Immunologic rheumatic disorders

Amy Joseph, Richard Brasington, Leslie Kahl, Prabha Ranganathan, Tammy P. Cheng, John Atkinson

Research output: Contribution to journalArticle

57 Scopus citations

Abstract

We provide the basics for clinicians who might be called on to consider the diagnosis of diseases such as systemic lupus erythematosus (SLE) or rheumatoid arthritis (RA) in their practice. We will emphasize clinical recognition and first-line laboratory testing. Only characteristics of the classic rheumatic inflammatory diseases (ie, RA, seronegative spondyloarthropathy, SLE, antiphospholipid syndrome, Sjögren syndrome, scleroderma, and polymyositis/dermatomyositis) will be covered. In the past decade, treatment for RA and seronegative spondyloarthropathy has substantially improved. Their treatment has been revolutionized by the use of methotrexate and, more recently, TNF inhibitors, T-cell costimulation modulators, and B-cell depletion. The goal of RA treatment today is to induce a complete remission as early as possible in the disease process, with the mantra being "elimination of synovitis equals elimination of joint destruction." The hope is that if the major mediators of Sjögren syndrome, SLE, or scleroderma can be identified and then blocked, as in the example of TNF inhibitors in patients with RA, more specific treatments will become available. Thus RA has become an excellent model of this evolving paradigm. Through the identification of major mediators in its pathogenesis, novel and highly efficacious therapeutic agents have been developed.

Original languageEnglish (US)
Pages (from-to)S204-S215
JournalJournal of Allergy and Clinical Immunology
Volume125
Issue number2 SUPPL. 2
DOIs
StatePublished - Feb 1 2010

    Fingerprint

Keywords

  • Rheumatoid arthritis
  • Sjögren syndrome
  • antiphospholipid syndrome
  • dermatomyositis, and inclusion-body myositis
  • juvenile rheumatoid arthritis
  • scleroderma polymyositis
  • seronegative spondyloarthritis
  • systemic lupus erythematosus

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Joseph, A., Brasington, R., Kahl, L., Ranganathan, P., Cheng, T. P., & Atkinson, J. (2010). Immunologic rheumatic disorders. Journal of Allergy and Clinical Immunology, 125(2 SUPPL. 2), S204-S215. https://doi.org/10.1016/j.jaci.2009.10.067