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14. Immunologic rheumatic disorders.

Richard D Brasington1, Leslie E Kahl, Prabha Ranganathan

  • 1Washington University School of Medicine, 660 South Euclid Avenue, St Louis, MO 63110, USA.

The Journal of Allergy and Clinical Immunology
|February 20, 2003
PubMed
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This review covers diagnosing and managing rheumatic inflammatory diseases like rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Advances in RA treatment, particularly with methotrexate and TNF inhibitors, offer a model for future therapies in other autoimmune conditions.

Area of Science:

  • Rheumatology and Immunology
  • Clinical Medicine

Background:

  • Rheumatic inflammatory diseases, including rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), Sjögren syndrome, scleroderma, and dermatomyositis/polymyositis, present diagnostic challenges for clinicians.
  • Significant treatment advancements have been made, particularly for RA.

Purpose of the Study:

  • To provide clinicians with essential information for diagnosing and initially managing classic rheumatic inflammatory diseases.
  • To highlight the clinical recognition and first-line laboratory testing for these conditions.
  • To discuss the evolving treatment paradigms in rheumatology, using RA as a model.

Main Methods:

  • Review of clinical recognition features of RA, SLE, Sjögren syndrome, scleroderma, and dermatomyositis/polymyositis.
  • Emphasis on first-line laboratory diagnostic testing.

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  • Discussion of current and emerging therapeutic strategies, focusing on RA.

    • Main Results:

    • Rheumatoid arthritis (RA) treatment has been revolutionized by methotrexate and tumor necrosis factor (TNF) inhibitors, leading to improved outcomes.
    • The goal of RA treatment is early and complete remission to prevent joint destruction.
    • RA serves as a model for identifying and blocking major mediators in other autoimmune diseases like SLE and Sjögren syndrome.

    Conclusions:

    • Effective management of rheumatic diseases relies on accurate diagnosis and timely intervention.
    • Targeting specific mediators in pathogenesis, as demonstrated in RA, holds promise for developing novel therapies for SLE, Sjögren syndrome, and other autoimmune conditions.
    • The paradigm shift towards early remission and targeted therapies is transforming rheumatologic care.