Rheumatic & Immunologic Diseases

Rheumatic and immunologic diseases are illnesses that are characterized by inflammation as a primary symptom and that appear in people with a compromised immune system. There are literally hundreds of diseases and disorders that fall into this general category, although some of them are so rare that those afflicted may only number in the hundreds. At the other end of the spectrum of rheumatic and immunologic diseases are other ailments that are diagnosed widely around the world.

Considerations

• A few of the diseases that fall under the umbrella of rheumatic and immunologic diseases also appear in people whose immune systems are functioning normally. If, however, their cause can be traced to a suppressed immune system response, those illnesses are generally much more difficult to treat than in other patients.

Expert Insight

• One of America's preeminent centers for the treatment of these diseases is the Cleveland Clinic's Department of Rheumatic and Immunologic Diseases. Its annual reports provide a good overview of the wide range of illnesses in this broad category. In 2006, for example, the department diagnosed 8,257 cases of rheumatic and immunologic diseases, ranging from well-known ailments to those that are much rarer. This was a jump of almost 25 percent from the 6,611 cases diagnosed in 2005.

Types

• The Cleveland Clinic lists the diseases diagnosed in 2006 (followed by the number of patients diagnosed with each in parentheses) as follows: osteoporosis (1,569), rheumatoid arthritis (1,565), fibromyalgia (1,354), systemic lupus erythematosus (562), bursitis (516), Wegener's granulomatosis (365), osteoarthritis (345), gout (333), psoriatic arthritis (253), vasculitis and nonspecific arteritis (250), scleroderma (241), juvenile rheumatoid arthritis (213), giant cell arteritis (110), ankylosing spondylitis (103) and polymyositis (101). Other illnesses, each of which was diagnosed in less than 100 patients, include dermatomyositis (96), Takayasu's disease (78), hypersensitivity angiitis (43), cerebral arteritis (39), Bechet's disease (33), polyarteritis nodosa (27), Reiter's syndrome (26), pseudogout (16) and Henoch Schonlein purpura (12).

Significance

• Although some diseases in this category are very rare indeed, others are widespread and cause considerable suffering for millions of Americans and others worldwide. The American College of Rheumatology (ACR) offers some simple but helpful insights into the mechanism of autoimmune disease. ACR explains that the immune system is designed to protect us from harmful agents in the environment and "watch for any early damage in our cells." However, the immune system sometimes goes haywire, misinterpreting the signals it's receiving. "As a result, our defenses do not recognize our own body at work, and begin 'attacking' cells," thus triggering autoimmune disorders.

Treatment

• Because there is no real cure, the focus of treatment for rheumatic and immunologic diseases routinely has been relief of symptoms. This is generally accomplished with prescription and over-the-counter anti-inflammatory medications, including nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids. In recent years, however, there has been an increase in research on biologic therapies "directed against the small molecules which orchestrate our own immune response," according to ACR. Such research holds the promise of more effective modes of treatment in the future.