What is Rheumatology?

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Rheumatology is a subspecialty of medicine that focuses on the treatment of conditions due to immune system dysfunction. These are referred to as autoimmune diseases.  The immune system is our body’s defense mechanism against infection. Its job is to recognize foreign invaders like bacteria and viruses and stop them from causing disease by making antibodies. In autoimmune disease the immune system wrongly identifies its own body as foreign and creates an attack against itself. This leads to the development of inflammation and damage to different areas of the body. An autoimmune condition can affect one area of the body or many areas. Autoimmune diseases can be difficult to diagnose because the symptoms can be subtle and nonspecific.

The cause of rheumatologic autoimmune disease

The reason person develops an autoimmune disease is unknown.  It is likely a combination of genetic predisposition along with an external trigger, like a viral illness that leads to development of disease. Many autoimmune conditions run in families.

Symptoms of autoimmune disease

People with autoimmune diseases can develop a wide range of symptoms from fever to joint pain. Even individuals with the same diagnosis can be affected very differently. Symptoms can be limited to one organ or multiple organ systems. 

Rheumatolgic autoimmune disease are diagnosed by putting together the clinical symptoms with blood tests.  There are over a hundred different autoimmune conditions. Some conditions include:

- Lupus

- Rheumatoid Arthritis

- Polymyalgia Rheumatica

- Dermatomyositis

- Polymyositis

- Psoriatic Arthritis

- Ankylosis spondylitis

- Vasculitis

- Temporal Arteritis

- Scleroderma

- Crohn’s Disease 

 Diagnosis of autoimmune disease

The diagnosis of an autoimmune disease includes looking at both patient symptoms and blood work. Early in the disease process it can be difficult to obtain the correct diagnosis because the symptoms are subtle and nonspecific. Many symptoms in autoimmune diseases can also be seen in other diseases as well. One of the key features that suggest a process is related to an autoimmune disorder is if symptoms are chronic, relapsing and have been occurring over 6 weeks. Lab tests look for elevated inflammatory markers in the blood as well as specific antibodies that are present in certain autoimmune diseases. It is important to correlate lab tests with symptoms. There are some people who have positive antibodies related to this disease process, but do have any underlying disease.

Treatment of autoimmune disease

Autoimmune conditions are chronic and require longterm treatment with immunosuppressive medications to keep the disease under control. Sometimes a flare up can develop and will require short acting treatment to help control symptoms. There are many different medications that can be used to treat autoimmune diseases and it can be a challenge to find the right one that works best for each patient. It is important to follow up regularly with your physician to monitor symptoms and disease activity by both lab work and physical exam.

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