Discover and read the best of Twitter Threads about #Sjogren
Most recents (13)
#Neuro manifestations in #Sjögren’s are common, present in nearly 20% (❗️), and 4M are estimated to have Sjögren’s in the US.
Neuro-Sjögren’s is poorly understood and underrecognized, and you’ll miss it if you aren’t looking for it. 🫣
But how do you find it❓
Neuro-Sjögren’s is poorly understood and underrecognized, and you’ll miss it if you aren’t looking for it. 🫣
But how do you find it❓
You’ve got to know the neurologic phenotypes.
What are they? Let’s see how well you know them ⬇️
What are they? Let’s see how well you know them ⬇️
What’s the most common neurologic manifestation?
1/🧵
#Dysautonomia is a condition that affects the ANS, which controls involuntary bodily functions, such as heart rate, blood pressure, digestion, and breathing. It can be caused by various factors, including #autoimmune diseases & viral infections like #COVID19.
#Dysautonomia is a condition that affects the ANS, which controls involuntary bodily functions, such as heart rate, blood pressure, digestion, and breathing. It can be caused by various factors, including #autoimmune diseases & viral infections like #COVID19.
2/🧵
The symptoms of #dysautonomia can vary depending on the underlying cause and can include lightheadedness, dizziness, syncope, rapid or irregular heartbeat, low blood pressure, gastrointestinal issues, difficulty breathing, and fatigue.
The symptoms of #dysautonomia can vary depending on the underlying cause and can include lightheadedness, dizziness, syncope, rapid or irregular heartbeat, low blood pressure, gastrointestinal issues, difficulty breathing, and fatigue.
El futuro de las terapias #biológicas en #Sjögren
Dra. Soledad Retamozo
👀👄💧🩻🫁🩺💊💉🧪
#25TenTopicsBCN #TenTopics
Dra. Soledad Retamozo
👀👄💧🩻🫁🩺💊💉🧪
#25TenTopicsBCN #TenTopics
While looking through case reports of #Sjogrens and renal tubular acidosis, came across a peculiar neurological demyelinating disorder...
A long 🧵
#rheumtwitter #neurotwitter #MedTwitter
A long 🧵
#rheumtwitter #neurotwitter #MedTwitter
Intriguingly, there were multiple reports of osmotic demyelination syndrome (ODS), aka central pontine/extrapontine myelinolysis.
Sensory Ganglionopathy & Sjogren Syndrome
⚡️what is it?
⚡️how to recognize/diagnose it
⚡️what's the underling cause?
latest @HRheuminations is up with link at the end of this ripping 🧶
a thread
#neurology #sjogren #rheumatology
⚡️what is it?
⚡️how to recognize/diagnose it
⚡️what's the underling cause?
latest @HRheuminations is up with link at the end of this ripping 🧶
a thread
#neurology #sjogren #rheumatology
Let's review anatomy 1st
Sensory nerves: travel from skin to the nerve cell body in the Dorsal Root Ganglion (DRG) then⬆️dorsal column of spine to the brain
DRG- ‼️cell body of sensory nerves‼️
Motor nerves: travel from brain and exit ventral (anterior) spinal cord ➡️muscle
Sensory nerves: travel from skin to the nerve cell body in the Dorsal Root Ganglion (DRG) then⬆️dorsal column of spine to the brain
DRG- ‼️cell body of sensory nerves‼️
Motor nerves: travel from brain and exit ventral (anterior) spinal cord ➡️muscle
Okay, so dorsal root ganglion only contains sensory nerves. This is an important part of the story.
Next important part, Sensory nerves are not all created equal.
Large fiber (myelinated) ➡️ small fiber (unmyelinated)
⭐️and lots in between
⭐️and they do different things
Next important part, Sensory nerves are not all created equal.
Large fiber (myelinated) ➡️ small fiber (unmyelinated)
⭐️and lots in between
⭐️and they do different things
#Sjogren’s is not rare. It is about as common as RA, but mostly undiagnosed. Prevalence estimates vary widely, from .1% to 3 %. Low estimates are derived from registries that do not account for underdiagnosis, under-reporting, and Sjogren’s w/ another AIRD. 1/18
About 1% of the US population has #Sjogren’s. It is a neglected disease, despite undeniable evidence that it is a serious, systemic disease. The “rare, nuisance sicca disease” paradigm remains deeply entrenched, even among some rheumatologists. 2/
Primary care, eye, and dental providers often encounter early signs of the disease but do not recognize them because Sjogren’s medical education is largely absent. It takes 10 years, on average, before Sjogren’s is diagnosed following a dry eye disease diagnosis. 3/
Abro hilo largo👇
Me gustaría compartir con vosotros mi último artículo de revisión. Desde hace mucho tiempo se sabe que el virus de Epstein-Barr (EBV) está detrás del desarrollo enfermedades autoinmunes, cáncer e incluso se sospecha que está detrás... (1)
Me gustaría compartir con vosotros mi último artículo de revisión. Desde hace mucho tiempo se sabe que el virus de Epstein-Barr (EBV) está detrás del desarrollo enfermedades autoinmunes, cáncer e incluso se sospecha que está detrás... (1)
...del desarrollo de Síndrome de Fatiga Crónica/Encefalomielitis Miálgica y del Long COVID. Pero todavía no está claro las vías que utiliza. En esta revisión describo como la posesión de ciertos alelos ancestrales de HLA-II... (2)
...(sistema que utiliza nuestro sistema inmune para reconocer que proteínas son extrañas ,como lo patógenos, y cuales no) hace que el individuo sea débil genéticamente para controlar las células con latencia de EBV, desarrollando así distintas enfermedades. (3)
#Sjogren’s patients often have difficulty finding the care they need, especially when it comes to systemic manifestations. Many are told that they have the “glandular version”, despite undeniable evidence that Sjogren’s is a serious, systemic disease.
1/
1/
There is no “glandular version” of Sjogren’s. You can find systemic features in almost every patient- if you look for them.
“The evaluation of the systemic manifestations of SS are not properly incorporated into clinical practice”.
2/
pubmed.ncbi.nlm.nih.gov/35650656/
“The evaluation of the systemic manifestations of SS are not properly incorporated into clinical practice”.
2/
pubmed.ncbi.nlm.nih.gov/35650656/
When Sjogren’s is viewed as a nuisance sicca (dryness) disease, patients are not monitored for systemic manifestations. There are no guidelines for the routine monitoring of Sjogren’s. Until we have clear guidelines, suboptimal care will remain the norm.
3/
3/
"What’s more devastating is that the next three struggles the researchers identified—constructing an explanation for suffering, negotiating with the health care system, and proving legitimacy—are all toxic side effects of modern medicine" 1/
Sjogren's patients are often treated as if their symptoms could not be that bad; many physical symptoms are psychologized, especially autonomic and other neuropathies which are labeled as anxiety or FND. Patients often feel abandoned or gaslit. #dysautonomia
2/
2/
My 2021 informal survey of 100 patients asked their biggest challenge living w #Sjogren's. The top answer was not symptoms, but the failure of doctors to treat it as a serious systemic disease. Patients often had to seek specialty referrals on their own. 3/
My #Sjögren's patients often wonder about their lab results:
“What is SPEP & hypergammaglobulinemia?”
Let’s discuss…
1/14 (sorry, this one is a bit long!)
“What is SPEP & hypergammaglobulinemia?”
Let’s discuss…
1/14 (sorry, this one is a bit long!)
The other day I mentioned that low C4 complement levels are associated w/ lymphoma development & poor prognosis in Sjogren’s:
twitter.com/hashtag/Sj%C3%…
2/14
twitter.com/hashtag/Sj%C3%…
2/14
We also learned that having low C4 complement levels in someone being evaluated for possible #Sjögren's could be predictive for the diagnosis (“classification”, technically speaking) 2-3 years later even w/ a negative initial evaluation:
doi.org/10.1002/acr.23…
3/14
doi.org/10.1002/acr.23…
3/14
@angelmartin_nc Hoy es el día mundial de las Enfermedades raras #diamundialenfermedadesraras.
Estas enfermedades afectan a más de 3 millones de personas en España y a los que cuidan de los que las sufren, ¿me ayudas a compartir 7 píldoras de información? Mini hilo🧵👇
Estas enfermedades afectan a más de 3 millones de personas en España y a los que cuidan de los que las sufren, ¿me ayudas a compartir 7 píldoras de información? Mini hilo🧵👇
Píldora de información 1:
✅Una #EnfermedadRara es aquella que afecta a menos de 5 cada 10 000 personas, es decir, que no es que sea rara porque te transformes en un gigante verde radiactivo, si no porque poca gente tiene la misma enfermedad que tú.
✅Una #EnfermedadRara es aquella que afecta a menos de 5 cada 10 000 personas, es decir, que no es que sea rara porque te transformes en un gigante verde radiactivo, si no porque poca gente tiene la misma enfermedad que tú.
Píldora de información 2:
✅Se conocen más de 7000 enfermedades raras diferentes y el 80% son de origen genético, es decir, el bebé nace con ella y la padecerá toda la vida.
También las hay de otros orígenes, como #Sjögren, que es autoinmune (tu cuerpo te ataca a ti mismo)
✅Se conocen más de 7000 enfermedades raras diferentes y el 80% son de origen genético, es decir, el bebé nace con ella y la padecerá toda la vida.
También las hay de otros orígenes, como #Sjögren, que es autoinmune (tu cuerpo te ataca a ti mismo)
Now eye enjoyed an important question addressed at #EAN2020. Good to think about when you are called to ED for #opticneuritis. Let’s think about it together. Let’s focus on #clinicaldiagnosismaking #meded #medstudenttwitter #medtwitter #neurologyresident @WNGtweets @EANeurology
How do you tell if it’s optic neuritis or not? #painless #unilateral #altitudinal -means top half or bottom half of the field - vision loss more likely to be non-arteritic AION. Any other red flags less likely to be optic neuritis?
Now if it’s #painful it’s more likely #opticneuritis - but what sort? Bilateral vision loss and painful, think #MOG. Unilateral severe vision loss more than pain, think #Aquaporin4. MRI orbits show longitudinal extensive optic nerve enhancement in both. So MRI orbits for clues.
