Rheumatology

Vascular Neurology

Questions discussed in this category

How would you approach the upfront management of a patient with acute unilateral vision loss with strong clinical risk factors for both cardioembolic stroke and GCA if an expedited MRI is not possible due to the presence of an AICD?

2 Answers available

Would you consider using DOACs as a bridge to warfarin instead of heparin or LMWH?

For example, would you consider this method in an ESRD/HD patient with antiphospholipid syndrome who had a major bleed requiring reversal of warfarin ...

4 Answers available

Can anti-cardiolipin or anti-beta-2 glycoprotein antibodies cause prolonged PTT in the absence of a lupus anticoagulant?

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 ...

1 Answer available

Would you discontinue romosozumab in a patient who develops a hemorrhagic stroke while on therapy?

5 Answers available

When is brain biopsy useful/warranted as part of the diagnostic work-up in patients with suspected primary CNS angiitis?

3 Answers available

In antiphospholipid syndrome with recurrent strokes, would you consider adding antiplatelets to warfarin?

Also how would you manage this perioperatively?

7 Answers available

Would you start anticoagulation in a patient with a history of CVA 1 year ago and high risk APL profile who was never started on anticoagulation, but is now presenting for follow up and without recurrent thrombotic events?

The patient has no known history of autoimmune disease.

4 Answers available

What is your steroid-sparing agent of choice to treat GCA given the current tocilizumab shortage?

Thoughts on sarilumab vs methotrexate, or just treat with steroids alone

1 Answer available

Papers discussed in this category

N Engl J Med,

Trial of Tocilizumab in Giant-Cell Arteritis.

Lancet, 2016 Mar 04

Tocilizumab for induction and maintenance of remission in giant cell arteritis: a phase 2, randomised, double-blind, placebo-controlled trial.

Arthritis Rheum,

Adjunctive methotrexate for treatment of giant cell arteritis: an individual patient data meta-analysis.

Neurology, 2019 Jan 11

RCVS score and diagnostic approach for reversible cerebral vasoconstriction syndrome.

Arthritis and rheumatism, 2007-07

Aspirin for primary thrombosis prevention in the antiphospholipid syndrome: a randomized, double-blind, placebo-controlled trial in asymptomatic antiphospholipid antibody-positive individuals.

Stroke, 2014-07

Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association.

Cochrane Database Syst Rev, 2020 Oct 12

Antiplatelet and anticoagulant agents for secondary prevention of stroke and other thromboembolic events in people with antiphospholipid syndrome.

Archives of internal medicine, 1997-10-13

A retrospective review of 61 patients with antiphospholipid syndrome. Analysis of factors influencing recurrent thrombosis.

Lupus, 2011-02

Evidence-based recommendations for the prevention and long-term management of thrombosis in antiphospholipid antibody-positive patients: report of a task force at the 13th International Congress on antiphospholipid antibodies.

Annals of the rheumatic diseases, 2019-10

EULAR recommendations for the management of antiphospholipid syndrome in adults.

,

Diagnosis and Management of the Antiphospholipid Syndrome.

Lupus,

16th International Congress on Antiphospholipid Antibodies Task Force Report on Antiphospholipid Syndrome Treatment Trends.

Stroke, 2021 May 24

2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association/American Stroke Association.

J Autoimmun, 2018 Feb 13

The treatment of anti-phospholipid syndrome: A comprehensive clinical approach.

Int J Med Sci, 2009 Dec 05

Comparison between single antiplatelet therapy and combination of antiplatelet and anticoagulation therapy for secondary prevention in ischemic stroke patients with antiphospholipid syndrome.

British journal of haematology, 2024 Sep 02

Measurement of heparin, direct oral anti-coagulants and other non-coumarin anti-coagulants and their effects on haemostasis assays: A British Society for Haematology Guideline.

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