Krankheitsaktivitätsmessung im klinischen Alltag: Kollagenosen

Zusammenfassung

In der Behandlung von Kollagenosepatienten sind die Verlaufsbeurteilung der bekannten Organmanifestationen und die Suche nach neu aufgetretenen Komplikationen meist bedeutsamer als die globale Krankheitsaktivität. Organbezogene Parameter sind daher oft wichtiger als Autoantikörpertiter, auch wenn die Antikörpertests in der Diagnosestellung und der Vorhersage bestimmter Komplikationen eine wesentliche Funktion haben. Die Erfragung typischer anamnestischer Details und die klinische Untersuchung sind wesentlich und werden durch gezielte technische Untersuchungen ergänzt. Im Gegensatz zur rheumatoiden Arthritis haben sich Krankheitsaktivitätsindizes bei aller wissenschaftlicher Bedeutung nicht als Hilfsmittel zur Therapieentscheidung durchgesetzt. Da sich die verschiedenen Kollagenosen zum Teil erheblich unterscheiden, versucht der folgende Beitrag auf diese Aspekte jeweils nach Erkrankungen gegliedert einzugehen.

Abstract

In evaluating patients with connective tissue diseases (CTDs), it is often the case that the course of known organ manifestations and the repetitive search for new complications are more important than the overall disease activity. Laboratory parameters reflecting organ involvement are therefore often more relevant than autoantibodies, in spite of the value of the later in the diagnosis and prediction of certain complications. Specific anamnestic details and a physical examination are central measures, but should be supplemented by focused technical investigations. In contrast to the situation with rheumatoid arthritis, disease activity indices remain largely limited to scientific questions and have little clinical impact. The current overview attempts to discuss these aspects for each single entity, since the various CTDs behave quite differently in many aspects.

Schlüsselwörter

Kollagenosen - Krankheitsaktivität - Screening

Key words

connective tissue diseases - disease activity - screening

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