Reumatizam, Vol. 62 No. suppl. 1, 2015.
Review article
OVERALL CHARACTERISTICS AND EARLY DIAGNOSIS OF PATIENTS WITH CONNECTIVE TISSUE DISEASES
László Czirják
Abstract
The most important issue in regard to systemic autoimmune
diseases is early recognition and early, long-term treatment.
In certain disorders, including rheumatoid arthritis
and systemic sclerosis, the revised new classification criteria
help to identify the cases as early as possible. Once the
diagnosis has been established, a “treat-to-target” approach
is important. Further work is required to improve the
currently available activity damage indexes and outcome
measures in these particular disorders; in particular, better
composite activity indexes seem to be necessary for the future.
Early recognition of the typical symptoms and signs of
these particular diseases is crucial. These disorders are
usually accompanied by permanent or temporary inflammatory
signs, and the inflammation often occurs in waves.
The most frequent symptoms of systemic autoimmune
disorders include polyarthritis, Raynaud phenomenon,
inflammatory and non-inflammatory skin symptoms, sicca syndrome (dry eyes, dry mouth), pulmonary arterial
hypertension/lung fibrosis, a variety of central and peripheral
nervous system-related symptoms, and symmetric
proximal muscle weakness and pain. Furthermore, proteinuria,
hematuria, and recurrent pleuritis/pericarditis also
belong to the disease spectrum of these disorders. Symptoms
representing antiphospholipid syndrome (recurrent
thrombo-embolic events, fetal morbidity, and presence of
antiphospholipid autoantibodies) can also be typical contributors.
There are further rare findings, including persistent
peripheral/central nervous system-related symptoms,
leukopenia, and pulmonary arterial hypertension.
The early recognition of “unusual” associations of organ
symptoms is a crucial point.
Keywords
systemic autoimmune disease; systemic lupus erythematosus; systemic sclerosis; classification; treat-totarget
Hrčak ID:
182723
URI
Publication date:
10.10.2015.
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