What Are Autoimmune Rheumatic Diseases?
Autoimmune rheumatic diseases are a group of chronic conditions in which the immune system mistakenly attacks the body's own tissues, causing inflammation, pain, and progressive organ damage. The most common include rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), ankylosing spondylitis (AS), and Sjögren's syndrome. These conditions require expert, long-term management to control disease activity, prevent organ damage, and maintain quality of life. Ruijin Hospital's rheumatology department is one of China's most prestigious, with internationally recognized specialists including Professors Bao Chunde and Shen Nan.
Common Rheumatic Conditions
- Rheumatoid arthritis (RA) — chronic inflammatory joint disease causing synovitis, cartilage destruction, and joint deformity; affects approximately 1% of the global population
- Systemic lupus erythematosus (SLE) — multisystem autoimmune disease affecting the skin, joints, kidneys, heart, lungs, and nervous system
- Ankylosing spondylitis (AS) — inflammatory arthritis primarily affecting the spine and sacroiliac joints; causes progressive spinal fusion
- Psoriatic arthritis — inflammatory arthritis associated with psoriasis; affects skin and joints
- Sjögren's syndrome — autoimmune exocrinopathy causing dry eyes, dry mouth, and systemic complications
- Systemic sclerosis (scleroderma) — fibrosis of the skin and internal organs including the lungs, heart, and kidneys
- Inflammatory myopathies — polymyositis, dermatomyositis, anti-synthetase syndrome causing muscle weakness and ILD
- Vasculitis — ANCA-associated vasculitis, giant cell arteritis, Takayasu arteritis causing blood vessel inflammation
- Gout and pseudogout — crystal arthropathies causing acute joint inflammation
- Antiphospholipid syndrome (APS) — autoimmune thrombophilia causing recurrent clots and pregnancy loss
Symptoms
Rheumatoid Arthritis:
- Symmetric joint pain, swelling, and morning stiffness lasting more than one hour
- Fatigue and low-grade fever
- Joint deformity in advanced disease (ulnar deviation, swan neck deformity)
- Extraarticular features — rheumatoid nodules, interstitial lung disease, vasculitis
Systemic Lupus Erythematosus:
- Butterfly (malar) rash across the cheeks and nose
- Photosensitivity — skin rash worsened by sun exposure
- Joint pain and swelling
- Fatigue and fever during flares
- Hair loss (alopecia)
- Oral ulcers
- Kidney involvement — proteinuria, hematuria (lupus nephritis)
- Serositis — pleuritis, pericarditis
- Neuropsychiatric manifestations — seizures, psychosis, cognitive impairment
Causes & Risk Factors
- Genetic predisposition — HLA-DR4 (RA), HLA-B27 (AS), multiple SLE susceptibility loci
- Female sex — most autoimmune diseases are more common in women, particularly SLE (9:1 female predominance)
- Hormonal factors — estrogen influences immune regulation
- Environmental triggers — infections (EBV, Parvovirus B19), smoking (RA), UV light (SLE)
- Gut microbiome dysbiosis
- Family history of autoimmune disease
Diagnosis
Ruijin Hospital's rheumatology team uses comprehensive immunological and imaging assessment:
- Rheumatoid factor (RF) and anti-CCP antibodies — highly specific for RA diagnosis
- ANA (antinuclear antibody) panel — screening test for SLE and other connective tissue diseases
- Anti-dsDNA and anti-Sm antibodies — specific for SLE
- ANCA (antineutrophil cytoplasmic antibody) — for vasculitis diagnosis
- Complement levels (C3, C4) — consumed during SLE flares
- HLA-B27 testing — for ankylosing spondylitis
- Joint ultrasound — sensitive detection of synovitis and erosions in RA
- MRI of sacroiliac joints and spine — for early AS diagnosis before X-ray changes appear
- Kidney biopsy — for lupus nephritis classification and treatment guidance
- Muscle biopsy and MRI — for inflammatory myopathy diagnosis
- Pulmonary function tests and HRCT — for ILD assessment in connective tissue diseases
Treatment Options
Ruijin Hospital offers individualized, evidence-based rheumatological care with access to the full range of conventional and biologic therapies:
- Conventional DMARDs — Methotrexate, Hydroxychloroquine, Sulfasalazine, Leflunomide; the backbone of RA and SLE treatment
- Anti-TNF biologics — Adalimumab, Etanercept, Infliximab, Certolizumab for RA and AS
- IL-6 receptor inhibitors — Tocilizumab for RA and systemic JIA; highly effective for refractory disease
- JAK inhibitors — Tofacitinib, Baricitinib, Upadacitinib for RA; oral targeted therapy with rapid onset
- B-cell depletion — Rituximab for refractory RA, SLE, vasculitis, and inflammatory myopathies
- Belimumab — BLyS inhibitor specifically approved for SLE; reduces flare frequency
- Anifrolumab — type I interferon receptor antagonist for moderate-to-severe SLE
- IL-17 inhibitors — Secukinumab, Ixekizumab for AS and psoriatic arthritis
- IL-23 inhibitors — Guselkumab, Risankizumab for psoriatic arthritis
- Corticosteroids — for acute flare management; minimized for long-term use
- Immunosuppressives — Mycophenolate mofetil, Cyclophosphamide, Azathioprine for lupus nephritis and vasculitis
- Urate-lowering therapy — Allopurinol, Febuxostat, Pegloticase for gout management
- Treat-to-target strategy — systematic monitoring and therapy adjustment to achieve remission or low disease activity
Why Treat Rheumatic Disease in Shanghai?
- Ruijin Hospital's rheumatology department is one of China's most prestigious, with a national reputation for excellence in SLE, RA, and vasculitis management
- Access to the full range of biologic and targeted therapies at significantly lower cost than in Western countries — often 50–70% less expensive
- Expert lupus nephritis management combining rheumatology and nephrology expertise
- Multidisciplinary approach integrating rheumatology, nephrology, pulmonology, and dermatology for complex systemic disease
- Participation in international clinical trials for novel rheumatological therapies
Our Specialists
Professor Bao Chunde (鲍春德) — Chief of Rheumatology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. One of China's foremost rheumatologists, with particular expertise in rheumatoid arthritis, systemic lupus erythematosus, and biologic therapy. A key contributor to Chinese rheumatology clinical guidelines.
Professor Shen Nan (沈南) — Deputy Chief of Rheumatology, Ruijin Hospital. An internationally recognized expert in the genetics and molecular mechanisms of SLE, with extensive research contributions published in top journals including Nature Genetics and Arthritis & Rheumatology.
How CMCS Can Help
China Medical Concierge Shanghai (CMCS) coordinates comprehensive rheumatological care for international patients at Ruijin Hospital — from reviewing your immunological workup and imaging, to arranging specialist consultations, facilitating kidney biopsy and pulmonary assessment, coordinating biologic therapy access, providing medical interpretation, and supporting long-term disease management and follow-up care in Shanghai.
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