Sandhya Pulukool

Rheumatologist, @NarayanaHealth Bengaluru, India | Passionate about Sjögren’s Syndrome | Calicut - JIPMER - CMC Vellore | Co-convenor APLAR & IRA #Sjogrens SIG

[Sandhya Pulukool @SandhyaRheumat]

#Sjogrens Syndrome - Year-end thoughts.
Ever since I have been a rheumatologist, I have always found diagnostic delay distressing, and perhaps nowhere is it as prevalent as in Sjogren's.
I am summarising some of my thoughts in a short-long🧵

[Sandhya Pulukool @SandhyaRheumat]

@aditya_gan3500 Congratulations!

[Sandhya Pulukool @SandhyaRheumat]

10.1016/j.ard.2025.03.012

[Sandhya Pulukool @SandhyaRheumat]

New Study from OMRF: Salivary antibodies in so-called "sicca non-Sjogrens"
👉Saliva tests detected anti-Ro60 in 75 seronegative sicca patients
👉 Could be a new phenotype
PMID: 40320334
Could salivary antibodies also redefine the diagnosis of #Sjogrens in non-sicca phenotypes?

[Sandhya Pulukool @SandhyaRheumat]

@SarahSchaferMD @nileshnolkha It takes incredible strength and persistence to advocate consistently in a system that too often dismisses patients who don’t fit ‘checkboxes.’Deep admiration & utmost respect @SarahSchaferMD @arianek @NeuroSjogrens and many others

[Sandhya Pulukool @SandhyaRheumat]

Continuing #Sjogrens awareness posts.
🔬 Labs Suspicious for #Sjögrens

[Sandhya Pulukool @SandhyaRheumat]

@SarahSchaferMD @nileshnolkha Your story is so important—thank you for your blog. I’ve learned so much from you and the incredible Sjögren’s community here

[TheDaoIndex @KDAO2011]

“The future belongs to people who ask questions.” #Science
Prof McInnes #CCRE25

[TheDaoIndex @KDAO2011]

May is #LupusAwareness month! @rheumnow is running a #Lupus campaign: Keys to Unlocking Lupus.

First blog by Dr Sammaritano https://t.co/oVPxDf0dez

@Lupusreference @LupusOrg @EricFMorand @edvital @alhkim @alvinwellsmd @Janetbirdope

[Neuro Sjogrens @NeuroSjogrens]

Why do we think Sjogrens is only dryness? Is it time to contact our med schools and academies to ask them to address the incomplete (& inaccurate) education they provide so we can provide better care thru better understanding?
#MedTwitter #RheumTwitter #NeuroTwitter

[S Blitshteyn MD, FAAN, FANA, Dysautonomia Clinic @dysclinic]

I am happy to see great interest in our new new paper on what not to say to people with complex #chronicillness in a #rheumatology newspaper.
#MedTwitter #NeuroTwitter #LongCovid #MECFS #Dysautonomia

Read full article here: 👇
https://t.co/yiYN7OxeHr

[ThePOTSPostman @ThePOTSPostman]

You’d never know it from the outside, but someone with a chronic illness can hold a conversation, smile, even laugh…all while simultaneously fighting a battle inside their body.

Brain fog, tachycardia, fatigue, dizziness and more.

We get real good at pretending we’re okay.

[Sandhya Pulukool @SandhyaRheumat]

@_VFK_DAA Evidence supports Sjögren-like phenotype in animal models and increased prevalence of ANA, anti-SSA and histopathologic SS-like phenotype in convalescent COVID-19 individuals.https://t.co/IjRAtAr9j1

[Sandhya Pulukool @SandhyaRheumat]

🧠 Which neurological features should make you suspect Sjögren’s?
⚠️ Think beyond & before dryness
➡️ Sensory Neuronopathy/Ganglionopathy
➡️ Small Fiber Neuropathy
➡️ Autonomic Dysfunction
➡️ Optic Neuritis
➡️ Myelitis
➡️ Cranial neuropathy- esp trigeminal
#SjögrensAwareness

[Sandhya Pulukool @SandhyaRheumat]

@georgedemirakos @nileshnolkha Dazodalibep phase 2 trials r promising
Reduction in both disease activity and patient reported outcomes
Phase 3 awaited
No personal experience

[Sarah Schafer MD MPH @SarahSchaferMD]

Studies show ⬆️mortality in Sjogren’s, SMR ranging from 1.5 -4. Respiratory infections are a top cause. I expect this will increase both directly from Covid and from the immune system damage caused by Covid.
Air cleaners, N95 masks, and vaccines are all important.

[S Blitshteyn MD, FAAN, FANA, Dysautonomia Clinic @dysclinic]

Fascinating! Gut microbiota in patients may be a possible trigger of small fiber neuropathy in the skin. Conversely, gut microbiota of healthy people might reduce small fiber neuropathy in patients. There is a lot to be learned, but one thing is clear: your #fibromyalgia, #dysautonomia, #POTS and small fiber neuropathy are not caused by your thoughts and attitudes from higher cortical functions. 😉

[Sarah Schafer MD MPH @SarahSchaferMD]

@SandhyaRheumat It’s also good to remember that all of these tests can be negative and you can still have Sjogren’s. This is true for me and many other people with Dysautonomia and small fiber neuropathy. I have multiple systemic manifestations, but 34 years from symptom onset to diagnosis.

[Sjögren Europe @SjogrenEurope]

🌍 Sjögren’s Awareness Month ends — but our voice stays strong 💙

Thank you for sharing, supporting & raising awareness 🌟

You’ve shown one powerful truth: you are not alone.

We keep going. Together. 💙

#SjögrenEurope #SjögrenAwareness #YouAreNotAlone #Sjögrendisease

[Sandhya Pulukool @SandhyaRheumat]

@Amansharmapgi 🙏

[Sandhya Pulukool @SandhyaRheumat]

@SarahSchaferMD Absolutely!

[Sandhya Pulukool @SandhyaRheumat]

@aditya_gan3500 @Amansharmapgi true

[Sandhya Pulukool @SandhyaRheumat]

@anoofpp a subset of anti-CENP+ have SS rather than limited scleroderma phenotype