint was peritoneal metastatic events confirmed by imaging or pathology. The proportion of Lauren diffuse-type peritoneal metastases (65.6% vs. 34.4%, P = 0.002), serosal invasion (87.5% vs. 65.6%, P = 0.018), and persistent ctDNA positivity (53.1% vs. 19.8%, P < 0.001) were significantly higher. The Boruta algorithm identified Lauren diffuse type, serosal invasion, and persistent ctDNA positivity as key variables. The combined model (Model 1) constructed based on these variables demonstrated optimal performance (C-index = 0.853) and significantly outperformed the traditional clinical model (C-index = 0.840). A nomogram developed from this model enables personalized risk prediction. Based on the number of risk features (≥ 2 features in the high-risk group and ≤ 1 feature in the low-risk group), Kaplan-Meier analysis showed that the cumulative incidence of peritoneal metastasis was significantly higher in the high-risk group (51 cases) than in the low-risk group (77 cases) (Log-rank P = 0.0012). Early postoperative persistent ctDNA positivity (especially TP53 mutation) combined with Lauren diffuse-type classification and serosal invasion can effectively identify patients at high risk of peritoneal metastasis. This integrated model provides a new strategy for precise postoperative surveillance and intervention in advanced gastric cancer.

Total body irradiation (TBI) plus chemotherapy is commonly applied prior to allogeneic hematopoietic stem cell transplantation (SCT) for patients with acute lymphoblastic leukemia (ALL). Here, we retrospectively analyzed registry data from the German Multicenter Study Group for Adult ALL (GMALL) and report the outcomes for 111 adult ALL patients who received 8 Gy TBI-based SCT conditioning in first complete remission between 2002 and 2018 after initial treatment with pediatric-based approaches. Patients had a median age of 52 years (range 18-65) at initial diagnosis, and the majority of patients (93%) had a good performance status (ECOG 0/1). 97 patients (87%) showed high-risk features according to GMALL criteria, of whom 58 (60%) were Philadelphia chromosome/BCR::ABL1-positive. With a median follow-up of 3.1 years after SCT, the survival rates at one, three, and five years were 72%, 64%, and 57% for disease-free survival, and 76%, 67%, and 61% for overall survival, respectively. The rates of non-relapse mortality at one, three, and five years were 22%, 26%, and 30%, while the cumulative incidences of relapse were 7%, 10%, and 14%, respectively. In summary, 8 Gy TBI conditioning in ALL patients was feasible and resulted in outcomes similar to those previously reported for 12 Gy conditioning regimens.

Limited data are available on the management and outcomes of postoperative Crohn's disease (CD) in older patients. We aimed to describe the management of CD in the postoperative setting and assess surgical postoperative recurrence (POR) in this population. This was a case-control study including all adult patients with CD from the ENEIDA registry who had undergone a first intestinal resection with ileo-colonic anastomosis. Patients were grouped according to their age at the time of the first surgery in older (over 60years) subjects and controls (between 18 and 60years of age). A total of 3982 (535 older subjects and 3454 controls) underwent a first intestinal resection for CD with an ileo-colonic anastomosis. Time from CD diagnosis to surgery was significantly longer in older patients (114±128 vs. 93±97months; p<0.001). Older patients also had a lower proportion of penetrating CD (25% vs. 39%; p<0.0001) and perianal disease (14% vs. 25%; p<0.0001). A significantly lower proportion of older patients started preventive therapies for POR (32% vs. 51%; p<0.0001). The cumulative risk of surgical POR was 3.2%, 5.3% and 10.1% in the older group and 3.6%, 6.6% and 14.2% in the control group at three, five and 10years, respectively (p=0.093). In the multivariate logistic regression analysis, only prevention with thiopurines was associated with a lower risk of surgical POR. Although postoperative preventive therapy with immunomodulators or biologicals is prescribed less often in older patients after a first intestinal resection, they develop surgical POR as often as younger adult patients.

With increasing life expectancy and physical activity, patients with dental implants face a growing lifetime risk of traumatic injury. In this context, the present study aimed to evaluate and compare the traumatic biomechanical effects between titanium and zirconia single dental implant in maxillary central incisor localization exposed to frontal maxillofacial trauma. In a 3D-FEA study design, maxillary models with titanium (model-A-IT) and zirconia (model-A-IZ) implants in region 21 and a bone model without dental implant (model-B) were subjected to a frontal traumatic load of 2000N. The von Mises stress for all 3 models was measured at a predefined cortical peri-implant region of interest (ROI) and the stress values evaluated were compared between the models. Additionally, the maximum stress values within the implants were recorded and compared for the titanium and zirconia implants. The peri-implant cortical stress value/cortical fracture risk increased significantly for both implant models (model-A-IT, model-A-IZ) as compared to the implant-free bone model (model-A-IT/model-A-IZ vs. model-B; p < 0, 001); however, no difference between the two implant models evaluated (model-A-IT vs. model-A-IZ; P = 0.806) was seen. The stress values within the dental implants measured showed a higher maximum stress peak for the zirconia implant (IZ: 1137MPa) than for titanium implant model (IT: 686.7MPa). When exposed to frontal trauma application both implant materials showed similar effects on cortical peri-implant bone; however, zirconia dental implants provide for a significantly higher maximum stress value within the implant than titanium implants representing a higher risk of fracture.

Chronic hypertension in pregnancy is a risk factor for offspring long-term neurological morbidity.

As cancer therapeutics improve, more liver transplant (LT) candidates will have a history of prior to transplant malignancy (PTM), an established risk for cancer posttransplant. This study provides granular analysis (with focus on nonliver PTM) of posttransplant cancer risk relating to PTM in 1105 consecutive adult LT recipients (2009-2019, N = 542 with PTM). PTM prevalence increased from 37.8% to 63.2% during this timeframe. Post-LT survival was lower (10 y: 61.2% versus 75.1%; P < 0.001) with higher cancer-related mortality (17.6% versus 2.2%; P < 0.001) in patients with any PTM. The higher cumulative incidence of cancer post-LT associated with PTM (59.7% versus 37.6%; P < 0.001) was not attributable to de novo cancer (38.5% versus 37.7%; P = 0.21) but to recurrence. Cancer recurrence rate (10 y) was lowest in nonliver/nonskin ("other") PTM (10.6%) with mortality rates from recurrence of only 4% in this cohort. De novo cancers may present at more advanced stage in patients with PTM and lung cancer the most common nonskin de novo malignancy (PTM 21%, no PTM 7%). Family history of cancer was an independent predictor for de novo cancer. PTM associated post-LT cancer outcomes are dominated by skin and liver cancer recurrence and not recurrence of "other" cancers or de novo cancer. This data supports the guidance proposals for cautious liberalization of "other" cancer remission requirements before transplantation. As post-LT cancer is highly prevalent regardless of PTM status, adherence to posttransplant cancer screening and surveillance is critical to identify early cancer after transplant.

To improve the tolerability of post-transplant maintenance and outcomes despite poor risk disease genetics, we conducted a phase 1 study of venetoclax/FluBu2 RIC transplantation with tacrolimus/methotrexate GVHD prophylaxis followed by all-oral venetoclax/decitabine-cedazuridine (ven/dec-c) maintenance in poor-risk MDS/AML patients (N=30). 58% had prior venetoclax exposure and 63% were TP53-mutated; 15/19 had TP53 multi-hit state. At a median of +55 days, pre-emptive maintenance therapy with venetoclax (400 mg on days 1-14) and dec-c (decitabine 35 mg/cedazuridine 100 mg on days 1,3,5 or 1,2,3) was initiated for eight 42-day cycles in 26/30 (87%) patients (remaining 3 relapsed early, 1 withdrew). On maintenance, grade 3-4 neutropenia (96%) occurred though infections were rare (N=2). No DLTs occurred. 6-month acute GVHD grade II-IV rate was 13%. 1-year moderate/severe chronic GVHD rate was 31%. At a median follow up of 25.1-months (range,15-33), median OS and PFS were not reached. On maintenance, 2-year OS was 77% (95%CI,55-89), PFS 62% (95%CI,38-79), NRM 0%, and cumulative incidence of relapse 38% (95%CI,18-59). Exploratory studies identified 96% had pre-transplant NGS-MRD+, favorable survival in those with non-TP53 MRD+, and delayed conversion on maintenance in 11/18 (61%) in those with TP53 MRD+. PROs assessed in first 6-months of maintenance were stable except for emotional function, which improved (P=0.008). Trial is registered at clinicaltrials.gov/NCT03613532.

Post Hematopoietic Cell Transplantation Maintenance Therapy with Low-Dose Azacitidine in a Pediatric Population with High-Risk Myeloid Malignancies.

There is little evidence regarding mitral transcatheter edge-to-edge repair (TEER) in the setting of severe pulmonary hypertension (PH), defined as an estimated pulmonary arterial systolic pressure (PASP) > 70 mmHg on echocardiography. We sought to explore the prevalence of, and correlates and postprocedural outcomes associated with, severe PH in patients undergoing mitral TEER. We retrospectively evaluated a single-center registry of isolated, first-time interventions as a function of severe PH presence at baseline. Outcomes included all-cause mortality, heart failure (HF) hospitalizations, and the persistence of significant mitral regurgitation (MR) and functional impairment during the first postprocedural year. A total of 1,182 individuals qualified for analysis. Of them, 100 (8.5%) had severe PH, demonstrating a median PASP of 78 (interquartile range, 75-85) mmHg. Compared to subjects free of severe PH, the former exhibited a higher interventional risk, a greater burden of comorbidities, and more severe MR and cardiac dysfunction, and were more likely to undergo an urgent procedure. General interventional features were unaffected by severe PH status, leading in both groups to a high (> 97%) technical success rate and, ultimately, significant improvements in PASP, MR grade and functional capacity. Severe PH was associated with worse residual MR in the total cohort - but not within a 187-patient, propensity score matched sub-cohort. In either, it did not correlate with the rate, cumulative incidence, and risk of mortality and/or HF hospitalizations. In our experience, severe PH preceding mitral TEER identified higher-risk patients but was unrelated to procedural feasibility, safety, or efficacy.

In recent years, with the rapid expansion of low-Earth-orbit (LEO) satellite constellations, the orbital decay of LEO satellites caused by atmospheric heating from solar irradiance and geomagnetic activity has become increasingly prominent. Accurately understanding the orbital decay behavior of LEO satellites during geomagnetic storms is essential for managing orbital lifetime, orbit determination, orbit control, and collision risk assessment. This study investigates the combined effects of solar radiation intensity and geomagnetic storm intensity on LEO satellite orbital decay by analyzing 130 representative intense geomagnetic storms from 1965 to 2025. The results demonstrate that during geomagnetic storms, both solar irradiance and geomagnetic activity jointly influence orbital decay: solar irradiance primarily determines the total decay magnitude, while geomagnetic activity mainly affects short-term decay rates through transient disturbances. Furthermore, solar radiation intensity shows a stronger correlation with orbital decay than storm intensity. Therefore, effective orbit maintenance strategies for LEO satellites should emphasize the influence of solar radiation intensity in addition to geomagnetic storm intensity. Our findings provide valuable references for developing operational orbit maintenance protocols for LEO satellites during space weather events.

Onco-hypertension recognizes well-controlled blood pressure as a favorable prognostic factor for survival in patients with hypertension and solid tumors, including hematologic neoplasms. However, it remains unknown whether continuous use of hydralazine-an antihypertensive agent (AHA) with notable anti-neoplastic activity-is associated with a lower risk of hematologic neoplasms compared to other AHAs. Utilizing Taiwan's National Health Insurance Research Database, we conducted a 16-year follow-up study (2000-2015) involving 375,107 patients with hypertension treated with an AHA for ≥180 days. The patients with hypertension were divided into two groups based on hydralazine prescription duration: an exposure group (hydralazine ≥180 days; n = 59,786) and a reference group (hydralazine <180 days; n = 239,144) after 1:4 matching for sex, age, and index date with the exposure group. Both groups were well-matched, with a mean age of approximately 60.8 years and 52.19% male. We assess the association between hydralazine use and the risk of hematologic neoplasms using Kaplan-Meier analysis and multivariable Cox proportional hazards regression, with models adjusted for concomitant medications possessing potential anti-neoplastic properties. The 16-year cumulative incidence of hematologic neoplasms was lower in the exposure group (105.58 per 100,000 person-years) than in the reference group (160.33). Accounting for death as competing risk, the exposure group exhibited an adjusted subdistribution hazard ratio (adjusted sHR) of 0.789 (95% confidence interval [0.667,0.913]; P < .001) for hematologic neoplasms compared to the reference group. Subgroup analyses demonstrated that the association with a lower risk was strongest in the longest prescription duration category. For example, for patients with prescription durations of ≥668 days, the adjusted sHR was 0.448 (95% CI [0.366,0.555]; P < .001) for other malignant neoplasms of lymphoid and histiocytic tissue, 0.552 (95% CI [0.453,0.683]; P < .001) for multiple myeloma and immunoproliferative neoplasms, and 0.555 (95% CI [0.457,0.689]; P < .001) for myeloid leukemia. The main limitation was the potential for residual confounding due to the unavailability of lifestyle and laboratory data in the administrative database. In this study, we observed that long-term hydralazine use in patients with hypertension was associated with a lower, duration-dependent risk of hematologic neoplasms. These findings warrant prospective studies to confirm this association and its potential clinical implications.

BackgroundOnco-hypertension recognizes well-controlled blood pressure as a favorable prognostic factor for survival in patients with hypertension and solid tumors, including hematologic neoplasms. However, it remains unknown whether continuous use of hydralazine—an antihypertensive agent (AHA) with notable anti-neoplastic activity—is associated with a lower risk of hematologic neoplasms compared to other AHAs.Method and findingsUtilizing Taiwan’s National Health Insurance Research Database, we conducted a 16-year follow-up study (2000–2015) involving 375,107 patients with hypertension treated with an AHA for ≥180 days. The patients with hypertension were divided into two groups based on hydralazine prescription duration: an exposure group (hydralazine ≥180 days; n = 59,786) and a reference group (hydralazine <180 days; n = 239,144) after 1:4 matching for sex, age, and index date with the exposure group. Both groups were well-matched, with a mean age of approximately 60.8 years and 52.19% male. We assess the association between hydralazine use and the risk of hematologic neoplasms using Kaplan–Meier analysis and multivariable Cox proportional hazards regression, with models adjusted for concomitant medications possessing potential anti-neoplastic properties. The 16-year cumulative incidence of hematologic neoplasms was lower in the exposure group (105.58 per 100,000 person-years) than in the reference group (160.33). Accounting for death as competing risk, the exposure group exhibited an adjusted subdistribution hazard ratio (adjusted sHR) of 0.789 (95% confidence interval [0.667,0.913]; P < .001) for hematologic neoplasms compared to the reference group. Subgroup analyses demonstrated that the association with a lower risk was strongest in the longest prescription duration category. For example, for patients with prescription durations of ≥668 days, the adjusted sHR was 0.448 (95% CI [0.366,0.555]; P < .001) for other malignant neoplasms of lymphoid and histiocytic tissue, 0.552 (95% CI [0.453,0.683]; P < .001) for multiple myeloma and immunoproliferative neoplasms, and 0.555 (95% CI [0.457,0.689]; P < .001) for myeloid leukemia. The main limitation was the potential for residual confounding due to the unavailability of lifestyle and laboratory data in the administrative database.ConclusionsIn this study, we observed that long-term hydralazine use in patients with hypertension was associated with a lower, duration-dependent risk of hematologic neoplasms. These findings warrant prospective studies to confirm this association and its potential clinical implications.

Osteopenia was recently reported to be a factor contributing to a poorer prognosis in various cancers. However, its prognostic impact on non-small cell lung cancer (NSCLC) patients remains unclear. In the present study, we focused on osteopenia in elderly NSCLC patients and investigated survival outcomes. This study included 315 NSCLC patients aged 75 years or older who had undergone radical lobectomy or segmentectomy at our institution between 2010 and 2023. Osteopenia was evaluated based on the average pixel density within a circle in the mid-vertebral core at the 11th thoracic vertebra on preoperative computed tomography. Osteopenia was identified in 126 patients (40%). This osteopenia group had significantly poorer overall survival (OS) than the non-osteopenia group (5-year OS: 71.4%vs 81.0%, p = 0.026). Multivariable analysis revealed that Charlson comorbidity index (CCI) ≥ 2 (p = 0.020), Brinkman index (BI) ≥ 400 (p < 0.001), pathological Stage ≥ II (p < 0.001), and osteopenia (p = 0.016) were independent factors affecting OS. The cumulative incidence of non-lung cancer mortality was significantly higher in the osteopenia group than non-osteopenia group (5-year mortality rate: 16.9% vs. 6.4%, p = 0.005). In multivariable analysis, CCI ≥ 2 (p = 0.009), BI ≥ 400 (p < 0.008) and osteopenia (p = 0.001) were independent factors affecting non-lung cancer mortality. Elderly patients with osteopenia have significantly poorer OS, and osteopenia was closely associated with non-lung cancer mortality. Screening for osteopenia may assist in identifying high-risk patients of non-lung cancer death and developing appropriate treatment strategies.

Background Pediatric uveitis, though accounting for less than 10% of all uveitis cases, presents significant diagnostic and therapeutic challenges due to its asymptomatic onset and potential for severe, vision-threatening complications. Despite known associations with autoimmune diseases, data on risk factors in Asian pediatric populations remain limited. This study aimed to quantify the risk of uveitis in Taiwanese children with autoimmune diseases, identify key comorbidities, and evaluate the effects of immunosuppressive therapies. Methods Using Taiwan’s National Health Insurance Research Database (2009–2019), we conducted a nationwide retrospective cohort study of 3,643 pediatric patients with autoimmune diseases matched 1:1 to controls. Patients were followed for up to 12 years, with uveitis risk assessed through Cox proportional hazards models and cumulative incidence analyzed using Kaplan-Meier curves. Results During a mean follow-up of 5.5 years, autoimmune diseases were associated with increased uveitis risk (adjusted HR [aHR] = 2.65 [95% CI, 1.67-4.19]), with juvenile idiopathic arthritis showing the highest risk (aHR = 25.70 [95% CI, 7.41-89.22]). Risk was significant only in adolescents aged 10-14 years (aHR = 2.58 [95% CI, 1.29-5.14]) and 15-18 years (aHR = 2.60 [95% CI, 1.27-5.31]) and was notably higher in patients without diabetes (aHR = 6.88 [95% CI, 2.54-18.61]) compared with those with diabetes (aHR = 1.67 [95% CI, 0.98-2.82]). In medication analysis, sulfasalazine use (aHR = 2.00 [95% CI, 1.04-3.84]) and high-daily dose prednisolone (≥30 mg/day; aHR = 2.25 [95% CI, 1.12-4.53]) were associated with increased risk, while moderate cumulative prednisolone doses were associated with a lower risk compared with low-dose exposure (aHR = 0.32 [95% CI, 0.13-0.79]). Conclusion This cohort study identified distinct patterns of uveitis risk across specific autoimmune diseases and age groups. These findings suggest the need for risk-stratified ophthalmologic screening based on autoimmune diagnosis and age in pediatric patients requiring immunosuppressive therapy.