Holistic Care of the Immunocompromised Rheumatologic Patient – Case Analysis

Abstract

Patients with rheumatologic conditions, such as eosinophilic granulomatosis with polyangiitis (EGPA), rheumatoid arthritis (RA), and systemic lupus erythematosus (SLE), often face being immunocompromised due to their disease state, or the immunosuppressive effect of their treatments. Managing immunocompromised rheumatologic patients can be challenging and complex. This article reviews a GSK-sponsored Innovation Theatre session that took place during the American College of Rheumatology (ACR) Convergence 2023 Annual Meeting in San Diego, California, USA, on 14th November 2023. Kevin Winthrop, Professor of Infectious Diseases at the School of Medicine at Oregon Health and Science University (OHSU); and Professor of Public Health at OHSU-Portland State University (PSU) School of Public Health, Portland, Oregon, USA, provided insights into the immunocompromised patient within rheumatology. He considered the challenges of associated comorbidities, diagnosis, and implementing preventative measures. Leonard Calabrese, Professor of Medicine at the Cleveland Clinic Lerner College of Medicine, Case Western Reserve University; Director of Clinical Immunology of the R.J. Fasenmyer Center; and Vice Chairman at the Department of Rheumatic & Immunologic Disease, Cleveland Clinic, Ohio, USA, presented an interactive patient case overview of EGPA. He identified the need for practitioners to take ownership of patients with serious and opportunistic infections. The session provided awareness of the origins of immunocompromised states, including disease pathophysiology and treatments. It also explained the increased risks of opportunistic infections among patients with rheumatological conditions, due to their disease and treatment. Additionally, it identified the need for holistic approaches in the management of those patients living with immunocompromising conditions.