Rheumatologists might not think of immunodeficiency often, but they should. Immunodeficiency and autoimmunity can be two sides of the same coin.
“We all tend to think of immunodeficiencies as diseases that open the door to infection,” said Mahta Mortezavi, MD, Assistant Professor of Allergy/Immunology and Rheumatology at Rochester University.
“A better way to think about immunodeficiency is as immune dysregulation. It is paradoxical, but many patients with immunodeficiencies are also at increased risk for autoimmunity and for granuloma formation. Therefore, rheumatologists may be the first point of contact for this patient population, and raising awareness can lead to earlier diagnosis for these patients.”
Owing to their heterogeneous presentation, immunodeficiencies such as combined variable immunodeficiency (CVID) tend to be the domain of multiple specialties, but also fall in between the different disciplines of medicine. Many patients with CVID and other immunodeficiencies suffer for years without a clear diagnosis. In the end, the most important first step in helping them is to think of immunodeficiency in our differential.
During the session entitled Immunodeficiency for the Rheumatologist: More Common Than You Think on Tuesday from 1:00 – 2:00 pm in Thomas Murphy Ballroom 1 & 2, Building B in the Georgia World Congress Center, Dr. Mortezavi and colleagues will discuss the most common clinical signs and appropriate initial workup for a patient with immunodeficiency. They will also discuss how the autoimmune complications of these diseases can act as a mimic for other diseases such as systemic lupus erythematosus, rheumatoid arthritis, and sarcoidosis. Finally, she will discuss the way in which some of the medications used commonly in rheumatology can lead to development of a chronic secondary immunodeficiency.
This session is unique in its multidisciplinary approach and shines a light on the role of the rheumatologist in a group of diseases traditionally relegaded to allergy/Immunology and infectious disease. All presenters at this session hold triple board certification in internal medicine, rheumatology, and allergy/immunology.