Discover and read the best of Twitter Threads about #ibdalgorithm
Most recents (2)
@MondayNightIBD 1/Differential of Non-infectious Non -IBD colitis:
🔆 Drug-induced
🔆 Common Variable Immunodeficiency
🔆 Behcet disease
🔆 Segmental Colitis Associated w/ Diverticulosis
🔆 Ischemic Colitis
🔆 Radiation Colitis
🔆 Malignancy
🤔Can you think of other dx?
#MondayNightIBD
🔆 Drug-induced
🔆 Common Variable Immunodeficiency
🔆 Behcet disease
🔆 Segmental Colitis Associated w/ Diverticulosis
🔆 Ischemic Colitis
🔆 Radiation Colitis
🔆 Malignancy
🤔Can you think of other dx?
#MondayNightIBD
@MondayNightIBD 2/Immune Checkpoint Inhibitor Enterocolitis
📌ICI = monoclonal antibodies that reactivate immune response to tumor cells
📌Activation of T‐cells can cross‐react with host antigens
📌Enterocolitis ⬆️anti‐CTLA‐4 > anti‐PD‐1/PD‐L1 agents
📌Diarrhea
⬆️risk perforation if unrecognized
📌ICI = monoclonal antibodies that reactivate immune response to tumor cells
📌Activation of T‐cells can cross‐react with host antigens
📌Enterocolitis ⬆️anti‐CTLA‐4 > anti‐PD‐1/PD‐L1 agents
📌Diarrhea
⬆️risk perforation if unrecognized
@MondayNightIBD @SanjeevaniTomar @halesj126 @JosephHabibi_MD @RomyChamoun @MarcelYibirin @ifrahfatima @GroverDheera @dunleavy_katie @drsophiadar @Spencerkelley7 3/ICI + Diarrhea:
📐R/o infection
🔦C-Scope: appearance of IBD; but mucosa can look normal -> always biopsy; consider EGD +Bx
🔬Path can have chronic IBD changes, crypt apoptosis
💊Depends on severity: budesonide -> IV steroids-> Biologic
✅#IBDAlgorithm👇
📐R/o infection
🔦C-Scope: appearance of IBD; but mucosa can look normal -> always biopsy; consider EGD +Bx
🔬Path can have chronic IBD changes, crypt apoptosis
💊Depends on severity: budesonide -> IV steroids-> Biologic
✅#IBDAlgorithm👇
@MondayNightIBD @SobiaMujtabaMD @NabilQuraishi @CholestasisDoc @DCharabaty 1/ 35 y/o M presents with fatigue & generalized pruritus x 6weeks. No skin rash, No abdo pain, diarrhea or 🩸 in stool. AST 62 ALT 64 ALP 435 Tbili 1.3. MRI/MRCP: multifocal strictures & areas of dilatation of intra +extra hepatic ducts. What’s the next step?💡 #Back2Basics #B2B
@MondayNightIBD @SobiaMujtabaMD @NabilQuraishi @CholestasisDoc @DCharabaty 2/ What’s #PSC & phenotypes?
🧩Idiopathic chronic inflam dis. of the biliary tree
🧩90%: Large ducts (LD): "Beads on string appearance” on ERCP/MRCP (pt👆)
🧩5% Small IHD only: nml MRCP, dx by liver bx, slide👇
🧩5% PSC w AIH overlap: abnl MRCP+liver bx w⬆️AST/ALT or IgG
🧩Idiopathic chronic inflam dis. of the biliary tree
🧩90%: Large ducts (LD): "Beads on string appearance” on ERCP/MRCP (pt👆)
🧩5% Small IHD only: nml MRCP, dx by liver bx, slide👇
🧩5% PSC w AIH overlap: abnl MRCP+liver bx w⬆️AST/ALT or IgG
@MondayNightIBD @SobiaMujtabaMD @NabilQuraishi @CholestasisDoc @DCharabaty 3/ 💎#B2BPearl #PSC w ⬆️IgG4
📌15% of LD-PSC
📌⬆️IgG4 serum>140mg/dL +/- tissue
💎✅IgG4 at least once w PSC dx
📌Assoc. w AI pancreatitis; other Ig4 dis.
💎⬆️severity of UC, colectomy
📌More rapid progression to cirhhosis
💎Steroid responsive: ️ ⬇️AlPhos, TBili, IgG4
📌15% of LD-PSC
📌⬆️IgG4 serum>140mg/dL +/- tissue
💎✅IgG4 at least once w PSC dx
📌Assoc. w AI pancreatitis; other Ig4 dis.
💎⬆️severity of UC, colectomy
📌More rapid progression to cirhhosis
💎Steroid responsive: ️ ⬇️AlPhos, TBili, IgG4
