[Uncertainties and the physician's responsibility in immunopathologic conditions]

Detailed clinical investigations and research revealed that immunopathological conditions are preceded by periods of varying length associated with different non-specific symptoms, sometimes also deviations in the basic and immunological laboratory examination. The progression of these symptoms can finally develop into some nosological unit of autoimmune disease. This prodromal stage is the period when irreversible damage of tissues did not yet occur and the vicious circle of the immunopathological process did not yet develop. This period is the moment when immunosuppressive treatment can prove effective. This approach is, no doubt, courageous if the patient does not meet all criteria of the pathological unit, but it is the only effective approach. Treatment started in a later stage of the disease is only a palliative approach which inhibits and retards for a certain time the manifestations of the process which is essentially incurable.