In January 2010, a new Department of Rheumatology and Clinical Immunology (since 1994 a division of the Department of Medicine) was created in SGRH. This department has three senior consultants, each with more than 20 years experience in the fi eld and one DNB student (DNB programme established in 2013) and a dedicated rheumatology nurse. The department also has a trained occupational therapist. At present it runs two free dedicated OPDs in a week and also this includes besides free consultations, free procedures such as intraarticular and soft tissue injections.
The department is geared to diagnose and treat various disorders such as rheumatoid arthritis, systemic lupus erythematosus (SLE), progressive systemic sclerosis (scleroderma), overlap connective tissue disorders, sero-negative spondylo-arthritides (including psoriatic, reactive arthritis and ankylosing spondylitis), osteoarthritis, juvenile idiopathic arthritis, rheumatic fever, vasculitides, idiopathic thrombocytopenic purpura (ITP), etc. The patients are treated with disease-modifying drugs such as methotrexate, hydroxychloroquine, sulfasalazine, lefl unomide, mycophenolate, cyclosporine, azathioprine. Patients are given pulse medication such as methylprednisolone and cyclophosphamide when indicated. Biological therapies such as infl iximab, etanercept, tociluzimab, secukinumab have been added to the armamentarium to treat early and resistant patients of rheumatoid arthritis and sero-negative spondyloarthropathies. AntiCD-20 molecule rituximab is also being used in patients with rheumatoid arthritis, SLE and ITP, vasculitides, connective tissue disease associated ILD, IgG4-related disease, etc. And most recently Janus Kinase Inhibitors (JAKi) have changed the treatment paradigm across most rheumatological conditions.
The daycare set up is the most important cog in the department, with increasing number of patients utilizing the facility specifi cally for biologics and non-biological infusions.
Multidisciplinary care is given to all patients. They are taught exercises by an effi cient physiotherapy department, joint protection and joint utility manoeuvres by a trained occupational therapist. The hospital orthopaedic department works closely with the rheumatology services for correction of deformities and for joint replacements.
The department is in liaison with the state-of-the-art laboratories in carrying out the following investigations:
- ASO, CRP, rheumatoid factor (quantitative) and anti-CCP
- Screening test for auto-antibodies by ANA (hep-2)
- Individual autoantibody profi ling:
- Anti-dsDNA levels (IFA and ELISA)
- ANA and ENA profi le
- Anti-mitochondrial antibody (AMA), anti-smooth muscle antibody (ASMA)
- ANCA (C and P) by IFA and PR3 and MPO by ELISA
- C3 and C4 assay
- HLA B27 by PCR
- Anti-platelet antibodies
The department has been represented at both national and international fora as faculty. It has many publications to its credit and is actively involved in teaching of postgraduates in DNB rheumatology. It has conducted many CMEs and conferences to educate physicians about rheumatology problems, with regular seminars, journal clubs and bedside teaching.
Our department has acquired Nailfold Capillaroscopy for early detection of Connective Tissue Diseases (CTD). It also has a polarizing microscope for crystal detection in synovial fl uid. It has a state-of-the-art ultrasound machine. This is utilized by the consultants for diagnosing and treating various rheumatological disorders along with teaching of the postgraduates.
It is also involved in social activities including patient awareness programmes such as on World Lupus and World Arthritis Days. It is our constant endeavour to make the department patient-friendly and a specialty for providing comprehensive rheumatology care under one roof.
Address
Room no: 2208A, 2nd Floor, SSRB Building, Ext: 2226
