Interdisciplinary care of vasculitis patients from the view of internal medicine

Systemic vasculitides (SV) represent a heterogeneous group of different ent ities with varying clinical and pathological-anatomical characteristics tha t physicians of diverse disciplines are involved in the treatment of patien ts with SV. At the onset of disease organ manifestations often present as a single symptom without appearance of indirect signs of vasculitis as muscu loskeletal complaints and constitutional symptoms indicating inflammatory s ystemic disease. Therefore early interdisciplinary care is extremely import ant to avoid major organ involvement with the development of fatal disease. Besides the multidisciplinary physical examination serological and immunolo gical parameters, particularly in small vessel vasculitides are relevant in establishing the diagnosis. Regarding the interdisciplinary care we differ entiate between primary diagnostic procedures and continuous followup to ob serve therapeutic and side effects of medications. Instruments for the asse ssment of disease extent (DEI), activity (BVAS) and irreversible damage (VD I) were developed in recent years to document prospectively the disease sta tus and support activity-adjusted treatment. Because of the chronic relapsing character of systemic vasculitides, the me asurement of health-related quality of life gained progressive interest in the longitudinal follow-up. In addition in these rare diseases early patien t education with information on the disease, treatment, side effects and tr aining in self management strategies will enable patients to actively parti cipate in the management of their disease and bear responsibility.