Systemic rheumatic diseases include diverse syndromes such as
Inflammatory arthritis (eg, rheumatoid arthritis, spondyloarthropathies)
Vasculitis (eg, granulomatosis with polyangiitis, microscopic polyangiitis)
The inflammatory arthritides, such as rheumatoid arthritis, the spondyloarthropathies and their variants, and the various forms of vasculitis are discussed in detail elsewhere.
The triggers and pathophysiology are incompletely understood for all of these disorders, but many aspects of pathogenesis are becoming clearer, enabling the development of more disease-targeted therapies.
Patients with most systemic rheumatic diseases are at increased risk of atherosclerosis, but that risk may be reduced with effective treatment of the underlying disease.
Patients who receive moderate doses of corticosteroids plus another immunosuppressive medication should usually receive prophylaxis for opportunistic infections such as Pneumocystis jirovecii (see prevention of Pneumocystis jirovecii pneumonia) and vaccines against common infections (eg, streptococcal pneumonia, influenza, COVID-19).
Corticosteroids also increase the risk of osteoporosis.
