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Nov 23 • 6 tweets • 2 min read
Learning mycobacterial rheumatism from the best @anupamwakhlu !!

#IRACON22
@IndianRheum
#Hansen's disease

✊ Arthritis in 1-78%🙀🙀🙀

Cause?

🧪Reactionary
🔥Direct inflammation
🧠neuropathic joints

#MedTwitter Image
😵confusing conundrums😵

Hansen's disease may present like

👉Rheumatoid arthritis
👉Carpal Tunnel Syndrome
👉Reactive Arthritis
👉Relapsing Polychondritis (YES!)
👉Sarcoidosis
👉Vasculitis (Lucio phenomenon)
And more! Image
Direct Reactive

↖️ ↗️

TB & #rheumatology

↙️ ↘️

Drug induced TB +
rheum dis
Remember: constitutional features may not be there !!

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More from @PanktiMehta24

Pankti Mehta Profile picture
Nov 23
Discussing problems unique to our region 🌍

🔘Kick-starting the South Asian Rheumatology Symposium with Prof. Syed Atiqul Haq joining us in spirit !

Vaccination in ##Rheumatology

#IRACON22 #vaccine
#RheumTwitter

@IndianRheum
Pneumococcal 'prime and boost'

🕜PCV13⏩ 8 ⏩ weeks PSV23

🕜PSV23⏩1 year ⏩PCV13

🔁Repeat PSV23 at 5 years and once after 65 years!
👉 Recombinant zoster vaccine (shingrix)

👌immunity

🚫need for past h/o of VZV

2 doses:
first dose 2 weeks prior to immunosuppressant initiation
2nd dose 3 months after end of intensive immunosuppression/ drug holiday

👉Zostavax- more than 50 years if previous VZV exposure
Read 6 tweets
Pankti Mehta Profile picture
Nov 18
Autoinflammatory syndromes by Dr Dan Kastner at #ACR22 !

1️⃣FMF🏖️

🧬AR, pyrin mutation, evolutionary resistance to Y pestis

🌡️Fever 1-3 days
😣Peritonitis (severe)
🫁Pleurisy unilateral
✊Mono or oligoarthritis

2%-->Amyloidosis

⚕️ colchicine, anti IL1 💉

#MedTwitter #MedEd
2️⃣TRAPS

No ethnic predisposition

🧬AD, TNGRSF1A- p55

🌡️Fever 4-6 weeks
😣Serositis
♨️Migratory rash proximal -->distal
💪fasciitis
👁️ conjunctivitis, periorbital edema

Amyloidosis occasionally

❌response to colchicine
⚕️Steorids ✅ anti IL1✅
3️⃣HIDS/MKD

Northern europeans

🌡️3-7 days
😣 Serositis
🦵✊Arthritis
♨️Diffuse MP rash
Cervical adenopathy
Aphthous ulcers

⚕️Canakinumab
Read 5 tweets
Pankti Mehta Profile picture
Nov 5
The prevalence of #rheumatoidarthritis 🌍 ~1%

🙀 So ~14 million suffer from RA!

So we 👩‍⚕️ have to deal with special situations while managing this fairly common disease!

#MedTwitter #MedEd #rheumatology #RheumTwitter

@MedTweetorials @nihardesai7

(1/9)
Let's begin with one of the most beautiful miracles of life ☺️

#pregnancy in #rheumatoidarthritis

(2/9)
🤔Is it safe to conceive for a patient with RA? 🤰

👉Overall it is safe ☑️☑️☑️

👉But a mild risk of hypertensive disorders, IUGR and need for caesarian section +!

(3/9)
Read 9 tweets
Pankti Mehta Profile picture
Nov 3
💭When we think of #Rheumatoid #Arthritis , a mental image of this comes up 👇

But does it have to get to this🤔???

🙅NO! Definitely, NO! 🙅

#MedTwitter #MedEd #RheumTwitter #Rheumatology

@MedTweetorials

(1/8) Image
🪜The first step is early diagnosis, do not wait until the deformities to form!

💬Think of RA when a patient presents with

🔸Peripheral
🔸Symmetric
🔸Arthritis
🔸Morning stiffness>30 minutes

#MedTwitter

(2/8) ImageImage
🧪👨‍🔬A positive Rheumatoid factor is seen in ~70% of cases and anti-CCP in ~75% cases, so about 1/5th of the cases may be seronegative!!

So a good history and clinical examination is the king 👑

(3/8)
Read 8 tweets
Pankti Mehta Profile picture
Aug 7
"Your diagnosis is elevated uric acid. You need to stop eating 🍅🥗🥦🥪🥩🫘, basically everything"

Beware of these!!

Elevated uric acid doesn't always 🟰 gout

#MedEd #MedTwitter #gout #Uricacid
Gout is a form of arthritis due to deposition of excess uric acid in joints and it usually has (not always) high serum uric acid levels.
If one has gout, then avoid:

🍺 Alcohol
🥩 Red meat
🧃 packed juices, carbonated drinks (high fructose corn syp)
Read 4 tweets
Pankti Mehta Profile picture
Jun 27, 2020
My experience: #Covid_19 ICU rotation at #SGPGI #Lucknow

1. All patients were >35 years of age with majority being males

2. Apart from the usual comorbidities, central #obesity without over #diabetes or #hypertension also predisposed to #SARI
3. #Lymphopenia was a great marker of severity and a rising trend predicted clinical recovery

4. #recoverytrial further reiterated the use of steroids for patients with severe disease which many centers including ours was already practising
5. Although initially we had a guarded approach towards it, but #NIV with low pressures worked wonders avoiding intubation

6. Once intubated, outcomes aren’t great. Multiple reasons: severity of disease, nursing care and feeding becomes suboptimal, bradycardia associated with
Read 7 tweets

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