Neurology vs. Rheumatology Question

[ok_record]

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I have noticed some diseases with overlap between the two specialties.

Who usually treats vascular immune disease such as primary angiitis of the CNS and giant cell arteritis?

Similarly, who treats conditions such as polymalgia rheumatica, inclusion body myositis, polymyositis, dermatomyositis, and other inflammatory or non inflammatory myopathies?

I imagine that the immunotherapy can become quite complicated with the various immunosuppressant/immunomodulatory drugs out there.

 

[Thama]

At my institution, neurology is 100% responsible for all of those. Neuromuscle does all the inflammatory myopathies and immune neuropathies, and either stroke or neuroimmunology does the various CNS vasculidities.

My experience with rheum is that they do RA, lupus, sjogrens, and rapidly get uncomfortable after that.

 

[Telamir]

This depends on your access to sub-specialties.

Primary angiitis of the CNS is usually diagnosed/followed up by neuro, but I have seen rheumatologists manage the medications if say a neurologist isn't comfortable/doesn't know how to follow cyclophosphamide or rituximab.

Polymyalgia rheumatica is usually a collaboration between the two, but inclusion body myositis is typically managed by neuro (not much treatment...but still). I haven't seen neuro manage polymyositis and dermatomyositis. We may make the diagnosis especially if they present with neurologic symptoms but those are typically followed by rheum.

Again, if you have access to fellowship trained neuromuscular folks they might be more comfortable taking care of/dealing with some of these conditions but if you don't have them then rheumatology will likely take a more active role.