Donald Thomas, MD
@lupuscyclopedia
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Advocate for #lupus , #Sjogrens , #MCTD , #UCTD patients, sharing empowering, educational information. Tweets are my own 🏳️🌈💜
Greenbelt, MD
Joined October 2013
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All immunosuppressed patients... please be careful. COVID is not over. I have a
#lupus
patient on oxygen from severe COVID last week. DO NOT let your guard down. I still wear my mask in public to protect my patients
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Thanks for recommending the following as well: ALSO:
Wear your mask
Do NOT be nervous to ask those around you to wear their masks
Wash your hands frequently
If you can stand 6 feet away from someone, do so
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📢New study shows that
#SLE
#lupus
patients, especially young, were at high risk of excessive death, kidney failure and dialysis due to COVID-19:
CLICK HERE:
#CovidIsNotOver
I still wear my mask to protect my patients
#LupusAwarenessMonth
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@SarahSchaferMD
Thanks Sarah… you are correct. I tried to get masks mandatory in our office but was outvoted
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Calling all patients with
#Sjogrens
Disease or possible Sjogren's disease:
We need you!
This is one of the most important studies ever done in Sjogren's!
We won't find great treatments unless we understand the disease better.
This NIH-sponsored study…
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More changes in rheumatologic names
Hopefully, NO ONE is saying "Sjogren's Syndrome" anymore, and everyone is on board with
🏜️"Sjogren's Disease"
#Sjogrens
@SjogrensOrg
It is a disease with a well-described pathophysiology
In addition, just saw this today; we should be…
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🔥 It is Lupus Awareness Month starting today
Thanks to
@TrishaReads8
and
@LupusNE
for my Lupus Cure and Lupus Awareness Month bracelets... keep up the wonderful work and advocacy!
-
#Lupus
patients are diagnosed on average 4-6 years after symptom onset due to antiquated labs…
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Another successful SSA+
#lupus
pregnancy! Say hello to Teagan! Born 3 weeks ago. Her mommy was the perfect patient: She saw me monthly, took her Plaquenil, vitamin D, low dose aspirin & used her sunscreen religiously, and got her fetal ultrasounds weekly. HIPAA OK by patient😍
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🔥 The evidence continues to mount that stressful life events increase the risk of developing autoimmune diseases.
This study used data gathered on close to 94,000 women and showed that:
🤕Physical abuse increased the risk of developing rheumatoid…
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🔥Could
#fibromyalgia
be an autoimmune disease?
👉
Before this research study, I would have said, "no."
💡However, now, this study suggests it could be an autoimmune disease. Could this be why so many
#lupus
,
#SLE
,
#Sjogrens
, and
#RA
patients also have…
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This just arrived in my mail today; online version should be available soon:
8 severe
#SLE
#lupus
patients
3
#scleroderma
3 severe
#myositis
(anti-synthetase)
Long-term drug free remissions
Only one severe infection (pneumonia hospitalization)…
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The Lupus Encyclopedia: A Comprehensive Guide for Patients and Health Care Providers, edition 2
⚕️ PATIENTS: Learn all the tips and tricks of doing better with your lupus and understanding this disease. Tons of practical tips. See reviews here (copy and paste the URL in your…
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#Remibrutinib
(an oral highly selective Bruton's tyrosine kinase inhibitor) has had excellent results in its phase-2 clinical trial for treating
#Sjogrens
!
This is impressive! It is difficult to reduce the ESSDAI (a research tool that measures…
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🙏 Thanks to Dr.
@MymaAlbaydaMD
for this Clinical Pearl!
👉
I have an
#SLE
#lupus
patient (early 30 yo female) with what I thought was lupus myositis or polymyositis overlap (proximal muscle weakness, proximal myalgias, high muscle enzymes, +EMG/+MRI…
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🔥This is a fantastic article by
@EricFMorand
@TimothyNiewold
and
@ashira_md
: well written about current
#SLE
#lupus
treatments:
👉HOWEVER, I really love their introduction. Instead of the typical, boring, simplified, and not totally correct intro of…
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Please everyone get your COVID XBB subvariant vaccine... FDA approved today! Yay! If you have
#Lupus
,
#SLE
,
#sjogrens
or immunocompromised in any way, especially get it! Anti-vaxers, just ignore my Tweet (but I would love some of you to change your mindsets)... Donald Thomas, MD
Today, we took action approving & authorizing for emergency use updated COVID-19 vaccines formulated to more closely target currently circulating variants & to provide better protection against serious consequences of COVID. Here’s what you need to know:
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🔥 My poster arrived today that I will display at the
@SLEuroSociety
#SLE
#lupus
meeting in Bruges in March. It came in this tiny package.
I am so happy with it. It is fabric from
@Spoonflower
. It is compact, will fit easily in my carry-on, no huge tubes to carry around, no…
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🔥 Patients taking hydroxychloroquine for lupus should ask their doctors to do a "trough, whole blood hydroxychloroquine drug level" regularly with their other labs.
Rheumatologists, please do your patients a favor and do the same.
This ensures…
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🔥My article discusses reasons why
#SLE
#lupus
and
#Sjogrens
(I used lupus as the reference model) are so hard to diagnose and so hard to follow patients and why it takes 4-6 years on average to get a diagnosis ... we need to fix the system.
👉Click on the image to read my…
The lab tests used to diagnose and treat lupus really haven’t changed much since the 1960s!
Dr. Don Thomas, a clinical rheumatologist and author of The Lupus Encyclopedia, gives his insights in this this important and informative article here!
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🔥Everyone with
#lupus
#SLE
#Sjogrens
#RA
should see this excellent review of the benefits of taking hydroxychloroquine. 45% of our patients are poorly adherent to taking it. This should motivate more people to not miss doses. Thanks
@CBartelsMD
Shivani Garg and authors! Well…
I love this HCQ education tool for
#lupus
by
@CBartelsMD
. Per 100
#lupus
patients taking
#HCQ
,
👉🏾46 will avoid organ damage/8 yrs
👉🏾12 will avoid death/3 yrs
👉🏾25 will avoid blood clots/30 yrs
👉🏾2 will develop eye toxicity/10 yrs. Avoid w/ Screening!
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🔥 Preventing Autoimmune Disease in Family Members:
Did you know that the Harvard VITAL study showed:
👉In those with a family history of autoimmune diseases, vitamin D supplementation was associated with a 57% reduction in autoimmunity
👉In those with a family history of…
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Sjogren's Disease and NOT
@Sjogrens
"syndrome." Dr. Alan Baer, MD (Johns Hopkins Sjogren's Center) &
@SjogrensOrg
makes an excellent argument. Let's stop calling it "syndrome," just like we got rid of "Reiter's" and "Wegener's". Spread the word:
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Just had a nice update on CAR-T therapy in
#SLE
#lupus
by Dr. Georg Schett at
@SLEuroSociety
#lupus2024
Some updates I learned:
- All 8 SLE patients were still in drug-free remission, one close to 3 years
- No reported severe side effects
- Three of the patients required one…
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Could we decrease lupus flares by decreasing bladder wall bacteria adhesion?
Interesting study suggests so...
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💊 How to take
#methotrexate
safely for
#SLE
,
#lupus
,
#Sjogrens
,
#RA
and other systemic inflammatory diseases:
🔥 UPDATED: A recent large study shows that methotrexate does not cause liver problems. The article is fascinating and well-written
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Unfortunately, living with
#lupus
,
#Sjogrens
, and related disorders is living with "an invisible disease"
You look great to friends and family and acquaintances and strangers; but it doesn't show the pain, fatigue, etc. Read
@LupusMore
:
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The NEJM finally released the CD-19 CAR-T cell therapy results in 15 autoimmune disease patients (including
#SLE
and
#lupus
,
#myositis
, and
#scleroderma
) with excellent effectiveness (drug-free remissions) and safety:
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Measure HCQ drug levels regularly in
#SLE
#lupus
. Aim for 1000 - 1200 ng/mL; measure trough levels. HCQ has a 25% to 75% absorption. Dosing only by body weight is ridiculous! Start with 5mg/kg, but then adjust as needed after that!
@talkmedspoke
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🧬🧬 If you have an autoimmune disease like
#lupus
,
#SLE
,
#Sjogrens
or
#RheumatoidArthritis
, understanding the genetic link is crucial.
Genetics can play a major role even if no one else in your family has it. Learn more about this important topic here:
…
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Anti-inflammatory diet pyramid for
#lupus
,
#Sjogrens
and other rheumatic diseases by
@ucsfoshercenter
. Thank you Dr. Sarah Patterson
To learn more about an anti-inflammatory diet go to:
Retweet with everyone who can benefit
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❤️🔥Calling all rheumatologists: please start checking trough whole blood hydroxychloroquine (HCQ) drug levels on
#SLE
#lupus
patients to ensure better adherence and aim for a drug level of 1000 ng/mL - 1200 ng/mL (not an exact science, some say 750 - 1100, some say 1000 - 1500).…
🔥 One of my favorite studies/posters (so many to choose from!) at
@ACRheum
#ACR23
#ACRambassador
:
📍 CLICK HERE:
THEN CLICK THE ACR ABSTRACT LINK UNDER MY FACE TO READ THE ABSTRACT
@ACRheum
and
@eular_org
… please note this for your next SLE…
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🔥 CAR-T Pioneer Dr. Georg Schett in Germany has made Time's Top 100 Health People of the year
That is how important this stuff is for autoimmune diseases like
#SLE
#lupus
#scleroderma
#rheumatoidarthritis
#myositis
Congratulations to Dr. Schett and the many healthcare…
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Physical trauma, emotional trauma, childhood trauma, sexual trauma have been associated with an increased risk of autoimmune diseases like
#Sjogrens
,
#SLE
,
#lupus
CLICK:
@LupusMore
has an excellent review on this topic this month
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What causes fatigue in
#lupus
? The NIH recently discovered that SLE patients have abnormal mitochondria (Energy producing organelles of cells). They also found a treatment that repaired the mitochondria and improved energy. Read more here:
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The video about CAR-T therapy use in
#lupus
,
#SLE
, and other autoimmune diseases produced by
@LupusMore
has been posted:
We discuss:
- Which CAR-T cell therapies could cause CAR-T lymphoma (and should they even be used at all in AI disease patients?)
-…
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💡 Tips to make methotrexate work better (read my post at the link for additional information):
👉Take on an empty stomach
👉Do not take with dairy products
👉Don't ingest caffeine
🔥If not in remission on 15-25 mg weekly, another choice other than SQ…
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Calcinosis cutis is among the most difficult cutaneous problems to treat in
#lupus
,
#SLE
, and dermatomyositis.
I found this case series from
@JohnsHopkins
to be quite interesting with patient case
#1
. The patient's calcinosis cutis responded to…
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Canandia research article shows that taking hydroxychloroquine decreases the risk of death in
#lupus
patients by 83%:
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HISTORY OF LUPUS:
Church built because a bishop was cured of
#lupus
I am in the Basilica of St. Martin, Liège, Belgium = built by Eraclius, Bishop of Liège, in the X Century because St. Martin cured him of lupus (he was dying from lupus, which was consuming his flesh and…
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Tulip fields starting to bloom in Holland…. View from train
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Finally,
@Sjogrens
disease (NOT syndrome) is getting the attention and research it needs; thanks for the summary
@Yuz6Yusof
@ACRheum
#ACR23
#ACRambassador
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❣️ I LOVE the new
@eular_org
#SLE
#lupus
guidelines:
This is how I've been treating my patients & most of my SLE patients are in remission/low dz activity and few are on steroids.
👉 However, they need to recommend checking hydroxychloroquine drug…
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In front of a 15 th century house close to our AirBnB in Bruges Belgium. Beautiful city with preserved Medieval architecture. Eating too much Belgium chocolate, trying to figure out who makes the best
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🔥 FANTASTIC SJOGREN'S MANAGEMENT GUIDELINES - published by the
@RheumatologyUK
NOTE: Before criticizing these too much (of course there will be numerous opinions on what should and should not have been included; we need more, better Sjogren's studies to help us and they had to…
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Have dry eyes or dry mouth? You could have
#Sjogrens
disease
Around 35% of my
#SLE
#lupus
patients have evidence for Sjogren's overlap disease (it is underdiagnosed)
Ask your rheumatologist
Join the Sjogren's Foundation
@LupusMore
@SjogrensOrg
LUPUS BLOG!
Millions suffer from Sjögren’s in the United States, making it one of the most common autoimmune disorders in America.
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🎇A
#lupus
clinical WIN today‼️
❣️Patient quote of the year, "Ben is my new boyfriend". See who "Ben" is below
🧟♀️
#SLE
patient, severe longitudinal myelitis, flares off MMF. Back on MMF+HCQ much better but still moderately active disease. We (me + NIH, thanks
@sarfarazhasni
)…
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🔥
#SLE
#lupusPatients
:
Make sure to know your labs!
Some antibodies predispose you to some possible complications from your SLE and if you know how to prevent them, it is empowering. Ask your rheumatologist.
30% - 50% of SLE patients have antiphospholipid antibodies, like…
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😃I am so happy that our abstract describing the 1st case of
#lupus
#SLE
and correcting the historical facts has been accepted for
#lupus2024
by
@SLEuroSociety
⛪️It is fitting that the 1st case was a Belgian Bishop who built a basilica in Liege, Belgium, because of lupus!
My…
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🔥ATTENTION all health care providers (docs, PAs, NPs, nurses, med students, techs) and PATIENTS ...
PLAY
#RheumMadness
2024!
12 excellent, practical, rheumatologic practice articles are being debated by 12 excellent rheumatology teams from around the…
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Picture of most of the 80
#SLE
#lupus
doctors (rheumatologists, nephrologists, dermatologists) who met in Munich last month for the ADVANCE Meeting (see my other post here):
We had great discussions, learned from each other, and more importantly, went…
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This is such an important thing to know for all
#Lupus
patients. Goes along with studies from Dr. Michelle Petri and Dr. Fasano for
#SLE
patients taking HCQ
Lupus News: A large Canadian study has found that when newly diagnosed patients with SLE take antimalarials (hydroxychloroquine) as prescribed, they have about a 29% lower risk of a cardiovascular event, like strokes or heart attacks!
Link to Details:
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🔥 One of my favorite studies/posters (so many to choose from!) at
@ACRheum
#ACR23
#ACRambassador
:
📍 CLICK HERE:
THEN CLICK THE ACR ABSTRACT LINK UNDER MY FACE TO READ THE ABSTRACT
@ACRheum
and
@eular_org
… please note this for your next SLE…
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10
38
Yesterday was my last day as Chair of the National Board of
@SjogrensOrg
. I hand over the Chair meeting Chimes (instead of a gavel) to our incoming Chair, Susan Barajas. I LOVE her expression... she will do a great job!
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Nice article about
#POTS
and AI dzs like
#Sjogrens
and
#lupus
. It is underdiagnosed. Get a dysautonomia expert & Tilt Table test in your patients who overwhelm you with dizziness, HA, fatigue, GI issues etc. IVIG has helped my pts
@talkmedspoke
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An underappreciated problem in
#lupus
#SLE
#sjogrens
as well . Poor dental health negatively impacts the biofilm microbiome and its impact on the immune system. Good oral care needs to be considered part of AI Dz therapy 💊
🦷 If you're a rheum warrior, don't let your mouth be a battlefield! ⚔️
🦠 Poor oral hygiene can worsen inflammation & pain 😓
🪥Brush like a pro, floss like a boss
🪥See your dentist regularly for a smile that's stronger than any rheumatic disorder! 💪😁
#ACR23
#ACRambassador
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Curbside clinical tip at
@ACRheum
#ACR23
#ACRambassador
from Dr
@MymaAlbaydaMD
: in
#Sjogrens
#lupus
#SLE
pts who have persistent CPK elevation but are otherwise better on tx: think of IBM overlap. PE tips: finger tip flexion weakness & “scooping” of forearm muscles from…
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2022 CDC vaccine guidelines are out; important changes for
#lupus
% other immunosuppressed patients:
- No more Prevnar 13
- Hepatitis B series for ALL aged 19-59
- Shingrix now formally added for immunosuppressed 19-40 yo
Read more information here:
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View from my hotel room in Rochester NY. Here to give a lupus talk
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🔥 Finally, someone (Mother Jones) is calling out the nonsense of these
#SLE
#lupus
#Sjogrens
#autoimmune
cure books that are leading many patients to false hopes:
NOTE: as all my readers know, I am 100% for a healthy diet which may be anti-inflammatory…
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I am counting down the weeks until the printed release and actually feel it in my hands. 6 years' worth of work with worldwide lupus experts on this edition:
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