Dr. Monach continues, “Although depletion is the most common cause of low C3 and/or C4 encountered by adult rheumatologists, an understanding of the consequences of inherited and acquired deficiency states provides a useful background for interpreting laboratory tests, disease states characterized by depletion or local activation without overt depletion, and the benefits and risks associated with complement-blocking drugs.” He goes on to deliver a concise review of each area mentioned with direct relevance to diagnosis and treatment.
Before concluding his complement review, Dr. Monach returns to the introductory case to wrap it up and provide additional take-aways.
With illustrative figures and legends, and a wealth of references, this review gives clinicians practical information they can use with patients in their own practices.
Looking Forward
Future reviews in this series will discuss interferons in disease, autoantibody formation, pathologic T cell subsets, immune tolerance and newly characterized inflammatory syndromes.
All the reviews will include patient scenarios to establish the scientific questions being addressed. “One can’t see a clinical case in which one can’t extract a couple of interesting scientific questions,” says Dr. Bucala.
“We all talk and train immunology, but it’s didactic,” he says. He likens the approach to these review articles to “the power of bedside teaching. It’s about learning with your heart, not just your head.”
Rheumatologists are often called upon to solve medical mysteries to help patients who have been suffering for want of a clear diagnosis. These educational reviews are designed to help clinicians solve these mysteries and provide practical help to their patients.
Keri Losavio is the editor of The Rheumatologist, a position she has held since 2014.
References
- Bucala R, Solomon DH. Immunology for the rheumatologist: A&R introduces a new problem-based immunology review series with great educational potential. Arthritis Rheumatol. 2023. Accepted author manuscript.
- Monach PA. Complement. Arthritis Rheumatol. 2023. Accepted author manuscript.
