RheumattDoc (2026)

21/10/2026

🧬 Anti-β2GPI Antibodies: Key Points

Anti-β2-glycoprotein I (anti-β2GPI) antibodies are an important component of the antiphospholipid antibody (aPL) profile in antiphospholipid syndrome (APS).

🔑 Clinical pearls:

1️⃣ Target β2-glycoprotein I, a phospholipid-binding protein.

2️⃣ Both IgG and IgM anti-β2GPI are included in APS classification criteria.

3️⃣ Antibody titres matter: values above the 99th percentile are relevant for classification.

4️⃣ Triple positivity (LA + aCL + anti-β2GPI) indicates a high-risk aPL profile.

5️⃣ IgG positivity is generally more strongly associated with clinical events than isolated IgM positivity.

6️⃣ A positive antibody test alone does not establish APS—correlate with clinical manifestations.

7️⃣ When APS is suspected, assess lupus anticoagulant (LA), anticardiolipin (aCL) IgG/IgM, and anti-β2GPI IgG/IgM.

8️⃣ Interpret results in the context of antibody type, titre, persistence, and the overall clinical picture.

💡 Remember: Risk assessment in APS requires more than a single positive antibody result.

19/10/2026

🧬 Anti-Cardiolipin Antibodies: Beyond a Positive Test

A positive anticardiolipin (aCL) antibody does not automatically mean antiphospholipid syndrome (APS)!

🔑 8 key clinical pearls:

1️⃣ What is aCL? An antiphospholipid antibody associated with APS.

2️⃣ Check both isotypes: IgG and IgM aCL.

3️⃣ Titre matters: Moderate/high titres (≥40 GPL/MPL or above the 99th percentile) are more clinically significant.

4️⃣ IgG vs IgM: Persistent IgG positivity is generally more strongly associated with APS manifestations than isolated IgM.

5️⃣ Antibody profile matters: Lupus anticoagulant, aCL and anti-β2GPI triple positivity indicates a higher-risk profile.

6️⃣ Positive aCL ≠ APS: Consider the clinical history, including thrombosis and pregnancy morbidity.

7️⃣ Test the complete panel: Lupus anticoagulant, aCL IgG/IgM and anti-β2GPI IgG/IgM.

8️⃣ Interpret in context: Consider antibody isotype, titre, persistence, the overall antibody profile and clinical phenotype.

💡 Clinical takeaway: Never diagnose APS based on a single positive aCL result. Clinical context and the complete antiphospholipid antibody profile matter.

16/10/2026

🔍 Malar Rash: Beyond Lupus!

A malar rash is classically associated with systemic lupus erythematosus (SLE), but several conditions can mimic it.

🩺 Key differentials to remember:

🔹 Autoimmune diseases
• SLE – Photosensitive rash sparing the nasolabial folds
• Dermatomyositis – Heliotrope rash, Gottron’s papules; nasolabial sparing is less typical

🔹 Dermatological conditions
• Rosacea – Central facial erythema, telangiectasia, papules and pustules
• Seborrheic dermatitis – Greasy scales involving the nasolabial folds
• Contact dermatitis – Pruritic rash related to exposure
• Photodermatitis – Rash over sun-exposed areas

🔹 Infectious causes
• Erysipelas – Acute, tender, well-demarcated erythema, often with fever
• Parvovirus B19 – Classic “slapped-cheek” appearance, especially in children

💡 Clinical pearl: Nasolabial fold involvement, associated skin findings, photosensitivity, and the acute or chronic course help narrow the differential. No single feature is diagnostic—correlate with the clinical context.

14/10/2026

🦋 Rowell Syndrome: Rare but Important!

Rowell syndrome is a rare condition characterized by lupus erythematosus associated with erythema multiforme (EM)-like targetoid lesions.

🔍 Key features
• Lupus erythematosus (ACLE, SCLE or DLE)
• EM-like target lesions
• Positive ANA
• Minor features described in proposed criteria include chilblains, anti-Ro/SSA or anti-La/SSB antibodies, and rheumatoid factor.

💊 Management
• Photoprotection ☀️
• Antimalarials such as hydroxychloroquine
• Corticosteroids when clinically indicated

🩺 Clinical takeaway: Think of Rowell syndrome when a patient with lupus develops characteristic targetoid skin lesions. Careful clinical assessment is essential, as the diagnostic criteria remain debated and overlap with other conditions.

12/10/2026

🌍 World Arthritis Day | 12 October 🦴

Move better. Live fuller. 💙

Arthritis is more than joint pain. It can affect mobility, independence, and quality of life but early diagnosis and appropriate treatment can make a meaningful difference.

This World Arthritis Day, let’s raise awareness, encourage early consultation, and support everyone living with arthritis.

✨ Stay active.
✨ Seek early care.
✨ Spread awareness.
✨ Break the myths surrounding arthritis.

Healthy joints. Healthy life. Stronger together! 💪

09/10/2026

🧬 HLA-B51: More Than a Genetic Marker

HLA-B51 is the strongest genetic susceptibility factor associated with Behçet’s disease. But does a positive result mean a person has the disease? Not necessarily!

🔹 Genetic susceptibility: HLA-B51 is strongly associated with Behçet’s disease.

🔹 Ocular involvement: Associated with eye involvement and earlier disease onset.

🔹 Not a diagnostic test: Diagnosis relies on characteristic clinical features.

🔹 Present in healthy individuals: Not everyone carrying HLA-B51 develops the disease.

🔹 A negative result does not exclude Behçet’s disease.

💡 Key takeaway: Treat the patient, not the gene. HLA-B51 supports clinical reasoning but never replaces clinical assessment.

07/10/2026

Löfgren Syndrome 🫁🦴

An acute form of sarcoidosis with an excellent prognosis.

🔹 Classic triad
• Erythema nodosum
• Bilateral hilar lymphadenopathy
• Acute ankle arthritis/arthralgia

🔹 Additional features
• Fever & fatigue
• Uveitis
• Elevated ESR/CRP
• Hypercalcemia may occur

🔹 Diagnosis
Often clinical when the classic triad is present. Biopsy may not be required in a typical presentation.

🔹 Treatment
• NSAIDs — first-line for joint pain and fever
• Short-course corticosteroids — for severe symptoms
• Disease-modifying therapy is rarely required

🔹 Prognosis
✨ >80–90% achieve spontaneous remission within 1–2 years.

💡 Key clue:
Bilateral ankle arthritis + erythema nodosum + bilateral hilar lymphadenopathy → Think Löfgren syndrome.

05/10/2026

🦴 Psoriasis isn’t just a skin disease.

Psoriatic arthritis (PsA) can affect the joints, spine, nails and entheses and early recognition matters.

🔹 Joint pain & swelling
🔹 Morning stiffness
🔹 Dactylitis (“sausage digits”)
🔹 Enthesitis, especially heel pain
🔹 Nail pitting / onycholysis
🔹 Inflammatory back pain

💡 Think PsA when psoriasis and musculoskeletal symptoms occur together.

Early diagnosis and treatment can help prevent joint damage, improve quality of life, and control both skin and joint disease.

👉 If you have psoriasis + persistent joint symptoms, don’t ignore them.

03/10/2026

🧬 ANA Profile: Know What the Antibody Means

A positive ANA is not a diagnosis. The next step is to interpret the specific antibody in the right clinical context.

🔹 Anti-Ro (SSA) → Sjögren’s, SLE, subacute cutaneous lupus
🔹 Anti-La (SSB) → Sjögren’s; often with Anti-Ro
🔹 Anti-Sm → Highly specific for SLE
🔹 Anti-U1-RNP → MCTD; also seen in SLE
🔹 Anti-Scl-70 → Systemic sclerosis, especially diffuse disease & ILD
🔹 Anti-centromere → Limited cutaneous systemic sclerosis
🔹 Anti-Jo-1 → Antisynthetase syndrome, myositis & ILD

💡 Remember:

ANA/ENA results should always be interpreted alongside the clinical picture. A positive antibody without compatible clinical features does not automatically mean autoimmune disease.

Treat the patient, not the antibody.

01/10/2026

When should you suspect vasculitis?

Think beyond the ESR/CRP.

Suspect vasculitis when systemic symptoms + unexplained organ involvement are present.

Look for:
• Large-vessel involvement
• Headache/visual symptoms
• Renal involvement
• Pulmonary involvement
• ENT involvement
• Skin involvement
• Neurologic involvement
• Ocular involvement

Remember: ANCA positivity alone does NOT diagnose vasculitis.

Diagnosis requires integrating the clinical pattern + labs + imaging + biopsy when appropriate.

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