Viêm khớp dạng thấp: Thận trọng với các thuốc ức chế miễn dịch
(SK&ĐS) - Trước kia, nguyên nhân gây viêm khớp dạng thấp (VKDT) được cho là do nhiễm đa khuẩn, rối loạn hormon chuyển hóa nhưng không có bằng chứng. Vài thập niên gần đây, tiến bộ về miễn dịch học, sinh học phân tử cho phép hiểu thêm sự khởi phát, duy trì, tiến triển bệnh và xác định là bệnh tự miễn. Thuốc điều trị bệnh cũng có những nguyên tắc nhất định.
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