Dr Azmad Kareem Anwardeen, an internal medicine specialist and rheumatology fellow at Hospital Putrajaya, received the top award in the Thieves Market Competition for his case titled “The Tale of the Silent Guard and the Ceramic Core”.

It centres on a 25-year-old patient whose immune system was not overactive but completely missing, leading to repeated infections and a condition known as “porcelain aorta”, a hardening of the artery.

“The idea that the absence of immunity – not its excess – could cause inflammation stunned many,” he told Bernama.

Azmad’s presentation on Oct 26 captivated the judges and audience with its blend of clinical reasoning and narrative clarity, highlighting how the absence of immunity can be as dangerous as an overactive immune system.

With more than 200 submissions from around the world, only four finalists were selected for a live presentation at the Thieves Market. Azmad’s case secured an overwhelming 75% of audience votes.

The ACR Convergence, attended by more than 13,000 delegates from over 100 countries, is recognised as the world’s largest and most prestigious rheumatology meeting, bringing together clinicians, researchers and educators to share advances in autoimmune and musculoskeletal disease care.

Azmad, who is undergoing rheumatology training at King’s College Hospital in London, said the award represents not only a personal achievement but also a proud moment for Malaysia in global medicine.

“I never expected to stand on that stage, representing Malaysia. This win is not just mine – it belongs to my consultants, my team, and every patient who trusted us with their story,” he said.