Hematology

General Rheumatology

Questions discussed in this category

For patients with VEXAS syndrome and good response to azacitidine, what duration of therapy do you consider?

How do you decide to trial a patient off treatment? When do you consider spacing therapy and at what frequency?

Do you routinely consider FDG PET/CT imaging for workup of fever of unknown origin?

Would you use the pneumococcal conjugate-21 vaccine (Capvaxive) instead of the conjugate-20 (Prevnar-20) for routine vaccinations in immunosuppressed patients?

2 Answers available

How do you counsel patients who experience diarrhea from mycophenolate mofetil (Cellcept)?

Do you generally recommend anti-diarrheals, dietary modifications, or consider this an unacceptable side effect and move to other therapies?

2 Answers available

Is it necessary to prescribe a steroid taper after two weeks of high-dose prednisone (60 mg daily)?

4 Answers available

For patients with SLE, is there an ANC level for which you would hold or adjust hydroxychloroquine in an asymptomatic patient?

UpToDate recommends Hydroxychloroquine for all SLE patients, but neutropenia is sometimes ascribed to HCQ rather than the underlying disease. What lev...

2 Answers available

How would you approach management of a patient with ESRD on the transplant list who is found to have high titer APS labs (ACL, B2GP1, LAC)?

1 Answer available

When would you consider using G-CSF in patients with rheumatic disease who have received cyclophosphamide?

2 Answers available

Do you perform genetic testing when patients have persistent hypogammaglobulinemia after rituximab therapy?

2 Answers available

What is your approach to DVT prophylaxis in patients who require IVIG but are at increased risk for thrombotic events?

E.g., a patient with newly diagnosed CIDP who is wheelchair-bound.

2 Answers available

How are you utilizing vibratory devices for reducing pain associated with injection or procedures?

In which situations or patient populations do you find this useful? How is it sterilized?

3 Answers available

How do you utilize cytokine panels in your clinical practice?

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

1 Answer available

How do you approach evaluation for underlying rheumatologic disease in patients with chronic asymptomatic thrombocytopenia?

Thrombocytopenia is moderate (80-100,000 microL). No concomitant cytopenias present.

2 Answers available

Do you utilize post-vaccination IgG titers to detect common variable immunodeficiency in patients who are about to start or are actively on B cell depleting therapy?

2 Answers available

What is your approach to evaluation in patients who present with erythromelalgia?

1 Answer available

How would approach the management of a patient with significantly positive anticardiolopin and beta 2 glycoprotein antibodies in the absence of any clotting (including obstetric) history but with significant thrombocytopenia (but no other features of active connective tissue disease)?

1 Answer available

How do you approach evaluation and management of arthralgia in a patient after CAR-T cell therapy?

1 Answer available

What is your approach to management of chronic neutropenia in a patient with Sjogren’s who was recently diagnosed with metastatic endometrial cancer and plans to start chemotherapy?

ANC <500

1 Answer available

How do you approach dosing of anakinra in MAS?

1 Answer available

What is your approach to evaluating a patient with known rheumatologic disease and elevated free kappa:lambda ratio, but no evidence of monoclonal immunoglobulins?

1 Answer available

What would be the main indications for opting for biosimilars over an original biologic, outside of insurance barriers?

Are there any instances where you would prefer a biosimilar rather than the reference product?

2 Answers available

How do you approach the workup for a patient with persistently elevated inflammatory markers (CRP and ESR) whose history and exam do not point to a clear cause?

4 Answers available

How do you manage a patient with progressive cerebellar ataxia and positive cardiolipin antibodies?

Do you wait 12 weeks for confirmation to begin treatment if patient is declining?

1 Answer available

Do you typically see peripheral neuropathy in patients with castleman syndrome?

2 Answers available

Is rituximab for refractory ITP contraindicated in the setting of an active COVID infection, particularly in a patient with asymptomatic COVID?

2 Answers available

How do you interpret elevations in ESR and CRP in the setting of increased BMI?

4 Answers available

Do you discontinue or adjust azathioprine when a patient develops elevated MCV after starting it?

When it seems fairly certain that this is a drug effect is it something that can just be monitored or requires a change in approach?

2 Answers available

What is the appropriate management of arthralgias associated with bosutinib?

1 Answer available

Do you recommend continuous antibiotic prophylaxis for patients on complement inhibitors such as eculizumab?

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

3 Answers available

When considering the use of DOACs in APLS, does the number of positive APLS antibodies influence your decision?

2 Answers available

In patients who develop a VTE, what conditions do you consider as persistent, provoking risk factors, and at what point are they controlled enough to stop anticoagulation?

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

1 Answer available

Do you recommend routine use of Evusheld for pre-exposure prophylaxis for patients on immunosuppression?

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

1 Answer available

How do you handle hypogammaglobulinemia detected in patients prior to maintenance rituximab infusion?

2 Answers available