RT @AdelaCastro222: -HS ttx👇 1. Lifestyle changes: smoking cessation, obesity. 2. Management of comorbidities. 3. 🔍HS- related autoimmune d…

📊 **Study Snapshot: Lupus Nephritis (LN) vs. Non-LN SLE Patients** 🩺 🏥 **Overview**: - **Conducted by**: Kosałka-Węgiel et al. (2024) - **Participants**: 921 SLE patients; 331 (35.94%) with LN. 🔍 **Key Findings**: - **Demographics**: LN patients are typically younger and have a higher male presence. - **Clinical Features**: - LN patients exhibit severe SLE manifestations (serositis, hypertension, etc.) - **Autoantibody Profiles**: - Higher prevalence in LN: - Anti-dsDNA: 84.44% (LN) vs. 62.48% (non-LN) - Anti-nucleosome: 45.89% vs. 28.62% - Anti-histone: 37.66% vs. 22.1% - **Treatment**: More frequent use of immunosuppressants in LN patients. - **Risk Factors**: Female sex, younger age, specific autoantibodies linked to flare-ups. ⚰️ **Mortality**: Similar rates (5.57%) in both groups; primary causes include infections and SLE exacerbations. 📝 **Conclusions**: Significant clinical differences highlight the need for tailored approaches in managing LN. 🔗 **Limitations**: - Retrospective design & single-center context necessitating further diverse studies. 🌟 **Implications**: Early recognition & personalized treatment for better patient outcomes in LN. **#LupusNephritis #SLE #Autoimmunity #ClinicalResearch #Immunology #Rheumatology**

## Summary of Key Points on Hemophagocytic Lymphohistiocytosis (HLH) ### What is HLH? - **Hemophagocytic Lymphohistiocytosis**: A severe inflammatory syndrome that can lead to multiorgan failure and death if untreated. - **Classification**: - **Primary (genetic)**: Frequently affects children. - **Secondary (acquired)**: More common in adults; triggered by infections, cancers, and autoimmune diseases. ### Importance of Early Diagnosis - **Critical**: Early diagnosis and treatment can reduce mortality and morbidity. - **Epidemiology and Clinical Features**: The spectrum of HLH is diverse, emphasizing the need for awareness among clinicians. ### Pathophysiology - **Immune Dysfunction**: Resulting from genetic defects in genes essential for immune cell function. ### Diagnostic Criteria - Specific protocols and guidelines are established to identify HLH promptly. ### Therapeutic Approaches - **Medications**: - **Ruxolitinib and Tocilizumab**: Used for refractory cases of HLH. - **Chemoimmunotherapy**: Long-term results show efficacy in treatment regimens. - **Gene Therapy**: For inborn errors of immunity. ### Research and Reviews - Studies on virus-triggered secondary HLH and malignancy-associated HLH. - Reviews highlight the clinical diagnostic patterns and treatment outcomes in HLH. ### References - Bloch, C., Jais, JP., Gil, M. et al. (2024). Severe adult hemophagocytic lymphohistiocytosis correlates with HLH-related gene variants. *J Allergy Clin Immunol*, 153: 256-64. DOI: 10.1016/j.jaci.2024.01.004 --- #HLH #HemophagocyticLymphohistiocytosis #Immunology #ClinicalResearch #Healthcare #CytokineStorm #GeneticDisorders #CancerResearch

### Key Points on B Cell Depletion Therapies in SLE - **Rituximab Overview**: - Targeted therapy for CD20 B cells. - Limited by residual B cells and immunological reactions. - Enhances understanding of B cell biology. - **Emerging Therapies**: - **CAR T-Cell Therapy**: - Targets CD19. - Shown to have promise in severe lupus cases. - **Bispecific T Cell Engagers (BiTEs)**: - Simultaneously engage T cells and target cells (e.g., blinatumomab). - Same or enhanced efficacy compared to monoclonal antibodies. - **Combination Treatments**: - Targeting the BAFF pathway (belimumab) may improve outcomes. - Combination with CAR T cell approaches under investigation. - **Clinical Results**: - Genentech's Gazyva demonstrated efficacy over standard treatments. - Notable cases of deep B cell depletion improve symptoms in SLE patients. - **Future Directions**: - Need for well-powered studies comparing CAR T cell therapies and monoclonal antibodies. - Personalized approaches based on genetic biomarkers to optimize treatment outcomes. - DOI: ( #SystemicLupusErythematosus #BCellDepletion #CAR_TCells #BiTEs #LupusNephritis #Genentech #BAFF

🌟 Important Update on Acute Liver Failure (ALF) Prognosis! 🌟 Key prognostic factors include lactate, bilirubin levels, and liver volume (smaller → worse outcomes). 🧠 High-risk patients need intracranial pressure monitoring. An ONSD > 6 mm indicates increased pressure. Early management critical: Start N-acetylcysteine, monitor ammonia & fluid status, and use EEG for non-convulsive seizures. Novel biomarkers & dynamic models like ALFED & King’s College Criteria (KCC) crucial for treatment decisions. High MELD/KCC warrants urgent transplant evaluation. 👩‍⚕️ Collaborate early with transplant centers for better outcomes! #AcuteLiverFailure #Hepatology #CerebralEdema #IntracranialPressure #LiverTransplantation #ALFPrognosis #ClinicalGuidelines #LiverHealth #EmergencyMedicine

🚨 **Key Takeaways on Occupational Exposures & Autoimmune Rheumatic Diseases** 🚨 1️⃣ **Silica Dust Risk:** Increases chances for systemic sclerosis, rheumatoid arthritis, lupus, vasculitis, & sarcoidosis. 2️⃣ **Solvent Exposure:** Linked to higher risks of systemic sclerosis & rheumatoid arthritis; others may follow. 3️⃣ **Affected Professions:** Construction, mining, petrochemical & rubber industries are at high risk. 4️⃣ **Pathogenesis Insights:** Ongoing research into innate immune responses & their role in these diseases. 5️⃣ **Prevention Opportunities:** Focus on recognition & research for better workplace health policies. #AutoimmuneDiseases #OccupationalHealth #Research #WorkplaceSafety #HealthAwareness #Sclerosis #RheumatoidArthritis

### Summary of Systematic Literature Review on CPPD Diagnosis and Nomenclature 1. **Article Identification**: A systematic review included 886 articles after screening 2,375 initial records. Many were excluded due to duplication, unavailable full text, language barriers, and study design limitations. 2. **Study Composition**: Out of 886 articles, 44.5% were case reports; scoping reviews accounted for 19%. Randomised controlled trials were minimal (0.5%), and only 0.3% were meta-analyses. 3. **Diagnostic Modalities**: The main diagnostic methods reported were: - Synovial fluid analysis (30.7%) - Imaging techniques (27.5%) - Histology (18.1%) - McCarty criteria (3.2%) 4. **Nomenclature Issues**: A significant lack of standardised nomenclature for calcium pyrophosphate deposition disease (CPPD) persists, leading to confusion in clinical contexts. 5. **Clinical Presentation**: Commonly described forms include acute, chronic, and axial presentations termed incorrectly as ‘pseudo forms’ in some literature. 'Crowned dens syndrome' was frequently discussed regarding cervical involvement. 6. **Emerging Imaging Techniques**: Novel imaging modalities such as Ultrasound (US) and Dual-Energy CT (DECT) are currently underutilised but have the potential for greater application in diagnosing CPPD. 7. **Standardisation Efforts**: The Gout, Hyperuricaemia and Crystal-Associated Disease Network (G-CAN) is working to establish a consensus on CPPD nomenclature to improve clarity in research and clinical practice. 8. **Future Perspectives**: There is a call for more precise coding systems (like ICD-11) for CPPD to facilitate better understanding and diagnostic clarity in future research. 9. **Research Significance**: The review highlights the existing terminological discrepancies and the need for enhanced standardisation to optimise the clinical management of CPPD. **DOI:** ( #CPPD #Chondrocalcinosis #Pseudogout #SystematicReview #Rheumatology #GOUT #CrystalArthropathies #Imaging #Nomenclature #EULAR

**🔍 Title: Unveiling Cardiovascular Risks in SLE Patients with Nephritis** 🚨 **New Meta-Analysis Findings!** 🚨 This comprehensive study highlights the increased cardiovascular risks in **SLE patients**, especially those with **lupus nephritis (LN)**: 🔸 **Myocardial Infarction (MI)**: - LN: **8%** - Non-LN: **4%** (NS) 🔸 **Cerebrovascular Accident (CVA)**: - Higher prevalence in LN patients. 🔸 **Hypertension (HT)**: - Significant risk (OR=**5.22**, p<0.00001). 🔸 **Hyperlipidaemia**: - LN: **42%** vs. Non-LN: **19%** (p=0.022). 🔸 **Diabetes Mellitus (DM)**: - Increased risk in LN (OR=**1.88**, p=0.02). 🔸 **Plaque Occurrence**: - No significant difference (OR=0.85). 📈 Early screening for these conditions is crucial for improving patient care. Read the full study for more insights 👉 ( #SLE #LupusNephritis #CardiovascularRisk #MetaAnalysis #Healthcare #MedicalResearch #PatientCare #MedTwitter #RheumTwitter

🚨 **New Insights from the ReSScue Trial!** 🚨 🔎 Investigating ACHIM for lower GI symptoms in **Systemic Sclerosis**: - **Study Focus**: Did ACHIM relieve lower GI symptoms? - **Methodology**: Randomized, double-blind, placebo-controlled trial with 67 enrolled patients. - **Demographics**: Predominantly female (33 ACHIM, 29 placebo). - **Primary Outcome**: No significant difference in symptom reduction over 12 weeks. 💡 **Findings**: - Microbiota composition varied, but did not correlate with treatment efficacy. - Adverse events (nausea, abdominal pain) were short-lived and manageable. 🔮 **Conclusion**: ACHIM showed acceptable safety but lacked efficacy. Future studies needed for effective GI interventions in systemic sclerosis! 👉 [Read the full study]( #SystemicSclerosis #ClinicalTrial #Microbiota #Gastroenterology #HealthResearch

🚨 **Dystonia in Autoimmune Disorders** highlights: 🔹 Dystonia is prevalent across autoimmune conditions but often understudied. 🔹 Clinical patterns can vary: isolated or combined presentations, often responding well to immunotherapy! 🌟 🔹 Early intervention is crucial for better outcomes. Focal dystonia? Botulinum toxin offers effective symptomatic relief. Explore the nuances and clinical implications in our full review! 📖 [ #Dystonia #AutoimmuneDisorders #Neurology #Immunotherapy #MovementDisorders #ClinicalResearch #MedTwitter #RheumTwitter

Happy Basant Panchami! 🌼 Let the arrival of spring fill your days with joy, knowledge, and endless opportunities! 🌱

🧬 **Exploring Covert Cutaneous Manifestations of Dermatomyositis!** 🔍 1️⃣ **Wong-Type DM:** Rare variant mimicking pityriasis rubra pilaris; <30 cases reported. Potential association with malignancy. Corticosteroid treatment. 2️⃣ **Flagellate Erythema:** Linear streaky rash, seen in ~5% of patients; usually resolves spontaneously. 3️⃣ **Gingival Telangiectasias:** Oral lesions in ~20% of adults; recurrent gum bleeding may indicate vasculopathy and early diagnosis. 4️⃣ **Ovoid Palatal Patch:** Non-ulcerative red patch on the hard palate, linked to TIF-1-gamma antibodies and potential malignancy. 💡 Timely identification of these signs is crucial for improving patient outcomes. 📚 Read more: doi: ( #Dermatomyositis #WongType #FlagellateErythema #GingivalTelangiectasias #Dermatology #RareDiseases

🔍 **Emerging Insights into #HandOsteoarthritis Biomarkers:** 1. **Heterogeneous Joint Disease:** High prevalence, varied symptoms. 🔄 2. **Biomarkers Key Areas:** - Cartilage health & degradation 🦴 - Bone remodeling - Inflammation - Adipokines affecting metabolism - Miscellaneous markers 🧬 3. **BIPED Criteria:** None meet optimal classification yet. 4. **Future Focus:** Develop sensitive assays & standardized tools for global applicability in HOA treatments! 📈 🧪 **Conclusion:** More research is crucial for effective diagnostic tools & strategies! 📖 Read more: (. #Biomarkers #PrecisionMedicine #JointHealth #Rheumatology #MedTwitter #RheumTwitter

‼️Takayasu Arteritis & Spondyloarthritis: A Shared Immunopathology** - **Historical Context**: 50 years ago, the overlap between seronegative spondyloarthropathies was controversial but recognized. - **Inclusion of Takayasu Arteritis**: If more prevalent in the UK, TA would have been clinically included with spondyloarthropathies; now supported by shared immunopathology. - **MHC-1-opathy**: Evidence shows a common immunopathology in spondyloarthropathies linked to CD8 T-cell dysregulation and the IL-23–IL-17 axis. - **Overlapping Features**: TA shares clinical features with spondyloarthritis like aortic root inflammation, inflammatory bowel disease, and HLA-B*52 association. - **Pathophysiological Distinction**: TA's hallmark is granulomatous inflammation, driven by type 1 cytokines (IFN, TNF) from IL-12. - **Immunogenetics**: Both conditions linked to IL-12B, influencing IL-23 and IL-12, key in cytokine responses. - **T-cell Plasticity**: Explains both the distinct and overlapping features between TA and spondyloarthritis, including similar responses to TNF inhibitors. - **Therapeutic Implications**: Recognizing shared mechanisms suggests potential for unified T-cell targeting treatments across these diseases. #MedTwitter #RheumTwitter #Sharedimmunopathology #TA #TakayasuArteritis #MHC1opathy

### Summary of Covert Clues: Non-Hallmark Cutaneous Manifestations of Dermatomyositis 1. **Dermatomyositis (DM)**: A heterogeneous disease with a broad spectrum of cutaneous manifestations. 2. **Classic Hallmarks**: Traditionally identified signs such as heliotrope rash, Gottron’s papules, and Gottron’s sign. 3. **Lesser-Known Manifestations**: - Panniculitis - Diffuse subcutaneous edema - Erythroderma - Calcinosis - Ulceration - Flagellate erythema - Wong-type dermatomyositis - Gingival telangiectasias - Ovoid palatal patch 4. **Clinical Relevance**: Recognition of these non-classic manifestations is crucial for timely diagnosis and management, especially since some can precede the hallmark signs. 5. **Gingival Telangiectasias**: Notable as potential early indicators of DM, often presenting with gum bleeding. 6. **Ovoid Palatal Patch**: A specific lesion associated with TIF-1-gamma antibodies; it plays a role in diagnosing DM and requires malignancy screening. 7. **Importance of Early Detection**: Awareness of covert cutaneous clues can lead to improved patient outcomes and timely interventions, reducing the risk of complications like malignancy and interstitial lung disease. 8. **Clinical Approach**: Dermatologists and healthcare providers should be astutely aware of these subtle signs to facilitate effective diagnosis and management strategies. #### References & Resources: - Castillo RL, Femia AN. Covert clues: the non-hallmark cutaneous manifestations of dermatomyositis. Ann Transl Med 2021;9(5):436. doi: 10.21037/atm-20-5252 #### Hashtags: #Dermatomyositis #SkinManifestations #AutoimmuneDisease #Healthcare #MedicalDiagnosis #Dermatology #Rheumatology #MedTwitter #RheumTwitter

🌟 New Insights on Secondary Hemophagocytic Lymphohistiocytosis (sHLH/MAS) 🌟 This life-threatening immune disorder poses significant challenges due to its complex immunopathology and high mortality rate. Our systematic review unveils: 🔍 Terminology & Diagnosis 🧬 Immunopathological Mechanisms 💡 Potential Drug Targets Join the quest for novel therapeutics that can make a difference! #sHLH #Immunology #Research #CytokineStorm #NewTherapeutics #MedTwitter #RheumTwitter

Diagnostic Algorithm for Autoimmune Haemolytic Anaemia Diagnosis ‼️ #MedTwitter #RheumTwitter #AIHA