Raül Jordà

Alcoià /
Resident de Medicina Interna @internaclinic / Interessat en Malalties Autoinmunes Sistèmiques /
Muntanyenc i corredor ⛰️🏃

[NEJM @NEJM]

Inflammatory myopathies are typically associated with a myositis-specific autoantibody that determines the diagnosis and prognosis. Myositis subgroups have distinct pathomechanisms that now allow for targeted therapies.

Learn more in the Review Article “Inflammatory Myopathies” by Yves Allenbach, MD, PhD, and Olivier Benveniste, MD, PhD: https://t.co/ZeCKdNe87v

[Aravind Palraj @Rheumat_Aravind]

Cryoglobulinemic vasculitis is a classic example of immune complexes doing real damage.

Key clues to remember:
• Cold-precipitable immunoglobulins
• Palpable purpura + neuropathy + GN
• Low C4 is the hallmark
• Always rule out Hepatitis C
• Treat severity - rituximab over cyclophosphamide

Small vessels. Big consequences.
@DrAkhilX @IhabFathiSulima #MedTwitter #RheumTwitter #Vasculitis

[Rheuma Doc @LastManStand85]

Pulmonary Manifestations in GPA & MPA #Vasculitis patients
➡️Nodules GPA 63% vs 12% in MPA pts
➡️DAH MPA 61% vs 31% GPA
➡️🫁 ILD MPA 11% vs 1%
➡️ Endobronchial involvement 12% in GPA vs 2%
Abstract 0721 #Rneumatology #MedTwitter

[Dr.Mukesh , MD , DM @dr_immuno29]

🧵 Blast from the Past | #ACR25 | Systemic Sclerosis: Screening for Organ Involvement
By Francesco Boin, Cedars-Sinai

1️⃣ Always think multi-organ – SSc hits skin, lungs, heart, kidney, GI, joints, muscles — screen all!
2️⃣ Timing matters – Max organ risk in first 2–4 yrs (esp. diffuse SSc).
3️⃣ Autoantibodies = Organ Clues
•🧬 Anti-Scl70 → ILD
•🧬 RNA Pol III → Renal crisis, cardiac
•🧬 Centromere → PAH, limited cutaneous, “protective” for ILD
•🧬 U3 RNP / Th/To → PH, GI, kidney
4️⃣ ILD – Commonest killer.
•Risk: diffuse SSc, early disease, reflux, ↑ESR/CRP, AA race.
•HRCT = 🥇 gold standard (PFTs miss up to 60%).
•Baseline + annual follow-up.
5️⃣ Pulmonary Hypertension (PAH) – silent early!
•Clues: late onset, limited cutaneous, telangiectasia, low DLCO, ↑BNP.
•Screen via DETECT / ESC-ERS / ASIG → Confirm by RHC.
6️⃣ Renal Crisis 💥
•Early diffuse + RNA Pol III + steroids (>15 mg) → 🚨 risk.
•Sudden HTN/AKI → act fast.
7️⃣ Cardiac Involvement ❤️
•Silent but deadly; screen yearly (Echo, PFT, BNP, Troponin).
•Risk: diffuse, myositis, tendon friction rubs, anti-Scl70/RNA Pol III/U3RNP.
8️⃣ Screen early → intervene early → save organs.
•Annual PFT + Echo, HRCT if at risk.
•Physical exam + antibody-guided vigilance = 💡 best prevention.

#ACR25 #BlastFromThePast #SystemicSclerosis #ACRAmbassador #RheumTwitter

[Autoinmunes-Clínic @MAS_Clinic]

ANCA-associated vasculitis and interstitial lung disease: challenges and open questions 🫁

European Journal of Internal Medicine https://t.co/BCaznm85a5

@sergioprietoglz @raaulasoo @FerHernandezG @davidjayne2

[Autoinmunes-Clínic @MAS_Clinic]

📢 EULAR 2025 Update LES con afectación renal🧬

Lectura de fin de semana!!

▶️Tto combinado de inicio MMF/CYC + Beli; MMF + CNI (TAC o VOC); MMF + Obi

▶️PDN 5mg/d a los 4-6 meses

▶️Inclusión de SGLT2is en la terapia no immune

https://t.co/aa3r0HDVn9

[NatRevRheumatol @NatRevRheumatol]

New content online: Challenges in the diagnosis, classification and prognosis of ANCA-associated vasculitis https://t.co/2hS0GnMCjc

[Ravi Kumar @RheumattDoc]

🧬 2025 ACR/EULAR Classification Criteria – Anti-synthetase Syndrome (ASS)

🔹 Entry:
Patients suspected of ASS

⚖️ Clinical Domains

🦴 Joint involvement
• Inflammatory arthritis → +1.0

💪 Muscle involvement
• Subclinical (CK↑/EMG/MRI) → +1.0
• Clinical myositis → +1.5
• Biopsy-proven myositis → +2.0

🌬️ Interstitial lung disease
• UIP / unclassifiable → +1.5
• NSIP or OP pattern → +2.5

🌸 Other Clinical Features

🤲 Mechanic’s hands / Hiker’s feet → +1.5
❄️ Raynaud’s → +0.5
🌺 Inflammatory rashes (Gottron’s, heliotrope, V-sign, etc.) → +0.5
🔥 Unexplained fever → +0.5

🧪 Serological Domain

Anti–ARS antibodies
•Non–Jo-1 (non-IP method) → +3.0
•Jo-1 or non–Jo-1 (by IP) → +3.5

Other supportive antibodies
•ANA with cytoplasmic pattern → +1.5
•Anti–Ro52 / Anti–SSA → +1.0

📏 Scoring rules
•Count highest weight per domain only
•Unassessed / absent = 0 points
•Threshold: typically ≥5.5 points → classified as ASS

🧠 Takeaway

Anti–ARS antibody + ILD ± myositis or arthritis = Anti-synthetase Syndrome

#RheumatDocX #rheumatology #MedTwitter #rheumTwitter @IhabFathiSulima @DrAkhilX @CelestinoGutirr

[Aravind Palraj @Rheumat_Aravind]

ANCA Patterns — Simplified 🔬
• c-ANCA → Cytoplasmic glow → PR3 → Granulomatosis with polyangiitis (GPA)
• p-ANCA → Perinuclear halo → MPO → MPA, EGPA, autoimmune liver disease
• Atypical ANCA → Patchy fluorescence → IBD, autoimmune hepatitis, infections, drugs

👉 Always confirm with PR3/MPO ELISA + clinical context.
@DrAkhilX @IhabFathiSulima
#Rheumatology #Vasculitis #LabMedicine #MedEd #MedTwitter

[S.Enf.Infecciosas HRUM @infeccHRUmalaga]

En #RMDOpen REVISION🙇🏻‍♀️📚 #Fármacos #Inmunomodulares en #EnfReumatológicas y #Autoinmunes (BIOLOGICOS, INMUNOSUPRESORES…) riesgo INFECCIÓN GENERAL🤒(bacterias🧫, virus🦠hongos🍄) y ESPECÍFICA (Asperg,CMV,TBC, pneumocystis,listeria…)
Tablas muy útiles!
🔗🆓https://t.co/0wDxQop4Rm

[Autoinmunes Medicina Interna Parc Taulí @autoinMI_tauli]

ERS/EULAR clinical practice guidelines for connective tissue diseases associated interstitial lung disease

⏩Early screening: HRCT recommended in SSc, MCTD & high-risk IIM; RA & Sjögren with risk factors.
⏩Close monitoring:
⏩Tailored treatment

https://t.co/imHNb3X330

[Dr Nilesh Nolkha @nileshnolkha]

🧵 ANA Testing in Rheumatology — Masterclass for Doctors & MedTwitter

1/ 📢 What’s ANA?
ANA = Anti-Nuclear Antibodies.
It’s a surrogate marker for >50 nuclear antigens (Ro, Sm, dsDNA, La, Scl-70, etc).
✅ Can be positive in many CTDs
❌ Positive ≠ disease
❌ Negative ≠ rule out all CTDs.

[Raül Jordà @raaulasoo]

Great work 🤜🤛
@sergioprietoglz

[Autoinmunes-Clínic @MAS_Clinic]

A man with fever, retinal artery occlusion, atrioventricular block and bilateral renal masses

What is the diagnosis?

⁦⁦@raaulasoo⁩ @RadiologiaBcn⁩
⁦@sergioprietoglz⁩
https://t.co/JN6INWGnxg

[Autoinmunes-Clínic @MAS_Clinic]

Aspectos controvertidos en el #síndromedebehçet
@gerardespinosa5 @hospitalclinic
Medicina Clínica @ElsevierConnect
Acceso al artículo disponible hasta el 22 de agosto👇👇
https://t.co/w1JmgG2u0i

[Autoinmunes-Clínic @MAS_Clinic]

De lectura y análisis obligado a la espera del artículo original
Recomendaciones ACR 2025 de manejo de #LES
https://t.co/H17UKYR1Vq

[Laurent ARNAUD @Lupusreference]

🚨🚨🚨 AHHH we have just been granted a 🔓 FREE 50-DAY ACCESS LINK to the expert #consensus on the therapeutic management of RARE systemic #lupus erythematosus manifestations
Can you please re-tweet the link so that a MAXIMUM have access for free 🔄 LINK: https://t.co/wNrq1i2Cms

[gerard espinosa @gerardespinosa5]

Enfermedad de Behçet
Revisión de aspectos controvertidos en @MedClinBarc @ElsevierConnect
Artículo en abierto hasta el 4 de julio
https://t.co/sOL2qCMndh

[S.Enf.Infecciosas HRUM @infeccHRUmalaga]

Sesión @ESCMID 2025 con “Lo MEJOR del AÑO”👌🏻🗓️de @YoavKeynan 🇨🇦 y #ElisaCordero🇪🇸os dejamos los 20 artículos seleccionados y links (algunos🆓)👇🏻sigue🧵para conocerlos!
1️⃣ Tratamiento exclusivamente ORAL en neumonía de la comunidad hospitalizada💊🏥🫁
🔗🆓 https://t.co/N8p14FOdIr

[Arturo Renú @RenuArturo]

We must change not just habits, but the passive mindset around brain health!!

🧠 Medical prescription: Endurance exercice

The Lancet https://t.co/eG5oX7q7bh

[Gabriel Puche, MD/PhD @gabi_puchepalao]

CASOS CLÍNICOS 🔥TROMBOCITOPENIA INDUCIDA POR HEPARINA

1️⃣ ¿Qué es la HIT?

✔️Reacción adversa grave al uso heparina.
✔️Causa caída brusca de plaquetas (>50%) o trombosis.
✔️Riesgo: 0,5-1% HNF; 0,1-0,5% HBPM.

⚠️ ¡Altamente protrombótico!

#5FOROETV @asemeve @SyHmedical
👨‍🏫