Controversies in Rheumatology & Autoimmunity Conference

As the root cause of autoimmunity is still being explored, we are constantly examining the way this category of diseases is diagnosed, managed, and treated. There is no one-size-fits-all approach, and as such, there is ample room for debates on topics like pharmaceutical drugs, diagnostic tests, and disease risk factors. 

At the March 2019 CORA Conference in Florence, Italy, leading scientists gave lectures and presented their cases for and against the existence of effective treatments for scleroderma, the risk of cardiovascular disease in SLE, weaning patients off drugs, and a host of other controversies.

TAKEAWAYS:

  • Progress is being made towards non-biopsy approaches in diagnosing celiac disease in children. This study shows the efficacy of the IgA-tTG test in properly diagnosing symptomatic children. These findings could mean reduced bowel biopsies, anesthesia, and costs for the health care system in a large percentage of celiac patients.

Clinical Pre-Test Probability for Celiac Disease and Value Added Reporting of IgA-Tissue Transglutaminase Antibodies in the Pediatric Setting from UZ Leuven Hospital

  • There is an association between inflammation and autoimmune disease, as well as cancer. Acute inflammation could lead to chronic inflammation, which – along with epigenetic and environmental factors – could lead to autoimmunity. Chronic inflammation could also lead to cancer. The same path can lead to two different outcomes.

Should mild cases of arthritis be managed by oncologists?  by Maurizio Cutolo

  • Autoimmune disease is more prevalent in females and affects the sexes in different ways: 
    • Estrogen has the most diverse effects of any hormone in the body
    • There is a strong association between female hormones and the onset of autoimmunity
    • Estrogen and estradiol receptors have a hand in intestinal permeability (a.k.a. leaky gut), females and males respond differently to stress
    • Early differences in the female microbiome may be why women respond differently to infectious challenges

Dilemmas in Autoimmune Diseases by Eric Gershwin