#EULAR2022
How To Treat (HOT)
Anti-phospholipid syndrome
#EULAR2022
How To Treat (HOT)
Anti-phospholipid syndrome
🩸Primary Thromboprophylaxis
🩸Aspirin is recommended but might not be sufficient
🩸VKA use is asso. ⬆️ Bleeding risk (Risk>Benefit)
#EULAR2022
How To Treat (HOT)
Anti-phospholipid syndrome
🩸Secondary Prophylaxis
🩸INR: 2-3 for venous thrombosis (Controversial)
🩸Is not effective in preventing arterial events though
#EULAR2022
How To Treat (HOT)
Anti-phospholipid syndrome
🩸For Recurrent/Arterial Thrombosis
🩸INR 3-4 or 2-3 with LDA might be needed
🩸We still need more data on this
🩸The role of NOACs is controversial might be tried in low risk pts who don't tolerate VKA
#EULAR2022
How To Treat (HOT)
Anti-phospholipid syndrome
🩸CAPS: Triple therapy
🩸GC+ IVIG/PLEX+ anticoagulation works well
#EULAR2022
How To Treat (HOT)
Anti-phospholipid syndrome
🩸 Ritux and Eculizumab have shown some efficacy in refractory CAPS
#EULAR2022
How To Treat (HOT)
Anti-phospholipid syndrome
🩸Obstetric APS
🩸1 Prophylaxis: LDA or LDA+LMWH
🩸2 Prophylaxis: LMWH + LDA
🩸Refractory: LMWH+LDA+HCQ+ Low dose steroids (Upto 15mg/day)
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🧵 1/9 Key insights on AAV treatment from #ACR24. Dr. Langford's session highlighted the latest guidelines and therapeutic strategies. Let's dive in! #Vasculitis #Rheumatology
🎯 2/9 AAV Treatment Goals: Remission, relapse prevention, minimize toxicity, organ damage, and optimize patient quality of life. Keep these in mind when choosing therapies. #AAV #TreatmentGoals
📚 3/9 Guidelines: ACR/VF (2021), KDIGO (2024), EULAR (2022), PANLAR (2023) - all provide crucial recommendations. Familiarize yourself with these! #AAVGuidelines #EvidenceBasedMedicine
(1/10) #ACR24 Key Sarcoidosis Takeaways for Rheumatologists:
Sarcoidosis diagnosis relies on clinical probability, not "proof."
Patient-reported outcomes (ROS) are crucial for understanding disease extent & activity, guiding us to occult disease.
Diagnostics have limitations!
(2/10) #ACR24 Sarcoidosis epidemiology is complex.
Prevalence & incidence vary globally, with higher rates in Black individuals & females.
While ~80% achieve resolution in 2 years, disparities in diagnosis & treatment lead to poorer outcomes.
More research is needed!
(3/10) #ACR24 Sarcoidosis etiology remains unknown.
Environmental, occupational, & infectious agents are suspected triggers.
Genetic predisposition plays a role.
Remember to consider medication reactions (TNFi's, ARVs, CTx) in the differential diagnosis.
#ACR22#ACR2022
12S129. Purple Peripheries: Vasculopathy VS Vasculitis
Philip Seo is awesome as always
The most common cause is Cardiovascular followed by Rheumatic
More commonly vasculopathy than Vasculitis
#ACR22#ACR2022
12S129. Purple Peripheries: Vasculopathy VS Vasculitis
Algorithm for Digital ischemia in Rheum
Mx for Gangrene in SSc
#ACR22#ACR2022
12S129. Purple Peripheries: Vasculopathy VS Vasculitis
Large and Small vessel rarely cause Digital gangrene
#ACR2022#ACR22
12S130. Rheumatology Secrets and Pearls
Dr John Stone, at his best
🎯RA may present with asymmetric arthritis
🎯AAV might present with migratory oligoarthritis, which is steroid responsive
🎯Only a quarter of RA patients go into remission during pregnancy
#ACR2022#ACR22
12S130. Rheumatology Secrets and Pearls
🎯Following trends is more important in pregnancy that stat values (ESR/Complements)
🎯Proteinuria⬆️ creat ⬇️ due to ⬆️ GFR and maternal Blood volume in pregnancy
#ACR2022#ACR22
12S130. Rheumatology Secrets and Pearls
🎯Puffy fingers may be the first sign of SSc in RNApolIII SSc and No Raynaud's - May present with SRC
🎯ACEi are best kept reserved for SRC
#ACR2022#ACR22
12S130. Rheumatology Secrets and Pearls
Jason Kolfenbach, with his wonderful pearls 1. Vasculitis Pearls
🦪For Steroids ➡️ Less is more
🦪Be very careful in stopping Rx in AAV pts
🦪Don't give up on PLEX in suspected AAV Anti-GBM may have ANCA positivity.
#ACR2022#ACR22
12S130. Rheumatology Secrets and Pearls
🦪Not all Skin thickening = SSc
🦪Lipodermatosclerosis (with inverse 🍾 sign)
🦪Thyroid disease important mimics
🦪PPI can cause diarrhoea
🦪FVC/DLCO ratio can help diagnose ILD/PAH
#ACR2022#ACR22
12S130. Rheumatology Secrets and Pearls
🦪30% SLE pts have APS
🦪DLE uncommonly progresses to SLE
🦪PPIs, NSAIDs, Anti-HTN meds commonly cause SCLE