Rheumatology Pearls

Post-infectious #Lyme #arthritis ➡️Persistent #synovitis that worsen post-antibiotic ➡️Excessive dysregulated pro-inflammatory immune response ▶️Exceptionally high amounts IFNγ ▶️Inadequate anti-inflammatory cytokine IL-10 👉🏽nature.com/articles/s4158… via @NatRevRheumatol

Turn in on March 2nd to hear me talk about our efforts to treat lupus nephritis.

The @NephJC team is going to be discussing the Belimumab in #LupusNephritis (BLISS LN) for #NephJC on Nov 24/25 #RheumJC

@psufka As long as we are talking about Krispy Kreme... or maybe Duck Donuts.

We all agree on donuts. 🍩

People here don’t mind following guidelines. That’s pretty much it. No complaints about personal loss of freedoms or politicization of mask wearing. #rheumjc

Hi. Chris Collins here in Denmark. Jet lagged and can’t sleep. #rheumjc

Next #RheumJC will be Thursday, June 25th Topic: Data from the COVID-19 Global Rheumatology Alliance Physician-Reported Registry More info: rheumjc.com/2020/06/data-f… Summary from @HealioRheum: healio.com/news/rheumatol…

@philipcrobinson @DavidLeverenz @Nephro_Sparks @EBRheum @jeffsparks @alhkim @rheum_cat @psufka @RheumResearch @LisaCriscione It’s an ACR Clinician Scholar Educator Award funded project in the model of #NephMadness. Just getting started

@DavidLeverenz @Nephro_Sparks @EBRheum @jeffsparks @alhkim @rheum_cat @psufka @RheumResearch @LisaCriscione @RheumPearls Can I ask what #RheumMadness is? I have cleared missed something.

Time is running out (last day!!) Who knows Neph Better @alhkim versus @jeffsparks versus @rheum_cat versus @DavidLeverenz versus @psufka #JeffsDad says for all #RheumTwitter to fill out your #NephMadness bracket now!! 👇👇 tourneytopia.com/ajkd/nephmadne…

A book on immunology. One of our faculty use thins one... amazon.com/gp/aw/d/111954…

@Tiff_Caza Dont know... but maybe

#rheumjc Would the AVISE testing be helpful to distinguish idiopathic membranous (that's PLA2R/THSD7A/NELL1 neg) from membranous lupus nephritis? Anyone currently using it in this setting?

Thanks for participating tonight.... sorry to sound like a commercial, but I do like to test. It's helped my group in several instances. DM me if you have an specific questions. #rheumjc

the test gets you not only the SLE "likelihood ratio" but also also a ton of other antibodies like APLs, RA specific antibodies, thyroid antibodies (as a know cause of ANA positivity), anti-C1Q (renal SLE predictor) and others. #rheumjc

The out of pocket cost for the test (currently) is max $45 for the patient. My understanding is that the company tries to get reimbursed from insurance (most of the time success, but sometimes no) but will only bill patient $45 and write off any losses #rheumjc

The AVISE test came back positive for SLE and helped us with deciding which meds were best for her. #rheumjc

And we use it in those patients in whom we just aren't sure what the hell is going on... I recently had a patient with only positive nucolear pattern ANA, Raynaud's, serositis, and pan-cytopenia. Was this scleroderma or SLE?#rheumjc

We user this test fairly regularly in my clinic... 1) because this is a dedicated immunology focused lab so quality control for tests like ANA and dsDNA are trusted (so many false negs and positives out there in commercial assays) #rheumjc

anyone else want to ask me about this study or the CB-CAPs (cell-bound complement activated products) technology? #rheumjc

ncbi.nlm.nih.gov/pubmed/26870391 #rheumjc

we did another study where we looked at ANA positive fibro patients.... and none of them tested positive for lupus using the AVISE test... none. Very helpful in keeping these patients off meds like steroids and HCQ. #rheumjc

At the end of the day, this is but one more tool in the diagnostic algorithm. A piece of the puzzle so to speak. Clinicians still make the diagnosis of lupus based on all available information. This test just adds to it. Sometimes very helpful, other times not needed. #rheumjc