Modern algorithm for early diagnosis of autoimmune rheumatic diseases (36 hours)

Relevance of the topic.

Currently, the burden of chronic immuno - inflammatory diseases (IVD), a group of severe human diseases that includes more than 100 nosological forms, is increasing. IVZS are represented in almost all sections of medicine, their frequency in the population can reach 10%. The IVZ spectrum contains well-known conditions such as rheumatoid arthritis( RA), psoriatic arthritis, ankylosing spondylitis, inflammatory bowel diseases (IBD), systemic connective tissue diseases, and systemic vasculitis.
Systemic autoimmune rheumatic diseases (SARDs) are characterized by a chronic course, variable symptoms with alternating remissions and exacerbations, and the possibility of developing severe and irreversible damage to internal organs. The clinical picture of SARZ has significant differences in the advanced stage of the disease, but in the onset of the disease, the symptoms are usually non-specific and similar. This often causes diagnostic problems, especially in the early stages of the disease. Even at the present stage of development of medical science in some rheumatic diseases, the time interval from the appearance of the first symptoms to the verification of a reliable diagnosis can reach several years. There may be atypical variants of the debut, in connection with which patients seek primary care from doctors of therapeutic specialties who do not have sufficient skills in curating such patients. There are errors in the interpretation of laboratory and instrumental methods of examination. At the same time, an early diagnosis of systemic ARD is important for conducting an effective treatment strategy and improving the prognosis.
Late diagnosis and delay in the appointment of adequate treatment methods lead to disability, a reduction in the duration and quality of life of patients, which leads to an increase in the socio-economic burden of rheumatic diseases.
Thus, the expansion of doctors ' knowledge about the features of rheumatic diseases, modern diagnostic methods, including in the early stages, the use of adequate methods of treatment of patients is an urgent need, and explains the need for continuous education of doctors of therapeutic specialties in rheumatology.

As part of the course, we:

• Let us consider the main aspects of the etiology and pathogenesis of autoimmune rheumatic diseases.
• Let's analyze the features of physical examination of patients with rheumatic diseases.
• Let's analyze the variants of the debut and the features of the early stages of rheumatic diseases.
• We will discuss modern diagnostic and classification criteria for autoimmune rheumatic diseases.
• We will consider the formulation of the preliminary diagnosis and the preparation of a plan for laboratory and instrumental examinations of the patient, the algorithm for verifying the diagnosis, taking into account the current international statistical classification of diseases (ICD).
• We will determine the order of the volume, content and sequence of diagnostic measures in patients at the early stages of autoimmune rheumatic diseases.
• Let us consider the interpretation of the results of clinical, laboratory and instrumental examinations.
• Let's analyze the algorithm of differential diagnosis in patients with early stages of rheumatic diseases.
• We will discuss the need and scope of additional methods of examination in patients with rheumatic diseases.
• Consider the necessary list of therapeutic and preventive measures in patients at early stages, including those aimed at early detection and prevention of comorbid conditions (atherosclerosis, cancer, osteoporosis, etc.).
• We will hold discussions on topical issues of diagnosis, treatment and monitoring of patients with autoimmune rheumatic diseases at the outpatient stage.

Internship base: Loginov Moscow State Medical Research Center (Moscow City Rheumatology Center, Center for Diagnosis and Treatment of Autoimmune Diseases, Rheumatology Department)

Internship Supervisors: 
Lukina Galina Viktorovna, MD, Professor; 
Natalia G. Klyukvina, MD.

Working Group:
Alexandrova Elena Nikolaevna, MD.
Novikov Alexander Alexandrovich, Doctor of Biological Sciences
Diana S. Novikova, MD.