Systemic and autoimmune inflammatory diseases

The term “systemic and autoimmune inflammatory diseases” encompasses a range of different conditions that share an abnormal and persistent activation of the immune system, leading to impaired function of several organs, tissues and/or systems.

These include, in particular:

• Autoimmune diseases, such as systemic lupus erythematosus, Sjögren’s disease, scleroderma (or systemic sclerosis), and polymyositis
• Vasculitis, such as granulomatosis with polyangiitis (formerly Wegener’s disease), eosinophilic granulomatosis with polyangiitis (formerly Churg-Strauss syndrome), giant-cell arteritis (also known as Horton’s disease), and Behçet’s disease
• Non-infectious granulomatous diseases, such as sarcoidosis
• Autoinflammatory diseases, such as familial Mediterranean fever and TRAPS
• And various other conditions, including IgG4-related disease and relapsing polychondritis.

Since 2011, several departments at Erasme Hospital have pooled their clinical immunology expertise to create a transdisciplinary care platform for these conditions, known as the MISIM platform (for “Systemic and Immuno-Mediated Inflammatory Diseases”). Numerous medical specialists are involved in this unique platform. Transdisciplinary care is essential for identifying, monitoring and treating, in the most appropriate way, complications directly related to diseases that may affect different organs and tissues, as well as complications resulting from prolonged treatments.

The departments actively involved in this platform include:

• Internal medicine
• Rheumatology
• Nephrology
• Pneumology
• Gastroenterology
• Neurology
• Dermatology
• Ophthalmology
• Cardiology

The optimal management of chronic inflammatory diseases also often relies on specific blood tests, the interpretation of which can be challenging and may require discussion between laboratory specialists and clinicians. This is why an immunology laboratory specialist is also involved in the platform.

The creation of a single platform for such diverse diseases is justified by a number of reasons related to the diseases themselves (the way they manifest and their complications) and to their management. Indeed, although each of these diseases has its own specific features, they share many common characteristics:

In terms of manifestations and complications, there is considerable overlap between these diseases. For example, the lung inflammation that may occur in scleroderma or Sjögren’s disease is the same; it requires the same diagnostic tests and the same treatments.
In terms of medical management, the approach is similar, particularly with regard to the investigations leading to the diagnosis, the types of medication prescribed, the prevention of treatment-related complications, and follow-up.