Understanding ANAs, Antinuclear Antibodies — with
@AnnKumfer
▶ What does a +ANA mean?
▶ What is the significance of the ANA titer/pattern?
▶ What rheumatic diseases and non-rheumatic diseases are associated with a +ANA?
#MedTwitter
#Rheumatology
#ANA
🆕 NIH Guidelines for COVID-19 Treatment in High-Risk Patients (including immunocompromised) in the Outpatient Setting
Outpatient Rx Recommendations:
1️⃣ Paxlovid PO
2️⃣ Sotrovimab IV
3️⃣ Remdesivir IV
4️⃣ Molnupiravir PO
#RheumTwitter
#IDTwitter
#Omicron
It’s official !! Excited to announce that I have been promoted to Assistant Professor of Medicine 🧑🏽🏫🎉🥳
Thank you to all who made this possible AND to the
#MedTwitter
community 🙏🏻
🆕
#Rheumatology
Secrets & Pearls at
#ACR22
| By Dr.
@JKolfenbach
& Dr. John Stone (
@MGHrheumatology
) 📚
Unique Pearls to Know:
💊 Reducing Steroids; PPI & MMF
🦵 Scleroderma Mimics
🫁 FVC/DLCO Ratio for ILD vs PAH
👁️ Inflammatory Eye Dz
🤰🏽 Changes in Pregnancy: C3/4, UPC, sCr
#ACR21
The Great Debate: Belimumab vs Voclosporin as Add-On Therapy in
#LupusNephritis
| Dr. Petri & Dr. Rovin
Audience Vote 🗳: What would you add to mycophenolate first?
Belimumab 71%, Voclosporin 29%
#ACRAmbassador
@ACRheum
Summary of Pros & Cons of Each⬇️
Clinical Year in Review | Presented by Dr. Carol Langford at
#ACR22
🌟 Review the Most Important Clinical Research Studies in the Past Year in
#Rheumatology
! 💫
Rheumatology Guidance for 3rd Dose (Booster) COVID-19 Vaccines | 8.19.21
Patients with Rheumatic Diseases can use this
@RheumOnePagers
to see if eligible for a booster & determine if medications qualify ⬇️
I’m incredibly excited to announce I will be starting on faculty
@dukemedicine
as an attending Rheumatologist this July!
Thank you to everyone — friends & family, my residency/fellowship PDs & mentors — who supported me over the years. Looking forward to this new chapter! 🥳
Excited to announce my new project
@RheumOnePagers
is live!🥳
Looking forward to creating more infographics and visual abstracts in
#Rheumatology
! 📚
Website:
Today is my last day of fellowship culminating 11 years of training!
☑️ 4 Years of Medical School
☑️ 4 Years of Residency
#MedPeds
☑️ 3 Years of
#Rheum
Fellowship
Now officially a rheumatologist! 🥳
🆕 2020 ACR Guidelines for Management of Reproductive Health in Patients w/ Rheum & MSK Diseases 🤰🏽
🔸 Pregnancy Counseling
🔸 Meds in Pregnancy/Breastfeeding
🔸 Male Medication Safety for Conception
#RheumTwitter
#OBTwitter
#ReproRheum
#MedX
#ACR22
Lupus Line-Up: Difficult to Treat Lupus Cases
Fantastic Session by Prof David Isenberg & Dr. Maria Dall'Era
❓ Deciding Belimumab vs Voclosporin
💉 Role of Combining Biologics in SLE
🫘 Changing Rx Paradigm for
#LupusNephritis
#Lupus
#RheumTwitter
#NephTwitter
#ACR22
The Jury on JAKs: Future of JAKi in Rheumatic Diseases | presented today by Dr. Jon Giles
📝 Review ORAL Surveillance Data
♥️ CV Risks & Risk Stratification
🛑 Malignancy Risk
🦠 Other: Infection, Zoster, PE/VTE
#Rheumatology
#RheumTwitter
🆕 Let’s Learn about Sarcoidosis!
Created with
@mwsharp5
⭐️ Sarcoidosis = inflammatory condition characterized by NON-necrotizing granulomas
• multi-system involvement 🫁🫀🧠👁️
• April is Sarcoidosis Awareness Month!
#RheumTwitter
#PulmTwitter
#MedX
🆕 COVID-19 Vaccines for Immunocompromised Individuals 💉
🌟 New CDC Guidance Recommends a 4th Vaccine (Booster) *3 Months* after the 3rd Shot [in those who are Immunocompromised] ⬇️
Thank you Dr. Rebecca Sadun for reviewing!
#RheumTwitter
#OncTwitter
#MedTwitter
#PedsTwitter
🆕 2021 ACR Guidance for Adjusting Immunomodulatory Therapy related to the COVID-19 Vaccine in Patients with Rheumatic & MSK Diseases 💉
#RheumTwitter
#Rheumatology
Updated Version Released 6/15/21 ⬇️
🔗:
🆕 Visual Abstract with
@HealioRheum
🟢
Lymphadenopathy in
#Rheum
• Compare LAD in SLE, RA, SjD, sarcoid, IgG4-RD
• Identify red flags for malignancy
• Recognize features of Castleman's
📖 by Stefano Rodolfi
@DrPujaMehta1
@DavidFajgenbaum
et al
🔗:
🆕 Updated 2021 ACR Guidance for Adjusting Immunomodulatory Therapy with the COVID-19 Vaccine in Patients with Rheumatic & MSK Diseases
Discussed at
#ACR21
COVID-19 Hub!
V4 Link:
👨⚖️ The Great Debate: should we use advanced therapies / biologics at disease onset in PMR & GCA?
#ACR23
By Dr. Robert Spiera & Dr. Phil Seo
@philseo
#Vasculitis
#PMR
#GCA
COUNTDOWN to
#RheumBoards
📚
I will be posting some tips and tricks for high-yield board topics!
First up, Periodic Fever Syndromes! Trying to remember # days of fever?
• FMF = 3 letters = 3d max
• Hyper IgD = ~7 letters = 7d max
• TRAPS = don’t fall into trap! >7 days
#ACR21
Clinical Review of ILD by Dr. Kristin Highland
Approach to SSc-ILD (and often how she approaches CTD-ILD): how to consider incorporation of nintedanib and tocilizumab after focuSSced and SENSCIS Trials ↓
#Scleroderma
#RheumTwitter
#PulmTwitter
🔥 New Visual Abstract in Collaboration with
@HealioRheum
💫
🫁🫘 Rituximab vs Cyclophosphamide for Induction in GPA: which therapy was more likely to achieve remission in Granulomatosis with Polyangiitis?
📖 Article by: Puéchal et al,
@TerrierBen
#RheumTwitter
#Vasculitis
Had a few requests to take 📸 of my handouts from my FIT Roundtable on Graphics, and promised I’d post them on here!
#ACR23
Tips for More Effective Graphics in Posters/Talks:
• Use less text; ⬆️ graphics/images
• Avoid blocks of text, bulleted lists
• Spice it up 🌶️
✨ Check out our new
#RheumMadness
x
@RheumOnePagers
Bracket Infographic! 🏀📟
📖 Review Most Pivotal Studies in Rheum
🖥️ Read Scouting Reports Online
🏀 *1 Week Left to Submit Bracket*
📆 Bracket Due: Wed, Mar 22 at 11:59pm EST
Thank you
#RheumMadness
Team &
@DavidLeverenz
!
🚨 Are you an
#URM
medical student interested in Rheumatology (especially Peds, IM or
#MedPeds
)?
🗣 Duke Rheum is excited to sponsor 3 URiM MS4 students for a visiting
#Rheumatology
rotation:
📆 2 wks Adult / 2 wks Peds
🏠 Housing & Travel Stipend Provided
#MedStudentTwitter
Enjoyed speaking at the 2024 NC ACP Meeting on Rheumatology for the PCP!
🎤 Covered inflammatory vs non-inflammatory pain and appropriate laboratory testing & interpretation (including ANA, RF/CCP, HLA-B27)!
#NCACP24
#Rheumatology
#ACP24
🆕 COVID-19 Vaccines for Immunocompromised Individuals 💉
🌟 CDC Guidance Recommends a *5th* Vaccine (Booster) in those who are
#Immunocompromised
⬇️
Thanks Dr. Rebecca Sadun for reviewing!
#RheumTwitter
#OncTwitter
Had fun speaking today at the 2023 APDIM (Association of Program Directors in IM) meeting on Use of Novel
#SocialMedia
strategies in
#MedEd
Thanks for having me!
#APDIMFall23
As
#ACR22
ends, I am so thankful for this conference & our lovely Rheum community. I presented my first poster as a MS2 med student at ACR 2012) & 10 yrs later, this was my 1st conference as an attending!
Happy I got to meet many of you! Already excited for
#ACR23
#ChooseRheum
Fact Sheet: COVID-19 Vaccines for Patients with Rheumatic Diseases 💉
Thank you Dr. Rebecca Sadun for reviewing the infographic!
#COVID19Vaccine
#Rheumatology
Around 33% of academic physicians report intention to leave their jobs in the next 2 years!
📊 Rheumatology Specific Data (n=102)
• Intention to Leave 35%
• Professional Fulfillment ~33%
• Burnout Present ~40%
Suspect not surprising data to many of us in
#Rheumatology
#MedX
1 in 3 academic physicians report they are considering leaving their institution within 2 years. Burnout and lack of professional fulfillment were associated with intention to leave; a comprehensive approach will be needed to reduce physician turnover.
CDC ACIP recommend today for
#immunocompromised
individuals to receive an additional 3rd (���booster”) dose of Pfizer or Moderna mRNA COVID-19 vaccines after completing the primary series:
• same mRNA vaccine as primary series, if possible
• at least 28 days after primary 💉
Confused about ANAs? Check out the latest episode on
@COREIMpodcast
!
✅ Interpreting +ANAs (Titer/Pattern)
✅ Ordering ANAs: when to order and when *not* to!
✅ Understanding the Broad DDx for a +ANA
Had so much fun working on & recording this!
#Rheumatology
1/ 🚨 New Episode🚨
ANA (Antinuclear Antibody) Test:
#5Pearls
Segment
What does the titer mean? Is the pattern of the ANA helpful? What is the
#ddx
for a positive ANA?
🎧:
Show Notes:
Sponsor:
Want to use infographics & visual/graphical abstracts for research, medical education & w/ patients?
Join us for our talk at
#ACR23
!
🗣️ “Harnessing the Power of Graphics for Presentations, Publications & Education” 🎨
📆 Tues Nov 14, 4-5p PT
👥 w/
@AriellaStudies
“You don’t have to look like or speak like the majority to make an impact. Understand and embrace your superpower. No one can be a better you than you” —
@ShreyaTrivediMD
This resonated *so* much with me - at
#iMED2022
via
@tony_breu
🆕 CDC Guidance on COVID-19 Vaccines for Children <18 yrs who are Immunocompromised 👧🏾👦💉
Updated 10/2022 with New Bivalent Booster Vaccine Recommendations💉
Thank you, Dr. Rebecca Sadun for review!
#PedsTwitter
#PedsRheum
🆕🌟CDC Guidance on COVID-19 Vaccines for Children <18 yrs who are Immunocompromised 👦👧🏾💉⬇️
Thank you Dr. Rebecca Sadun for reviewing!
#PedsTwitter
#PedsRheum
#Pediatrics
🆕 Commentary on Creating a
#Lupus
Patient Education Event, which I helped create as a med student
@MUSChealth
#HealthLiteracy
#PatientEducation
🐺Top 3 Requested Topics:
1️⃣ Fatigue, Fibromyalgia, Depression
2️⃣ Lupus Medications
3️⃣ Understanding Labs
Excited to collaborate with
@theMednet
on a special conversation around ACR Guidelines for Management of Reproductive Health in Rheumatic and MSK Diseases! Four
#ReproRheum
experts are ready to answer your Qs - post them on ! 🤰🏽
@melbussey
@RheumDr_Nina
🆕 2020 ACR Guidelines for Management of Reproductive Health in Patients w/ Rheum & MSK Diseases 🤰🏽
🔸 Pregnancy Counseling
🔸 Meds in Pregnancy/Breastfeeding
🔸 Male Medication Safety for Conception
#RheumTwitter
#OBTwitter
#ReproRheum
#MedX
For any fellows-in-training at
#ACR23
interested, l’ll be hosting FIT roundtables on how to create more effective posters and presentations using graphics 🎨
Hope to see some of you there
#RheumTwitter
!
⏰ 345pm-525pm PST
🗺️ Location: Room 29A-D
@rabihmgeha
@DxRxEdu
Non-Infectious Fever 🤒
• very high ferritin → should at least consider HLH/MAS
• periodic fevers → consider autoinflammatory syndromes
• evaluate for other s/sx → some rheumatic diseases present with fever like SLE or sarcoidosis; have seen ANCA vasculitis present as FUO
🆕 Updated 2022 ACR Guidance for Adjusting Immunomodulatory Therapy with the COVID-19 Vaccine in Patients with Rheumatic & MSK Diseases
Version 5 Update (February 2022) ▼
🦋 New Visual Abstract with
@HealioRheum
🟢
• Environmental factors that may contribute to
#lupus
are poorly understood
• This study showed ⬆️ Ultraprocessed Food (UPF) Intake is associated with ⬆️ risk of developing SLE
📖 by Rossato et al
🔗:
Update: I made an error and forgot to include all 3 speakers on the original graphic, in my speed to release this at
#ACR23
!
My apologies to Dr. Marta Mosca, and thank you
@AliDuarteMD
for catching and notifying me of this mistake!
Duke Rheumatology is excited to participate in the upcoming
#ACR23
Here are some highlights from our division at the conference this year 🔽
@ACRheum
#DukeRheum
Had an amazing time watching
@DGlaucomflecken
&
@LGlaucomflecken
live with
#DukeRheum
friends at their first stop of their 2024 Tour, “Wife and Death” 🎭
Such an incredibly funny & moving show evoking so many emotions with powerful messages…strongly recommend!!! 🥇