Autoimmune Rheumatic Diseases

Autoimmune Rheumatic Disease Care at UVM Health

Your immune system protects your body from foreign invaders, such as bacteria and viruses. Autoimmune diseases cause your immune system to target healthy cells. There are many types of autoimmune diseases. Autoimmune rheumatic diseases affect your joints, bones, tendons, ligaments, blood vessels and other tissues in your body.

At University of Vermont Health, rheumatologists provide comprehensive, compassionate care for common and rare autoimmune rheumatic diseases. Our rheumatologists combine advanced expertise with a patient-centered approach to ensure you receive the care you need to live a healthier life.

Rheumatology appointment between patient and provider.

Why Choose UVM Health?

As a leading rheumatology program in the region, we offer:

Expertise: You receive care from board-certified rheumatologists who specialize in a wide range of autoimmune rheumatic diseases. Our physicians are active researchers, many of whom are training the next generation of experts.
Multispecialty team: Your care team may include primary care providers, cardiologists, dermatologists, pulmonologists, ophthalmologists, orthopedic surgeons, and physical and occupational therapists.
Advanced treatments: Our physicians stay up to date on the newest medication therapies. They work with you and other specialists to find the right medications to achieve positive results.
Convenience: We provide rheumatology services at locations across the region. For your convenience, we schedule multiple appointments on the same day and offer telehealth whenever possible.

Types of Autoimmune Rheumatic Diseases

Physicians group autoimmune rheumatic diseases based on the part of the immune system and the types of tissues involved.

Autoimmune Connective Tissue Diseases

Connective tissues bind, support and separate other tissues. Autoimmune connective tissue diseases occur when immune system proteins (antibodies) attack your connective tissues. These diseases include:

Rheumatoid arthritis: Causes joint damage and may lead to a loss of function and deformity. Rheumatoid arthritis can affect multiple joints, such as the hands, wrists, knees and feet, as well as other organs.
Systemic lupus erythematosus: Causes widespread inflammation in the joints, skin, brain, blood vessels and internal organs. Symptoms of systemic lupus erythematosus vary widely. Over time, this condition may damage the affected tissues and organs.
Systemic sclerosis: May cause scarring and hardening of your skin (scleroderma) and can affect other tissues including your lungs and kidneys.
Sjögren’s disease: Affects the moisture-producing glands in your eyes and mouth. Sjögren’s disease can also cause damage to other parts of your body, including your muscles, joints, nervous system, blood vessels and internal organs.
Mixed connective tissue disease: Has features of three connective tissue diseases — systemic lupus erythematosus, systemic sclerosis and autoimmune myositis (muscle inflammation). Symptoms of each disease may appear over time, rather than all at once.

Seronegative Spondyloarthropathy

Seronegative spondyloarthropathies include diseases that affect the spine, spine-pelvis (sacroiliac) joint and other joints, especially in the hands and knees. They are “seronegative,” meaning blood tests are negative for the antibodies found in rheumatoid arthritis.

The main types of seronegative spondyloarthropathies treated by our rheumatologists include:

Ankylosing spondylitis: Causes inflammation, pain and stiffness in the joints of your spine and sacroiliac joint. Ankylosing spondylitis can also affect other joints, such as your hips, knees and ankles.
Psoriatic arthritis: Causes inflammation in joints, at the sites where ligaments and tendons attach to bones (entheses), and puffy fingers or toes (dactylitis). Most people with psoriatic arthritis have a scaly skin rash called psoriasis.
Inflammatory bowel disease (IBD)-associated arthritis: Occurs when people who have IBD (which includes Crohn’s disease and ulcerative colitis) develop arthritis. IBD-associated arthritis may affects the spine and peripheral joints, such as the elbows, hands, knees and ankles.
Reactive arthritis: Occurs after a bacterial infection, such as chlamydia or salmonellosis. The main symptoms are joint pain, urinary problems and eye inflammation.

Vasculitis

Vasculitis is a group of diseases that cause inflammation of blood vessels. Giant cell arteritis is a common type of vasculitis that affects the large blood vessels in the head and torso. It can cause vision loss if not treated right away.

Autoinflammatory Diseases

In these diseases, white blood cells — part of your immune system — attack your own cells. Adult-onset Still’s disease is a type of autoinflammatory disease that causes joint and muscle pain, fever, and rash.

Autoinflammatory diseases most often affect children.

Learn more about pediatric rheumatology

Sarcoidosis

In this autoimmune disease, groups of inflammatory cells (granulomas) collect in different tissues of your body, including your lungs, lymph nodes, nervous system, skin, eyes, and internal organs. Sarcoidosis may go away on its own. In some cases, it can cause severe disease that leads to permanent organ damage.

Diagnosing Autoimmune Rheumatic Diseases

Diagnosing autoimmune rheumatic diseases requires a skilled team with deep experience in these complex conditions. Depending on your symptoms, our rheumatologists’ evaluation may include:

Medical history: To find out about past illnesses and the symptoms you are having
Family history: To determine if a condition may run in your family
Physical exam: To assess your overall health and look for joint inflammation, skin rashes and other problems
Blood tests: To look for markers of inflammation or disease
Joint fluid analysis: To detect inflammation in the fluid within your joints
Imaging tests, such as X-ray, ultrasound, CT and MRI scans: To look at your bones, joints, blood vessels and internal organs. We offer in-office ultrasound performed by a rheumatologist with specialized expertise in musculoskeletal ultrasound.

Treating Autoimmune Rheumatic Diseases

Once you receive a diagnosis, we prioritize your needs and preferences to ensure you receive the care that’s right for you. Your personalized treatment plan may include:

Lifestyle Changes

Lifestyle factors can make the symptoms of autoimmune rheumatic diseases worse. As part of your treatment plan, your provider may suggest adopting the following healthy habits:

Exercise routinely
Get enough sleep
Limit alcohol use
Maintain a healthy weight
Manage your stress
Quit smoking

Medications

Disease-modifying antirheumatic drugs (DMARDs) are the main treatment for autoimmune rheumatic diseases. These drugs reduce disease activity and can help you achieve remission — a period of time during which you have no symptoms. Our rheumatologists are up to date with the latest DMARD therapies and experienced in helping find the right strategy for you.

DMARDs work by suppressing your immune system to keep it from attacking healthy tissues. These drugs include traditional DMARDs, which provide general immunosuppression, and biologic and targeted synthetic DMARDs, which target specific immune pathways. DMARDs come in different forms:

Pills you take by mouth
Injections you or a caregiver administer at home
Infusions you receive at infusion centers across UVM Health or in your home

Your provider may also recommend nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids to reduce pain and inflammation. Injecting corticosteroids into a joint can be helpful in some cases. If you experience pain despite good control of your rheumatic disease, your provider may refer you to a pain management specialist.

The medications we prescribe can be complex. Our clinical pharmacists check for interactions with other medications you are taking. They also take the time to help you understand your medications and how to take them correctly.

Physical and Occupational Therapy

Physical and occupational therapy can help improve your strength, range of motion and ability to perform daily activities.

Surgery

Surgery may be an option to reduce joint pain and improve function if you have severe joint deterioration. Our rheumatologists partner with UVM Health orthopedic surgeons, who have extensive experience performing joint surgeries.

Wellness & Prevention

Evidence shows that proactive health care focused on preventing illness leads to better outcomes. We're here to help you live a healthier, happier life. We offer wellness and prevention services to empower you to take control of your health.