Discover and read the best of Twitter Threads about #hlh

Most recents (5)

Fantastic heme grand rounds on HLH at @DanaFarber @BrighamHeme today from @ZorefAdi @CCHMCPostdoc - a 🧡

Starting with a timeline, the pathogenesis and defining the clinical syndrome of HLH
#HLH #lymsm (1/8) ImageImageImageImage
How to diagnose HLH? Soluble CD25 and ferritin are the most specific inflammatory markers (best ROC), so @ZorefAdi et al combined them into an 'optimised HLH inflammatory' (OHI) index, with an improved specificity for HLH

ashpublications.org/blood/article/… @BloodJournal (2/8) ImageImage
Once you have made the diagnosis of HLH, the next step is to find the underlying cause.

Great flowchart from Paul La RosΓ©e et al in @BloodJournal: ashpublications.org/blood/article/…

A tip: 'lymphadenopathy is not a symptom of HLH so should raise suspicion for underlying lymphoma' (3/8) Image
Read 8 tweets
Impressing π˜Ύπ™€π™£π™¨π™ͺ𝙑𝙩𝙖𝙣𝙩 𝙀𝙣 𝙍𝙀π™ͺ𝙣𝙙 ❓

Residents use the fancy diagnosis and terms like
𝐇𝐋𝐇 - Hemophagocytic lymphohistiocytosis

A 🧡 on what is 𝐇𝐋𝐇 and how to diagnose it
#MedTwitter
#HLH
#MedEd
#usmle Hemophagocytosis
πŸ“Hyperinflammatory syndrome caused by ⬆️cytokine release

πŸ“ Either due to genetic or acquired overactivation of CD8 T cells and natural killer (NK) cells

✴️ Hemophagocytosis is neither sensitive nor specific for HLH

πŸ…²πŸ…»πŸ…°πŸ†‚πŸ†‚πŸ…ΈπŸ…΅πŸ…ΈπŸ…²πŸ…°πŸ†ƒπŸ…ΈπŸ…ΎπŸ…½ πŸ‘‡
Lets discuss one of the π–ˆπ–†π–˜π–Š π–˜π–ˆπ–Šπ–“π–†π–—π–Žπ–”π–˜ that came to AIIMS:

24,πŸ’ƒ, without any Co-morbidties

C/O Fever, Malaise, Sore throat, Headache

𝐎𝐧 π„π±πšπ¦π’π§πšπ­π’π¨π§ :
πŸ”ΈHR ~125/min πŸ”Ί
πŸ”ΈSevere Pallor
πŸ”ΈCervical Lymphadenopathy
πŸ”ΈPetechial Rash

InvestigationπŸ‘‡
Read 12 tweets
1/🧡 You are a BAD #GOLFER & have a big day with buddies & are in the tall grass a LOT. Later, you take off a #tickπŸ‘‡and in 7 days develop a fever & headache. You have no rash. The emergency room gives you acetaminophen. Is that OK?
Β 
#medtwitter #Nurse
2/ Tick bites are a big deal in Summer months. Rocky Mountain Spotted Fever is a concern, and the absence of rash also brings up #Ehrlichiosis. This @NEJM paper showed that worse golfers retrieved balls from the rough & got the dz more often!
Β 
bit.ly/3e6vQrF
3/ Of those with #Ehrlichiosis, 20% get bad nervous system dz & 20% of those die. If you live in Southern US and find a Lone Star tick (pic above), and then develop fever & headache, get evaluated and probably start the antibiotic doxycycline quickly!
Β 
bit.ly/3e5ndxF
Read 5 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
Starting a series on clinical Pearls I am gathering in #COVID19 patients based on experiences of many experts

Will add as we go along

Feel free to add your own observations/experiences

#covidclinicalpearls /1
Anosmia is likely the most specific #COVID19 related symptom
30% of patients have anosmia as their 1st symptom
#covidclinicalpearls /2
Around 90% of patients have fever.
50% maybe afebrile at the time of presentation
Fever tends to be very resistant to routine measures in hospitalized patients
There is no consensus that NSAIDs are to be avoided in #COVID2019 patients

#covidclinicalpearls /3
Read 66 tweets

Related hashtags

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3.00/month or $30.00/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal Become our Patreon

Thank you for your support!