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A systemic disease is an inflammatory disease that affects different organs and alters their functioning. What are the most common systemic diseases? The rarest? The most serious? Answers with Pr Aleth Perdriger, head of the Rheumatology department at the Rennes University Hospital.

Definition: what is a systemic disease?

The systemic diseases (sometimes also called connectivitis or collagenosis) are of the inflammatory diseases secondary to immune system dysfunction. “The role of the immune system is to defend us against attacks, in particular, infections. Dysfunction of the defense system leads to hyperactivity of the immune system. Instead of defending against external aggression, the immune system turns to the organs it should be defending. The functions of these organs are altered, to a greater or lesser extent“, develops Professor Aleth Perdriger. However, not all the organs are affected at the same time, and the damage makes it possible to “classify” systemic diseases. There are thus a large number of systemic diseases, which are defined by the damage of a particular organ. Thus, for example:

  • the rheumatoid arthritis affects the joints,
  • the systemic lupus erythematosus affects the skin, more rarely the kidneys.

What is the list of major systemic diseases?

All systemic diseases can be complicated by damage to another organ.

The most common inflammatory disease is rheumatoid arthritis. Systemic lupus erythematosus is the systemic disease in which there is the most organ damage. We also mention the Gougerot-Sjögren syndromea disease that targets the exocrine glands, the lacrimal and salivary glands, but also the inflammatory myopathies with muscle damage. Other illnesses include the sclerodermaand vasculitis, with Horton’s disease, periarteritis nodosa, sarcoidosis, or Behçet’s disease. “All systemic diseases can be complicated by damage to another organ. For example, polyarthritis with lung involvement, Gougerot-Sjogren syndrome with lung involvement, lupus with kidney involvement… In other words, there can be different manifestations for the same disease“, specifies Professor Aleth Perdriger.

What are the most serious systemic diseases?

It cannot be said that one systemic disease is more serious than another. The severity depends on the number of organs affected. For instance, lupus disease is most often a disease that is expressed by joint pain and skin lesions, without major consequences. But you can have lupus that is complicated by kidney damage, and the damage is more severe. More rarely the kidney damage is very important and the disease becomes serious. Polyarthritis alone can be embarrassing and painful, but with good treatment, joint damage can be limited. When it is complicated by lung damage, it becomes serious. Different organs can be affected in the same disease“, develops the rheumatologist.

What are the rarest systemic diseases?

All systems diseases are rare diseases. Knowledge of these pathologies now makes it possible to make early diagnoses, with implementation of treatments and most often favorable evolution, without the complications observed more than 20 years ago.“, argues the expert.

Who is the systemic disease specialist?

Systemic diseases do not belong to a single medical specialty because they affect different organs. All specialists can be affected by system diseases. For instance :

  • lupus erythematosus requires contacting a dermatologist,
  • inflammatory myositis at a neurologist,
  • one-sided scleroderma dermato-internist,
  • polyarthritis at one rheumatologist,
  • lupus with simple joint involvement at a rheumatologist,
  • polyarthritis with kidney damage, nephrologist.

The role of the general practitioner will be to examine his patient and send him to the right specialist depending on the damage.

What causes systemic disease?

There are probably genetic causes.

The causes of systemic diseases are poorly known. There probably exists genetic causes, but very many genes can be involved, and none has a decisive role. Some environmental factors have been implicated, including the tobaccocurrently recognized as a factor favoring inflammatory diseases. The microbiota could be involved, but again, no serious leads were discovered. Today, systemic disease research has provided insight into how the immune system malfunctions.” explains the rheumatologist.

Thanks to Pr Aleth Perdriger, Head of the Rheumatology Department of the University Hospital of Rennes

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