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Emergencies in rheumatology.

Ashok Kumar1, V Marwaha, Rahul Grover

  • 1Clinical Immunology and Rheumatology Service, Department of Medicine, All India Institute of Medical Sciences, New Delhi 110029.

Journal of the Indian Medical Association
|June 1, 2004
PubMed
Summary

Rheumatological conditions can manifest as critical emergencies, affecting joints, organs, and the nervous system. Prompt recognition and management, including critical care and immunosuppression, are vital for patient outcomes.

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Area of Science:

  • Rheumatology
  • Emergency Medicine
  • Critical Care

Background:

  • Rheumatological conditions can present as medical emergencies, arising from disease processes or iatrogenic causes.
  • These emergencies span multiple organ systems, including articular, gastrointestinal, respiratory, renal, neurological, and cardiac systems.

Purpose of the Study:

  • To review and highlight the spectrum of rheumatological emergencies.
  • To emphasize the importance of timely diagnosis and appropriate management strategies for these critical conditions.

Main Methods:

  • Literature review of rheumatological emergencies.
  • Categorization of emergencies by affected organ system.
  • Discussion of key management principles.

Main Results:

  • Articular emergencies include septic arthritis and polyarthritis.
  • Gastrointestinal emergencies involve bleeding and perforation from polyarteritis nodosa.
  • Respiratory emergencies encompass ARDS and ventilatory failure in conditions like lupus and polymyositis.
  • Renal emergencies include scleroderma renal crisis and rapidly progressive renal failure in vasculitis.
  • Neurological complications include CVA, seizures, and psychosis.
  • Cardiac emergencies involve tamponade and myocarditis.
  • Ocular complications affect vision in diseases like Behcet's.
  • Catastrophic antiphospholipid syndrome represents a severe thrombotic emergency.

Conclusions:

  • Effective management requires critical care, immunosuppression, and drug withdrawal when necessary.
  • Specific treatments like anticoagulants are crucial for antiphospholipid syndrome.
  • A comprehensive understanding of these rheumatological emergencies is essential for optimal patient care.

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