USA Health residents present rare rheumatology cases at national conference

By Michelle Ryan-Day
[email protected]

Four internal medicine resident physicians represented USA Health, the academic health system of the University of South Alabama, recently at the Congress of Clinical Rheumatology East 2026, where they presented research and complex clinical case studies highlighting rare autoimmune and rheumatologic diseases.

The team included first-year residents Abina Chapagain, M.D., and Awais Manan, M.D., second-year resident Brandon Boeur, D.O., and third-year resident Ekta Khubchandani, M.D. Together, they contributed multiple presentations that highlighted diagnostic challenges and evolving treatment strategies in rheumatology.

The Congress of Clinical Rheumatology brings together clinicians, researchers, and trainees from across the country to share advances in patient care, research findings, and emerging therapies in autoimmune disease.

The following poster presentations were made:

Boeur presented “An Unusual Case of Negative Anti-dsDNA Lupus Nephritis,” which described a patient with biopsy-confirmed lupus nephritis despite negative anti-dsDNA antibody testing — an uncommon finding that complicated diagnosis. The case emphasized the importance of clinical judgment and kidney biopsy in confirming systemic lupus erythematosus (SLE) when standard laboratory markers are absent, as well as outlining treatment approaches and eventual patient improvement.

Chapagain presented “A Steroid-Refractory Case of Anti-HMGCR Immune-Mediated Necrotizing Myopathy,” describing a rare autoimmune muscle disease that causes progressive weakness and severe muscle damage, sometimes associated with prior statin exposure. In this case, the patient did not respond adequately to steroids alone, requiring escalation to therapies such as IVIG and immunosuppressive agents. Her case highlighted the importance of early recognition to prevent long-term disability.

Manan contributed two separate case presentations. One, titled “When Preseptal Cellulitis is not Infection: Systemic Lupus Flare Presenting as Refractory Periorbital Swelling,” described a patient whose lupus flare mimicked an orbital infection, initially failing antibiotic therapy before autoimmune inflammation was correctly identified and treated with immunosuppression.

He also co-presented a poster on systemic lupus erythematosus with atypical vascular involvement, emphasizing how autoimmune disease can masquerade as infection or other inflammatory conditions, requiring careful imaging and diagnostic reassessment.

Khubchandani presented a striking vascular case titled “Behçet’s Disease Presenting with Recurrent Arterial Aneurysms and Deep Vein Thromboses in a Young Adult.” The report detailed a young patient with repeated blood clots and arterial aneurysms affecting multiple vascular territories. It highlighted the diagnostic complexity of Behçet’s disease, which can mimic other vascular and inflammatory disorders, and underscored the role of immunosuppressive therapy and vascular intervention in management.

"This opportunity marks an important milestone in my academic and professional journey, allowing me to share my work, learn from leading experts, and engage with peers in the field,” Chapagain said. “I am deeply grateful to USA Health for their continued support, guidance, and encouragement in making this achievement possible."

Manan echoed the gratitude for the experience and the support of USA Health.

“It was an amazing experience being around people who are genuinely pushing the field forward,” he said. “I learned a lot, met some great minds, and came back even more motivated."

The Congress of Clinical Rheumatology (CCR) provides rheumatologists and rheumatology providers with the latest information, tools, and resources to enhance their knowledge and expand their skills.