Collagen disease: the enemy within

Recent evidence suggests that these
diseases are the result of some interaction of the
hypothalamic-gonadal axis with the immune system. The median
age for rheumatoid arthritis is 45 years, the median age for
lupus erythematosus is 25. Other illnesses, which are
autoimmune in character, such as Sjogren syndrome, scleroderma
and the vasculitides, are also more commonly found in women.
There is no link that ties these illnesses together, except
for gender and various disparate immune manifestations such as
autoantibodies. The etiopathogenesis of these diseases is
reviewed. These diseases are notoriously difficult to
diagnose; they mimic other illnesses in their early
presentations. Accompanying illnesses such as migraine
headaches, Hashimoto's thyroiditis, and fibromyalgia are
discussed as related entities. Immunosuppression of diseases
like rheumatoid arthritis and lupus erythematosus, is
discussed. Various methods of management are considered, such
as the use of steroids, cytotoxic agents, and new experimental
agents, such as DHEA and IVIG.

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