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Nov 11 • 13 tweets • 10 min read
#ACR22 #ReviewCourse
Dr Sara McCoy on #Sjogrens & mimics

Nomenclature: Sjogren's disease Image
Tear films are complex, with 3 layers

Comorbidities & meds can deplete the tear film too

#ACR22 #ReviewCourse Image
Oral exam:

👄r/o other causes of dry mouth, e.g. angular cheilitis
👅check under tongue for salivary pooling
👅do a thorough tongue exam (lack of papillae)
🦷eval the dentition

#ACR22 #ReviewCourse
How do to unstimulated salivary flow? Simple - just need Dixie cups and a scale

Passively collect saliva (aka drool) into cup x 5 min

Weigh it; 1g = 1mL of saliva

#ACR22 #ReviewCourse Image
A bit on salivary gland ultrasound, which can improve Sn, Sp of classification criteria

Looking at echogenicity, the Sjogren's scan looks like swiss cheese 🧀

#ACR22 #ReviewCourse Image
More on salivary gland ultrasound:



#ACR22
When considering the bx in #Sjogrens think of the DDX

🔍Benign lymphoepithelial lesion: can be a MALT precursor; take special notice of it

#ACR22 #ReviewCourse Image
Back to the importance of the DDX for dry eye👁️ & dry mouth 👄

#ACR22 #Reviewcourse Image
Case to illustrate differentiating SjD from HCV

What can help?
🔹SSA/B positivity
🔹infiltrate type on bx (CD8+ T ly in HCV)
🔹salivary gland US

HCV, HIV both implicated in SjD tho

#ACR22 #ReviewCourse Image
What about SjD vs DILS in HIV?

🔹Salivary gland US: more diffuse infiltration with HIV
🔹Infiltrate on bx: CD8+ T ly in HIV

❗️Both can have LIP type of ILD!

#ACR22 #ReviewCourse Image
SjD vs sarcoidosis or IgG4RD: often comes down to histopathology

#ACR22 #ReviewCourse ImageImage
Side note:
In past years @BharatKumarMD and #ACRKnowledgeBowl organizers would pull facts from the #ReviewCourse as questions

Which was esp fun the year I did not attend the Review Course!

#ACR22
This is that potential #ACRKnowledgeBowl question

Eosinophilic sialodochitis

❗️history of expressing mucous plugs from the salivary glands

⬆️peripheral eos, IgE

#ACR22 #ReviewCourse Image

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More from @rheum_cat

Rheum Cat Profile picture
Nov 13
#ACR22 social media talk, very meta Image
Part 1️⃣: optimize your conference tweeting
If you're reading this you probably know all of this!

The first pro-tip was figure out the conference hashtag
The second? Engage with others in rheum
#ACR22 Image
What else?

👉amplify your group
👉amplify speakers and sessions of interest
👉amplify your colleagues so they will amplify you in turn

#ACR22
Read 10 tweets
Rheum Cat Profile picture
Nov 13
#ACR22 infection (COVID) posters Image
Abs 0784 @CCalabreseDO

Cleveland Clinic breakthrough infections, including data on n=21 who received Evusheld

📌Publication here: pubmed.ncbi.nlm.nih.gov/35791921/

#ACR22
@CCalabreseDO Abs 0779 @CCalabreseDO

Experience with evusheld PrEP with IMID on BCDT at Cleveland Clinic

📌Publication here: pubmed.ncbi.nlm.nih.gov/36123015/

#ACR22
Read 13 tweets
Rheum Cat Profile picture
Nov 13
#ACR22 #Feedback
The EULAR e posters were tiny (bad) but speakers could zoom in and out (good)

That would have been nice for #IgniteTalks #ACR22
The sound is adequate though. EULAR issue was that the sound was poor in their (smaller) poster tour stages #ACR22 #IgniteTalk
Read 4 tweets
Rheum Cat Profile picture
Nov 13
#ACR22 epidemiology posters Image
Abs 0700 @zach_wallace_md
💻Using NLP, ML algorithms to identify ANCA vasculitis cases

They also looked at the difference in performance metrics with/without filtering keywords

An explosion of NLP studies in rheum! #ACR22
@zach_wallace_md Abs 0732 Ho, et al. @JYazdanyMD @MilenaGianfran
💻Part of the explosion of NLP studies in rheum

Here the UCSF group aimed to capture VZV cases (differentiate from vaccination); and to capture active vs historical cases

See their diagrams explaining the steps!
#ACR22
Read 13 tweets
Rheum Cat Profile picture
Nov 13
We have learned quite quickly that a virtual ONLY poster hall mixed into a hybrid meeting doesn't work well.

Poor wifi and the crashing platform compound the problem

And if it's online ONLY, is that truly hybrid?

#ACR22
This is not a complaint thread. I am hoping we can have discussion about what works/doesn't work, and what could be done next year for #ACR23
It goes without saying that an in-person poster hall is the most requested item on the wishlist for #ACR23

@GrantSchulert @Tuhina_Neogi
Read 5 tweets
Rheum Cat Profile picture
Nov 13
Biostatician @MikeLaValley8 @BU_BMC_Rheum presents a quick overview on how to appropriately interpret results from studies #ACR22

Of course this is not an exhaustive deep dive, but covers some common errors of interpretation Image
@MikeLaValley8 @BU_BMC_Rheum First, what is your research question? What is the question you are trying to answer with t he study?

👉Does this exposure CAUSE this outcome?

#ACR22 Image
@MikeLaValley8 @BU_BMC_Rheum What are common observational study designs and what are big issues to watch out for?

These are issues that can affect the validity of their results.

There are more potential issues within these study designs that is beyond the scope of this table

#ACR22 Image
Read 15 tweets

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