Thread by @Rheumat_Aravind

🧵 “10 Rheumatology Diagnoses That Are Often Missed (Until It’s Too Late)”

Some autoimmune diseases hide in plain sight.
Here are 10 real-world diagnoses clinicians overlook—until disaster strikes 👇
#Rheumatology #MedTwitter @DrAkhilX @IhabFathiSulima

1️⃣ Antiphospholipid Syndrome (APS)
✅ Clue: Young patient with unprovoked DVT or stroke.
📌 Don’t call it “just a clot.”
→ Look for recurrent miscarriages, livedo, aPL antibodies.

2️⃣ ANCA-Associated Vasculitis
✅ Clue: Sinusitis + hematuria + pulmonary infiltrates.
📌 Early treatment prevents kidney failure and alveolar hemorrhage.

3️⃣ Adult-Onset Still’s Disease (AOSD)
✅ Clue: Daily spiking fevers, salmon rash, high ferritin.
📌 Often mislabeled as “sepsis”—delays can lead to MAS.

4️⃣ Relapsing Polychondritis
✅ Clue: Recurrent red ears sparing lobule, stridor, nasal collapse.
📌 Airway involvement = life-threatening.

5️⃣ IgG4-Related Disease
✅ Clue: Subacute masses (pancreas, salivary glands, retroperitoneum).
📌 Mimics malignancy—steroids are curative if recognized.

6️⃣ Anti-MDA5 Dermatomyositis
✅ Clue: Mechanic’s hands + rapidly progressive ILD.
📌 Early aggressive immunosuppression is critical.

7️⃣ Catastrophic APS (CAPS)
✅ Clue: Thromboses in multiple organs over days.
📌 Treat immediately—anticoagulation + steroids + plasma exchange.

8️⃣ Behçet’s Disease
✅ Clue: Oral/genital ulcers + uveitis + thrombosis.
📌 Underdiagnosed outside endemic areas.

9️⃣ Scleroderma Renal Crisis
✅ Clue: Sudden hypertension + AKI in diffuse scleroderma.
📌 Start ACE inhibitors without delay.

🔟 Macrophage Activation Syndrome (MAS)
✅ Clue: Fever, cytopenias, ferritin >10,000, liver dysfunction.
📌 A rheumatologic emergency—start steroids ASAP.

💬 Final Take:
Autoimmune disease can hide behind common symptoms.
✅ Pattern recognition saves lives.
✅ Early suspicion changes outcomes.

🩺 Follow @Rheumat_Aravind for practical, no-fluff autoimmune insights you can trust.

#Autoimmune #MedEd #RheumTwitter