Patient care of the department of Immunology

Introduction

The section clinical immunology of the EMC has earned national and international acknowledgement: the Dutch Federation of Universities (NFU) has awarded the section with seven predicates ‘centers of expertise’ and in 2010  the American Jeffrey Modell Foundation (JMF) officially awarded us the first Dutch ‘JMF center for immunodeficiencies’.

Clinical immunology focusses on rare inflammatory diseases and immune deficiencies.

Diseases that are studied and treated are summarized below.

At the section of clinical immunology in total over two thousand patients are being treated, of which around 350 have an immune deficiency, about 400 suffer from sarcoidosis, 160 have mastocytosis, over 400 have either uveitis or scleritis (immuno-ophthalmic disorders), 120 have SLE, over 200 have Sjögren’s disease and around 100 suffer from fever syndromes.

Diseases that are studied and treated

  • Behçet’s disease*
  • Sarcoïdosis *
  • Sjögren syndrome*
  • Systemic sclerosis*
  • Inflammatory ocular disease (uveitis and scleritis)*
  • Primary immunodeficiency disorders*
  • Mastocytosis*
  • Autoinflammatory diseases like Familial Mediterranian Fever (FMF)
  • IgG4-related disease
  • Endocrine autoimmune diseases like the polyglandular syndromes
  • Systemic lupus erythematosus/MCTD
  • ANCA-negative and ANCA-associated vasculitis
  • C1-esterase inhibitor deficiencies
  • Unspecified immune diseases

*  Diagnostics, treatment and research for this particular disease have been awarded the predicate ‘center of expertise’ (acknowledged by NFU)

Research, diagnostics and treatment of above mentioned diseases demand close collaboration with other specialties: Neurology, Dermatology, Pediatrics, Pulmonology, Rheumatology and Ophthalmology. Therefore so-called horizontal out-patients clinics have been formed, where patients can be seen by different specialists simultaneously. There is also an important alliance with the Rotterdam Eye Hospital. Regular meetings between staff members of both clinics are used to discuss severe and difficult clinical cases and to generate diagnostic and or treatment strategies.

Roughly there are three types of patient referrals to the section Clinical Immunology:  

  1. Patients with autoimmune and autoinflammatory diseases or immune deficiencies are referred for a second opinion or acquisition of treatment due to complexity;
  2. Patients with a disease that demonstrates mainly in the field of another specialty (for instance pulmonology) but with a big immunological component that needs complimentary diagnostic help from a clinical immunologist or even additional or concomitant treatment;
  3. Patients who need multidisciplinary care (horizontal outpatient clinics).