THE OFFICIAL NEWS SOURCE OF ACR CONVERGENCE 2022 • NOVEMBER 10-14



Experts to offer ‘curbside consults’ for challenging cases

Delamo Bekele, MBBS
Delamo Bekele, MBBS

The Tuesday ACR session Curbside Consults will feature a panel of experts discussing cases that highlight the latest scientific evidence and best practices in the diagnosis, work-up, and management of three challenging conditions managed by rheumatologists: antiphospholipid syndrome, Raynaud’s phenomenon, and autoimmune hearing loss. The session will be held from 4:30 – 6:00 pm, in Room A411-A412.

“As rheumatologists, we are commonly faced with rare and challenging conditions that can prove to be difficult to diagnose and/or manage, especially when there is insufficient data or evidence from clinical trials to guide care,” said Delamo Bekele, MBBS. “In those instances, it may be necessary to seek subspecialist insight for guidance. In this session, we’ve invited three accomplished experts in their respective fields to shed some insights on these conditions that we anticipate will be high yield for all.”

Dr. Bekele, a Fellow in the Division of Rheumatology and Instructor of Medicine at the Mayo Clinic in Rochester, MN, will co-moderate the session with Aruni Jayatilleke, MD, Associate Professor of Medicine at the Lewis Katz School of Medicine at Temple University in Philadelphia.

In the first presentation, Doruk Erkan, MD, Associate Professor of Medicine at Weill Cornell Medical College in New York, will discuss the “art and science” of the diagnosis and management of antiphospholipid syndrome.

“Antiphospholipid syndrome can occur on its own, but often occurs in the presence of lupus and other autoimmune conditions. It can be catastrophic, and we don’t have a whole lot of evidence on how to manage it,” Dr. Jayatilleke said. “Dr. Erkan will talk about how to interpret antiphospholipid antibodies, which are crucial to making the diagnosis, as well as current treatment and management options, including some of the newer oral anticoagulants.”

In the second presentation, Janet Pope, MD, FRCPC, MPH, will describe the evaluation, therapy, and management options for Raynaud’s phenomenon. Dr. Pope is Professor of Medicine at University of Western Ontario and Division Head of Rheumatology at St. Joseph’s Health Care in London, Ontario, Canada.

“Raynaud’s is a very common condition seen in rheumatology practices and by other internists. It is crucial that providers are able to differentiate between primary and secondary Raynaud’s. This is highly relevant given the differences in management, prognostic factors, and outcomes between the two groups,” Dr. Bekele said. “Dr. Pope will review best practices for the investigation and work-up of patients who have Raynaud’s and how to manage patient expectations regarding the benefits of treatment. She will also discuss some of the newer evidence we have regarding the management of Raynaud’s patients, inclusive of digital ulcers, which are rare and serious complications of long-term disease.”

In the final presentation, Gail Ishiyama, MD, Associate Professor of Neurology at the David Geffen School of Medicine at UCLA in Los Angeles, will discuss challenges in the management of patients with autoimmune hearing loss.

“Autoimmune hearing loss, or autoimmune inner ear disease, is a rare condition that rheumatologists need to be aware of, as it often occurs in conjunction with other conditions we see regularly,” Dr. Jayatilleke said. “Dr. Ishiyama will outline the differential diagnosis and evaluation of autoimmune hearing loss and will present a couple of challenging cases to illustrate this often under-recognized condition.”

All of the topics chosen for this session can present a myriad of challenges to clinicians and as result, Dr. Bekele believes that the session provides an invaluable opportunity for meeting attendees to compare their personal experiences and approaches to those of the experts.

“I believe this will be a wonderful forum, especially for medical students, residents and fellows, rheumatologists in practice, advanced practice providers, and other attendees to take away key pearls in the evaluation of these patients.” he said. “Given the case-based nature of the session and choice of speakers, it will be informative, interactive, and highly impactful.”