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Moving forward, the Romanian Group for #Autoinflammatory Diseases can also be found on #Substack, where we will dedicate our profile to sharing the latest news from the scientific world of autoinflammation (updates from medical conferences, educational materials etc.)
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Alexandru Stieber retweeted
Spinal cord involvement in histiocytic neoplasms is underrecognized, and it's often how the disease first shows up.
With effective MAPK-targeted therapies (BRAF/MEK) available, early diagnosis matters.
In @GreenJournal, we studied 415 patients with ECD, LCH and RDD from the @MayoClinic cohort:
🔹 10% had spinal cord or nerve root involvement
🔹 In 1 of every 2 symptomatic patients, it was the FIRST sign of the disease
🔹 ECD → mainly cord infiltration; RDD → mainly nerve roots or extrinsic compression
🔹 Improvement after treatment: RDD 91%, LCH 67%, ECD only 46%
👉 Think spinal MRI early in patients with neurologic symptoms or high-risk features.
🔗 neurology.org/doi/10.1212/WN…
#NeuroTwitter @Histiocytosis @HistiocyteSoc
Alexandru Stieber retweeted
Pleased to share my first CPS publication!
"Reading Between the Lines" 🕵️♀️
As pulm-crit master clinician Anna Fretz takes us through a case of rapidly-progressive hypoxemia unresponsive to therapies, we integrate "entropy" to showcase uncertainty mgmt. during mgmt. reasoning
Alexandru Stieber retweeted
Clemmensen et al. investigated the heredity of IFN-I #autoantibodies in adults in a large Danish twin cohort of 1,318 twin pairs. Overall, the data do not support a strong familial aggregation, as reflected by a low concordance rate for IFN-I auto-Abs. hubs.la/Q04zMRHg0
Alexandru Stieber retweeted
Clinical reasoning week loading! 🧠
@BIDMC_Medicine
@BIDMC_IM
Alexandru Stieber retweeted
I am excited to share my review article, “Amyloid Neuropathies,” published in @ContinuumAAN. My journey caring for patients with amyloid neuropathies began 14 years ago at the Brazilian Amyloidosis Referral Center at my alma mater, @ufrj. Since moving to @MayoClinic, I’ve continued my clinical work and research in amyloidosis, which has given me a unique perspective on patient care across two very different settings. I’ve aimed to simplify this complex topic, including many clinical pearls and a diagnostic flow chart highlighting key red flags.
I’m also proud to share that @LyellJ selected this article as one of the editor’s picks, making it freely available for the next three months. Don’t miss out—download it now! 😊
continuum.aan.com/doi/pdf/10…
Lastly, I want to say it's such an honor to write for @ContinuumAAN, which was the most important neurology journal throughout my (long) neurology training journey. The opportunity to give back through this review was very meaningful to me.
I hope you all enjoy it!
Alexandru Stieber retweeted
Cranial Neuropathies—Easy to See, Hard to Diagnose hubs.la/Q04yYPBD0
Alexandru Stieber retweeted
The October #PeripheralNerve and Motor Neuron Disorders issue, guest edited by Dr. Noah Kolb, is now available at hubs.la/Q04z2PKs0!
@LyellJ @AANmember #NeuroX #MedEd #Neurology
Alexandru Stieber retweeted
Swamy, @stutangye et al describe an Australian/New Zealand cohort where identification of monogenic #InbornErrorsOfImmunity through next-generation sequencing resulted in management change in 84% of cases incl. guiding #HSCT & initiating targeted treatment hubs.la/Q04yXtjn0
Alexandru Stieber retweeted
Skip the repetitive prompting and jump straight to the results with skills in Gemini.
Skills are saved sets of instructions for specific tasks that you do time and time again. Think of a skill like a shortcut, ready whenever you need it. 🧵
Alexandru Stieber retweeted
🩺 #ClinicalChallenge: A man with suspected but untreated secondary syphilis had nonscarring alopecia, photodistributed facial eruption, oral ulcers, leukopenia, and low C3 level; biopsy of a palmar lesion showed dyskeratotic keratinocytes, basal vacuolar alteration, papillary dermal edema, and perivascular and periappendageal infiltrates of lymphocytes and histiocytes.
📝 What is the diagnosis, and what would you do next?
ja.ma/3TaH6eE
Alexandru Stieber retweeted
Hot take: We neurologists probably don’t biopsy enough for Sjögren’s disease.
SSA/SSB antibodies have imperfect sensitivity, and we’re increasingly recognizing the breadth of neurologic manifestations.
Sjögren’s is also increasingly recognized as a cause of non-length-dependent small-fiber neuropathy, which is always in my head when a patient presents with facial numbness.
A minor salivary gland biopsy showing focal lymphocytic sialadenitis and other supportive features can be really helpful in giving patients an explanation for symptoms that may have otherwise been difficult to contextualize.
And maybe, in some cases, helping them feel a little less dismissed.
Alexandru Stieber retweeted
⭐️ What is the most likely diagnosis in this 65 yr old male presenting with painless progressive left eye vision loss? 👁️ 🧠
#Ophthalmology #Radres #futureradres #medicine #Neurosurgery #ENT #Neurology #MRI #FOAMed
Alexandru Stieber retweeted
1/2
THE LOST ART OF THE CLINICAL NOTE
Copying and pasting pages of imaging reports into a clinical note doesn’t make the note more thorough. It makes it harder to read.
The art of note writing is deciding what matters, synthesizing it, and telling the reader why it matters.
Alexandru Stieber retweeted
The best part of this prompt is "explain what's controversial". A tool that only tells you the consensus is a textbook. OpenEvidence can tell you where the field disagrees, and knowing that can change how you practice.
A prompt I’ve been using to stay up to date:
“Act as a [insert topic] expert. Identify the most important new evidence from the last 12 months, prioritize practice changing trials, guidelines and high-quality studies, and explain what is genuinely new, what is controversial, and what should influence current clinical practice.”
Staying up to date is harder than ever because of the amount of literature being published.
But with new tools, it’s also becoming easier than ever.
I’ve been using this prompt with @OpenEvidence and was surprised by how well it can work.
Of course, this doesn’t replace reading the original papers and it’s not medical advice. But I’ve found it a helpful guide to what’s worth reading and where the important debates are.
I imagine this prompt will need to evolve and change.
What’s the most useful prompt you’re using right now?
Alexandru Stieber retweeted
The “Kiss Swan” Sign: An MRI Clue to Adult Leukodystrophies hubs.la/Q04xMy-q0
Alexandru Stieber retweeted
Skin biopsy in adult-onset Still’s disease: A specific, rapid, and widely available diagnostic test rupress.org/jhi/article/2/6/…
Alexandru Stieber retweeted
Neurology in 2026 retains the same core clinical reasoning as it did fifty years ago. The neurological examination remains the most vital component of the evaluation. While trainees may get distracted by advanced MRIs, new antibodies, and podcasts, mastery of neurology must be learned at the bedside. What differentiates a Neurologist from an internist is the ability to perform a neurological examination. Without it, one cannot localize the problem, define the syndrome, or provide effective care for neurological patients. We must reinforce the fundamentals of neurology for the new generation. No matter how many tests are available, the basics are the same.
Alexandru Stieber retweeted
📷Image
Connaissez-vous le rein mastic ?
Un aspect radiographique caractéristique associé à une pathologie… Saurez-vous laquelle ?
La réponse et les explications dans cet article :
sciencedirect.com/science/ar…
Alexandru Stieber retweeted
SPLENIC INFARCTION
A splenic infarct tells you what happened.
It does not tell you why.
Embolism?
In-situ thrombosis?
APS or MPN?
Sickling?
Babesiosis or malaria?
Venous outflow obstruction?
Alexandru Stieber retweeted
Excellent paper & must read article on
Autoimmune encephalitis misdiagnosis in adults..
Look for etiologies: infections, metabolic, neurodegenerative, neoplastic, vasculitis etc causes
@Mayo_AING
@EoinFlanagan14
@Div_Dubey
@JAMANeuro
doi:10.1001/jamaneurol.2022.4251



































