Autoimmune rheumatic disorders include diverse syndromes such as
Rheumatoid arthritis Rheumatoid Arthritis (RA) Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease that primarily involves the joints. RA causes damage mediated by cytokines, chemokines, and metalloproteases. Characteristically... read more and the spondyloarthropathies and their variants Overview of Seronegative Spondyloarthropathies Seronegative spondyloarthropathies (seronegative spondyloarthritides) share certain clinical characteristics (eg, inflammatory back pain, uveitis, gastrointestinal symptoms, rashes). Some are... read more are also immune mediated. The triggers and pathophysiology are incompletely understood for these disorders, but many aspects of pathogenesis are becoming clearer, enabling the development of more specific therapies.
Patients with most autoimmune rheumatic disorders are at increased risk of atherosclerosis Atherosclerosis Atherosclerosis is characterized by patchy intimal plaques (atheromas) that encroach on the lumen of medium-sized and large arteries. The plaques contain lipids, inflammatory cells, smooth muscle... read more .
Patients who receive moderate doses of corticosteroids plus another immunosuppressive drug should usually receive prophylaxis for opportunistic infections such as Pneumocystis jirovecii (see prevention of Pneumocystis jirovecii pneumonia Prevention Pneumocystis jirovecii is a common cause of pneumonia in immunosuppressed patients, especially in those infected with human immunodeficiency virus (HIV) and in those receiving systemic... read more ).
Corticosteroids also the increase risk of osteoporosis.
Key Points
Patients with most autoimmune rheumatic disorders are at increased risk of atherosclerosis.
Patients who receive moderate doses of corticosteroids plus another immunosuppressive drug should usually receive prophylaxis for opportunistic infections such as Pneumocystis jirovecii.