Rheumatology   

Is there a target IgG level to aim for? What should hematologists be aware of in monitoring these patients?

Labs with normal PT, but prolonged PTT (47 sec, ULN 40 sec) that does not correct on immediate mix. Lupus anticoagulant negative (DRVVT and hexagonal ...

Is there utility when classic inflammatory markers (ESR,CRP) or disease specific markers (C3, C4, dsDNA) do not correlate with patients disease activi...

Is a BM biopsy a must when there is skin involvement? If tryptase level is mildly elevated but less than 20 would you recommend a BM biopsy?

There was a recall on viscous lidocaine and many of our patients cannot find it. What would you recommend as alternatives?

How should IVIG and either biologic injections or infusions be spaced?

How is this entity distinct from other secondary HLH entities? 

For example, a patient with a bone marrow biopsy that shows normocellular bone marrow. Prior management with leflunomide and HCQ with neutropenia attr...

Although testing was not indicated, what do u do with these results? Other hypercoagulability work up negative

Would the answer differ if the index event was arterial vs venous? 

Do you just use antibiotic prophylaxis if therapy is started prior to meningococcal vaccination?

I.e., what constitutes well-controlled cancer, IBD, nephrotic syndrome, etc. What other diseases do you put in this category (obesity, autoimmune dise...

(e.g. beta 2 glycoprotein IgM > 20 but <40)

How would the approach differ if the patient had a significant bleeding phenotype vs only minor bruising and mucosal bleeding?

This type of etoposide sparing therapy has been previously described in a case series at https://pubmed.ncbi.nlm.nih.gov/32725881/

If so, how long after diagnosis do you do so? 

Does treatment with B-cell depletion and/or negative anti-spike antibody status despite COVID mRNA vaccination influence your decision?

e.g. DITP from eptifibatide after a cardiac intervention

What if the patient is triple-positive or has continued seropositivity on repeat lab testing? What is the appropriate interval of monitoring and does ...

There are multiple difficulties that could be seen: steroids can precipitate a sickle cell crisis, vasculitis and sickle cell can produce similar clin...

Do you follow the 2019 EULAR Guidelines that SLE patients with asymptomatic, positive aPL should be on low-dose ASA?

Especially in a triple-positive patient with an acute ischemic stroke who may have urgency for anticoagulation with high bleeding risk and severe thro...

What if this was "triple-negative" antiphospholipid syndrome?

Acknowledging that there is no time for good trials yet in this setting