Other extrapulmonary manifestations of #sarcoidosis #ACR25 🔹Renal (≈7%) ➡️ Granulomatous interstitial nephritis or nephrocalcinosis 🔹Ocular (30–50%) ➡️ Uveitis, often the initial manifestation 🔹Cutaneous (25-30%) ➡️ Papules, plaques, lupus pernio, erythema nodosum

🩸 Scleroderma Renal Crisis (SRC) A medical emergency that can herald the onset of systemic sclerosis - sometimes even before skin changes appear! ⚠️ Key risks: •Early diffuse SSc •Anti-RNA polymerase III (+) •Corticosteroids >15 mg/day 📊 Prevalence: 12–20% #Rheumatology

🧠 Neurosarcoidosis — a true neuroimmunology puzzle. From cranial neuropathies to spinal cord & small fiber involvement — it can mimic almost anything. 📊 Cranial neuropathy: 50–75% Parenchymal disease: up to 50% Peripheral neuropathy: up to 86% #ACR25 #Rheumatology

ACR25: Orofacial SSc — The Neglected Frontier 🦷 Andrew Leask, Univ. of Saskatchewan 🔹 80% SSc → orofacial fibrosis, microstomia, xerostomia, ↓ QoL. 🔹 Findings: Widened PDL, tooth loss, xerostomia, mask-like face, ↓ mouth opening (esp. dcSSc). 🔹 Biomarkers: ↑ IL-6, MMP-9,

#ACR25: Dental Care in Systemic Sclerosis 🦷 🔹 Microstomia: Lip balm, gentle handling, breaks, measure opening. 🔹 Sclerodactyly: Electric / thick-handled brushes, molded grips. 🔹 Xerostomia: High-fluoride paste, saliva substitutes, frequent water, fluoride varnish. 🔹

U.S. FDA rheumatology approvals, 2025 #ACR25 Dr. John Cush

💡 When lupus meets minimal change disease… think Lupus Podocytopathy 🧬 Nephrotic-range proteinuria 🔬 Normal LM, negative IF 🧠 EM: podocyte foot process effacement 🎯 Steroid-sensitive but relapsing — CNI or Rituximab if recurrent #LupusNephritis #Rheumatology #Nephrology

🧠 #ACR25 Immunology Bootcamp I (Part 1): The Immune System Basics – Dr. Troy Torgerson •🧩 4 Core Compartments: Complement 🧬 | Phagocytes 🧫 | B cells 💉 | T cells ⚔️ → Innate + Adaptive arms in perfect coordination. •⚙️ Immune Activation: 1️⃣ Proliferation 2️⃣ Cytokines &

Hydroxychloroquine in SLE is all about the sweet spot. Not too hot with retinopathy, not too cold with flares, just right by the levels. Yet drug concentrations and TDM are not commonplace in many places - time for change Laura Coates in the #ACR25 meeting review Dr. John Cush

Juvenile Dermatomyositis (JDM) 💪 | #ACR25 Highlights •🧠 CMAS = Core tool to assess muscle strength & function; score >48 = no disability. •🧍‍♀️ Exercise is therapy! Safe & beneficial across all stages – improves strength, ROM & endurance. •⚡ Treadmill + resistance training →

Decoding Dermatomyositis Skin 🧬🔥 | ACR25 Insights •DM skin = Type I IFN storm 💥 + mitochondrial chaos ⚡ •Macrophages → STING on! → drive inflammation 🚨 •DM ≠ CLE: both IFN-driven, but DM = IFNβ + IL-18 + vascular stress 🩸 •Senescent endothelium + toxic JAK1+

👉NOMID is an autoimflammatory disease of childhood ⚡Fever, urticarial rash, joint pain in a young child is a clue ✅Imaging - bony overgrowth and premature ossification 🧬Dx - whole exome sequence NLRP3 mutation . ✊✊Best overall image from NIMS ,Hyd #ACR2025 #ACRambassador

HCQ monitoring in SLE ✊ 👉👉1842 patients data (SLICC & other cohorts) ✖️4.4% had toxicity , mostly retinal 💊HCQ < 750ng/ml -40%increase flare 💊💊HCQ > 1150-two fold high toxicity HCQ< 5mg/kg/d -52% subtherapeutic , 18%super therapeutic. #ACR2025 #plenary session

Hydroxychloroquine levels monitoring in #SLE 1842 pts - 4.4% had mostly retinal toxicity Levels < 750:40% ⬆️ in Flare Levels > 1150: 2 fold ⬆️ in Toxicity <5mg/kg 52% Subtherapeutic, 18% SUPER! Think Its time to incorporate HCQ levels in our practice 🧪 #ACR2025 [Laura Cootes]

🔥 Panniculitis — The Skin’s Alarm for Autoinflammation! (Borges & Silva, 2024) •🧬 Not just fat inflammation — it’s a cardinal sign of autoinflammatory diseases (AIDs). •💥 Seen in: •CANDLE / Nakajo–Nishimura / JMP / Otulipenia / PRAAS / POMP-related AID 🧫 •Familial

📝 Clinical Pearl: 🧪 ENA can only be positive in ANA negative pts if RO ab positive [Otherwise if ENA pos its likely a false pos +] 🧪 Ribosomal P abs can also be positive in ANA Neg pts [Cytoplasmic] Janet Pope #ACR25 #MedTwitter #Rheumatology

Thanks for sharing this Lupus Nephritis case refractory to treatment 🚩 Always consider other aetiologies when your patient does not respond including an APS Nephropathy 🚩Consider Repeat Renal Biopsy

#ACR25 Pearls in Drug Management of Rheumatic Diseases — Cecilia P Chung MD MPH #1 Pleiotropism = Power 🔁 •Leverage “side benefits” of drugs: • Losartan → lowers uric acid & BP (J Hypertens 2001) • SGLT2 inhibitors → ↓ gout risk (JAMA Intern Med 2024) • Statins →

🧬 Some autoantibodies are harmless alone — but when they pair up, they redefine the disease. These are the autoantibody pairs you must never miss. #RheumRounds #RheumTwitter #Immunology #Rheumatology #ClinicalPearls #Autoimmunity #MedTwitter Dr. Akhil 🇮🇳 Dr Ihab Suliman

#Lupus The ACR25 organ specific treatment guidelines 👇