Discover and read the best of Twitter Threads about #hematology

Most recents (24)

The journey to the diagnosis of Sweet syndrome and its differentials is too sweet 🍬🍩🍫

Let's explore the sweetness.

@rabihmgeha @DxRxEdu @Sharminzi @DrCindyCooper @jackpenner @sargsyanz @rav7ks @RebeccaEBerger @RosenelliEM @CPSolvers @MithuRheum #MedTwitter #rheumatology
#1 Malignancies & Sweet syndrome

- AML (common)
- MDS (common)
- MM
- Hodgkin's lymphoma
- Mycoses fungoides
- Cutaneous T-cell lymphoma
- Hairy cell leukemia
- Solid tumors

#oncology #hematology #MedTwitter
#2 Autoimmune disorders & Sweet syndrome

- IBD (common)
- Behcet (common)
- SLE (common)
- RA (common)
- Relapsing polychondritis
- Sarcoidosis
- Sjogren's
- Familial Mediterranean fever
- Undifferentiated connective tissue disease
- Erythema nodosum

#rheumatology #MedTwitter
Read 8 tweets
Hey #hematology aspirants, let's talk about #CMV today !! Post allogenic transplant CMV prophylaxis and pre-emptive therapy to be precise.

A short thread 🧵


#MedTwitter #MedEd #hematology
CMV a DNA virus, one of the commonest causes of infections post HSCT

Has the largest genome of any known human virus [200 genes]

Most humans harbour latent CMV, infection aquired in childhood.

Site of latency in humans-❓
In murine models- hepatic sinusoidal cells.

The risk of reactivation depends on CMV sero status:
D-/R+ > D+/R+ > D+/ R- > D- / R -

Other risk factors are:
1️⃣T cell depletion
4️⃣GVHD requiring steroids

So why not give prophylaxis to these "high-risk" patients ??

Read 11 tweets
Don’t miss a new accredited #tweetorial launching TOMORROW here on @cardiomet_CE. #Emergencymedicine #thrombosis researcher @md_pollack will be discussing safe, effective management of selected patients with venous thromboembolism (#VTE) from the #emergencydepartment.
It used to be SOOO much more complicated, but since we entered the era of the #DOACs, #lifeisgood! #Physicians #nurses #pharamcists all work together to make it happen, and all can earn CE/#CME here! @AlexSpyropoul @ScottKaatz @RenatoDLopes1 @GenoMerli @aakonc @vic_tapson
1) Welcome to a #tweetorial on the safe and effective management of acute venous #thromboembolism (#VTE) directly from the #emergencydepartment. This program is accredited for 0.50 credits for #physicians #nurses #pharmacists by @academiccme! I am @md_pollack. Image
Read 23 tweets
Not many entities in Medicine are as intricate as Paraproteinemias

As we celebrate National Internal medicine day today, here is a 🧵exploring its various associations and complications

#MedTwitter #hematology @AnnKumfer @RebeccaEBerger @Sharminzi @rabihmgeha @DxRxEdu @rav7ks
Entities that can feature a monoclonal protein/M component:

-Splenic Marginal Zone Lymphoma (HCV)
-Heavy Chain disease (Gamma, Alpha & Mu)

There are various others indirectly associated with the M component. More to follow
Skin manifestations

-Neutrophilic dermatosis
-Pyoderma gangrenosum
-Cutaneous macroglobulinosis
-POEMS: hypertrichosis, hyperpigmentation, hemangiomata, clubbing
-Clarkson/Systemic capillary leak syndrome
-Erythema elevatum et diutinium

Read 9 tweets
#tweetorial 🧵
🚩Metabolism and Acute Myeloid Leukemia
➡️📈🔎Increased attention over the last decade on the metabolic perturbations in AML
➡️Potential therapeutic implications – with ‘druggable’ targets Image
➡️🗒️📌Summary of recent concepts
👉📈🏹Increase potential of targeting the mitochondria
👉🦀Anti-cancer agents specifically targeting cancer cell mitochondria are referred to as 'mitocans'
➡️Metabolic adaptions of AML cells
AML is a 🦀cancer derived from the myeloid lineage of blood🩸cells, characterized by overproduction of malignant cells. Image
Read 26 tweets
#tweetorial 🧵
➡️Ph-like ALL / BCR-ABL1-like ALL

👉A provisional entity in the 2016 World Health Organization classification of acute leukemia 🩸🩸
👉Gene expression 🧬signature similar to Ph-positive ALL but lacks the BCR-ABL1 translocation
➡️Originally defined by gene expression 🧬profiling in 2009 by 2 groups
👉Children's Oncology Group (COG) and St. Jude Children's Research Hospital (referred to as Ph-like ALL) 👉Dutch Childhood Oncology Group (referred to as BCR-ABL1-like ALL) – DCOG/COALL
👉The differences in the approaches are outlined in the figure; more on the gene expression 🧬 signatures and diagnostic conundrums later!
Read 41 tweets
1/ 42 yo patient presents with 3 hours of left hemiparesis found to have right M1 thrombus. Platelets are 24,000/uL!

Welcome to a CANNOT MISS #EmoryNCCTweetorials @EmoryNeuroCrit on a rare etiology of #acuteischemicstroke

#Neurotwitter #FOAMncc #stroketwitter
2/ 🚨Goals for the scroll:

✅Discuss a rare cause of acute ischemic stroke
✅ Review thrombectomy safety w thrombocytopenia (tcp)
✅Review dx and pathophys of thrombotic thrombocytopenic purpura (TTP)
✅Review the treatment of TTP
3/ Our patient with plt of 24,000 /uL is taken for #thrombectomy. Would you send your pt w/ severe thrombocytopenia for thrombectomy?
Read 25 tweets
So there are a lot of people asking about the risk factors for #mucor post #covid.

The biggest risk factor isn't the steroid itself, it's the hyperglycemia that it causes. If the sugars are well controlled using insulin the risk is almost negligible. So STOP freaking out !!
The 2nd major risk factor is prolonged NEUTROPENIA but that's a problem in our #Hematology patient population and not in #covid patients, so we can safely ignore that for now.
Bring us back to hyperglycemia due to steroids. The sure shot way to prevent it is frequent monitoring of sugar levels and NOT self medicating with steroids. Steroids anyway don't have any benefit if one isn't hypoxic so don't use it because ur aunt/uncle/friend used it.
Read 6 tweets
Inspired by recent posts from @AaronGoodman33 , here is my attempt to review briefly the interplay between Hematology and Autoimmune phenomena.

It's magic when that fusion occurs.

Any comments & suggestions appreciated.

#MedTwitter @rabihmgeha @DxRxEdu @CPSolvers
CLL & Autoantibodies:

1.) WAIHA (IgG), CAD (IgM), PCH

2.) PRCA, Autoimmune Neutropenia

3.) C1-NH (acquired angioedema)

4.) GM-CSF (Pulmonary alveolar Proteinosis)

5.) Factor VIII, vWD, V (Coagulopathy)

6.) ADAMTS13 (TTP)

7.) CFH & CFI (aHUS)


8.) CaSR (Hypocalcemia or Hypercalcemia)

9.) Desmoglein, BPAG1 Envoplakin, Periplakin (Paraneoplastic Pemphigus)

10.) ITP, Evans syndrome

11.) Insulin or Insulin receptor (Hypoglycemia or Hyperglycemia)

12.) C3 Nephritic factor (MPGN1)

#MedTwitter #hematology
Read 8 tweets
🚨🚨🚨 @COVIDSciOntario Science Brief and layperson’s guide for vaccine-induced prothrombotic immune thrombocytopenia (aka. VIPIT) following AstraZeneca #COVID19 #vaccination. Read the 🧵! 1/n
AZ #COVID19 #vaccine appears to be associated with immune thrombosis that mimics heparin induced thrombocytopenia. It’s rare: 1/125K to 1/1 mill @EMA_News @uni_greifswald @PEI_Germany 2/n
@COVIDSciOntario brief helps clinicians identify, diagnose / rule out, and treat rare serious clots of VIPIT. Please read - and check out the figures for easy clinical reference.… 3/n
Read 11 tweets

Clinical trials in patients with hematological malignancies often present unique challenges for trial design due to complexity of tmt options and existence of potential curative but highly risky procedures, for example, SCT or tmt sequence across different phases.

I am very happy to see our paper

Estimands in hematologic oncology trials

now online at Pharm Stat:…

The paper illustrates how to apply the estimand framework in hematological clinical trials and how the estimand framework can address...

... potential difficulties in trial result interpretation. Three phase 3 RCTs are used to illustrate different scientific questions and the consequences of the estimand choice for

- trial design,
- data collection,
- analysis,
- and interpretation.
Read 4 tweets
#MedTwitter how often do you use 𝐏𝐫𝐨𝐜𝐚𝐥𝐜𝐢𝐭𝐨𝐧𝐢𝐧 ?

A thread on 𝐏𝐫𝐨𝐜𝐚𝐥𝐜𝐢𝐭𝐨𝐧𝐢𝐧 for those interested 😉

#MedEd #MedStudentTwitter #oncology #hematology #tweetorial
⚡️Procalcitonin as the name suggests is a precursor of the hormone calcitonin

⚡️Coded by the CALC 1 gene on Chr 11,its a 116AA peptide

⚡️PrePCT >> PCT >> Calcitonin

⚡️Bact inf=⬆️IL6⬆️TNFa⬆️IL1b=⬆️Productn of PCT
⚡️Normal PCT in health <0.1ng/ml

⚡️In patients with bacterial infections PCT ⬆️ corelates with severity of infection

⚡️PCT starts to⬆️3-4hrs following an infection,
peaks at ~12 hrs post infection.
Read 11 tweets
Humanity has always struggled to fight #viruses , best exemplified by the ongoing #Covid_19 #pandemic ,so I thought of doing a thread on a #virus which frequently troubles #hematology patients

It's called #CMV or #HHV5
It wrecks havoc #posttransplant

#MedTwitter @BloodJournal
⚡DNA virus ,1 of the MC infections post SCT

⚡It has the largest genome of any known human virus [230kb /200 genes]

⚡Most humans harbour latent CMV, infection MC aquired in childhood.

⚡Site of latency in humans- Not Known
In murine models - hepatic sinusoidal cells
⚡The risk of reactivation depends on CMV sero status and is as follows:
D-/R+ > D+/R+ > D+/ R- > D- / R -

⚡The other risk factors are
1️⃣ T cell depletion
2️⃣ HaploSCT
4️⃣ GVHD requiring Rx

⚡ So why not give prophylaxis to these patients ??
Read 10 tweets
Meet Dr Chantal Attard @Chantal_Attard, the researcher from @MCRI_for_kids who is transforming the lives of children living with complex heart disease!

A thread 👇

#blood #stroke #bleeding #haematology
@AcademicChatter #thrombosis #meettheresearcher #hematology #cardiology Image
The coagulation system prevents the body from bleeding after injury, but what you might not know is this system continuously develops with age. This means children & adults have different risks of blood clotting + bleeding. This alters how they react to blood-thinning medications
“How can we protect our most vulnerable children?” This is the research aspiration that Chantal pursues in her daily life.
Read 11 tweets
All right #dermtwitter & #medtwitter, it's time for the...

@MedDermSoc & @DermHospitalist Mini-Symposium on #COVID19 & #dermatology!!

I will be attempting to #livetweet the Zoom meeting!

Join along if you'd like. I will be using the h/t #COVIDDerm!

@RoxanaDaneshjou @dschless
Let's get started!!!!

Your cohosts are super excited to have you join. To give a little background, this meeting was planned in ~1 week, and we have over 500 RSVPs!

@MishaRosenbach now kicking us off with #COVIDDerm! Image
.@DrEstherFreeman is speaking and reminding us all to register our #COVID19 #dermatology cases in the @AADskin #COVID registry!

Reminder to do so here:

Read 39 tweets
Proposed COVID-19 Pathophysiology [Part 3 of (now) 4]:

Coagulopathy Strikes Back.

What happens when #COVID19 clashes with the world of hematology?

Buckle up again for a long one.

...let’s dive in like this macrophage (exploring all directions):
First, what do you think is the predominant mechanism by which thrombosis occurs in COVID-19?
Where does thrombosis typically first occur?
Read 38 tweets
Proposed COVID-19 Pathophysiology [Part 2 of 3]:

Enter the magnificent macrophage.

What do #COVID-19 and hemophagocytic lymphohistiocytosis (#HLH) potentially have in common?

...let’s continue our journey onward into the cytokine storm.
First, let’s briefly summarize what we covered before:

What mechanism may be partly responsible for heterogeneity of COVID-19 disease phenotype as well as its severity?
Correct! Antibody-dependent enhancement (ADE) is the result of producing sub-neutralizing antibodies which paradoxically enhance the rate of viral replication and severity of viremia.
Read 24 tweets
Proposed COVID-19 Pathophysiology [Part 1 of 3]

What do #COVID-19 and #Dengue fever potentially have in common?

The answers have significant potential clinical implications in COVID-19.

Buckle up. It's a long one.

Let’s take a hematological walk on the zoonotic side.
Dengue is a flavivirus that is called “breakbone fever”, a nod to bone-breaking pains that occur during the infection.

There are four serotypes of the dengue virus.

Infection with one serotype does not fully protect one from contracting a different serotype.
True or false: The second or later infection with dengue is often much more dangerous.
Read 26 tweets
A hematology @tony_breu-style tweetorial:

Why does lymphopenia occur in #COVID19?

A normal WBC count and lymphopenia are seen in patients affected by COVID-19, but why it occurs has bothered me since the pandemic onset.

The potential answer is surprising and interesting.
First, what do you think the mechanism is?
Does the degree of lymphopenia correlate with survival?
Read 26 tweets
Thread: I am getting tons of msgs from fellows since a few recent talks at @hopkinskimmel, @SocTransOnc Fellows Forum, etc, + Twitter. I am happy to hear from all of you, esp the many people interested in #regulatory science. But many similar Qs, so here goes w/ resources!
@hopkinskimmel @SocTransOnc The #FDA_ASCOFellowsDay is a 1d workshop for #hematology & #oncology fellows in last yr (+ lim # of next to last yr) of training. It happens 2x/yr (fall & spring) on FDA campus in MD & 1x/yr at @ASCO Annual Mtg (1/2 day on Fri am). Applications for #ASCO20 one will open soon. 2/X
@hopkinskimmel @SocTransOnc @ASCO Our next one at the FDA campus is coming up on 3/10/20 (already full). This is a screenshot w/ high-level overview of it, and here's the link where you'll find application instructions for the next one once it opens in a few wks:… 3/X
Read 9 tweets
1/ Can hemolytic anemia exist with no reticulocytosis?

Incoming #MedTwitter #Tweetorial #HemOnc #heme #hematology
2/ We've all been taught that hemolysis and hemorrhage are accompanied by a compensatory marrow response which leads to reticulocytosis and a slight increase in MCV (reticulocytes are larger than your average RBC).
But what if hemolysis co-existed with reticulocytopenia?
3/ A 46 y.o. M with no significant PMH and PSH presented after he noticed a change in his urine color (darker) for the past wk. He mentions that the last 2 times he tried to donate blood in the past year, he was told he was too anemic to donate. Prior to this, no issues donating.
Read 26 tweets
#HematologyTweetstory #6: the ‘pawn ball megakaryocyte’. We’ll revisit Dr. Frankenstein from Tweetstory #1, discover the origin of Santa Claus, and travel from Boston to Las Vegas – a flight the clever guys from the MIT Blackjack Team used to make every Friday. #hematopathology/1
‘Pawn ball’ megakaryocytes have 3 distinct nuclear lobes; this is abnormal. The first reference I’ve found that uses this term is a 1984 @BloodJournal paper by David Rosenthal & William C. Moloney (1907-1991). Dr Rosenthal @DanaFarber led @Harvard Health Services until 2011/2
Moloney, who became the champion of the 'pawn ball meg.' concept, came from @TuftsMedicalCtr & the old Boston City Hospital to become hematology chief at Peter Bent Brigham Hospital (now @BrighamWomens) in 1966. He continued to work until he turned 90 in 1997. @BrighamHeme /3
Read 22 tweets
Time for #hematology-#hematopathology-#history #tweetorial 4: the striking Pelger-Huët anomaly! These curious cells, sometimes mistaken for neutrophil bands, can be inherited; if acquired, they are often a sign of #MDS. I took this photomicrograph of a characteristic example./1 Image
There have been a few histories of the Pelger-Huët anomaly published over the years; a particularly nice one was done by my friend @mrinal90151372 @MayoClinic and colleagues in the American Journal of Hematology 2009). The below Tweets include original research. #PelgerHuet /2 Image
Karel Pelger (1885-1931) – often erroneously written “Karl” in reviews - was born in the village of Nijeveen in rural Drenthe in the Netherlands. Though a country boy who disliked cities, he lived in Amsterdam because of his enthusiasm for science & better access to facilities./3 Image
Read 21 tweets

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