Thirty years ago this area of medicine was restricted to steroids and anti-inflammatory non-steroids, used essentially for rheumatic diseases as rheumatoid arthritis, systemic lupus erythemathosus, or ankylosing spondilitis. In the late 70s, in a very few hospitals in the UK, Scandinavia and in the USA, there were medical advances in two different directions. Firstly, the spectrum of therapies was enlarged by medications coming out of transplant medicine. Secondly, the spectrum of diseases which could be treated was widened. New forms of administration of steroids, as alternate day and pulse regimens; therapies with blood derivatives as plasma exchange and hematopoietic stem cells; chemotherapy, until this time used primarily for cancer, was tamed to be used in smaller doses and specific regimens for non-neoplastic diseases. Morbidity and mortality associated with these forms of therapy decreased markedly, allowing physicians to venture treatment in diseases themselves not so deadly, in the pulmonary, neurological, rheumatological, renal and even skin systems. Bone marrow transplants were sub-classified in various forms, with differing intensities. Morbidity is the medical term for suffering associated with complications of diseases and their treatment.
New medications appeared that target directly the cells that cause immune diseases, frequently called auto-immune because the body attacks itself using its own mechanisms. Some of these drugs, called monoclonal antibodies are highly intelligent drugs, guided to attack specific groups of cells. Developed by genetic bioengineering, they decrease the production of substances that cause diseases such as dermatomyositis, myasthenia gravis, polimyositis, ankylosing spondilitis and rheumatoid arthritis. Drugs have been developed that target cells that attack the body’s myelin in multiple sclerosis. Diseases thought to be degenerative, as MS, Alzheimer’s and amyotrophic lateral sclerosis, have come to be considered the result of inflammation, and slowly are becoming treatable with immune protocols. Genetic diseases, like Duchenne muscular dystrophy, have become immunological disorders. Molecular therapies may target specific cell groups, like B or T lymphocytes or plasmocytes. Many other articles at rosaks.com.br/dimpna cover these issues.
Dimpna was a pioneer and has experience in the use of these forms of therapy in a variety of disorders. We are aware by personal and institutional experience that these are very severe and complex cases, each of them rare, many with unclear diagnosis or differing, often conflicting medical opinions. Our standard of care, at our own installations or at closely related partners, was honed through these years of pulse and high dose chemotherapy. We are able to follow closely patients under intense myelo and immune suppression, with extremely low white cell and platelet counts, under isolation and contact protection. Certified by the local health authority as a chemotherapy center, Dimpna has no hospital infection, because it is not a hospital and does not carry out hospital procedures. Rarely we have had complications that have warranted hospitalization in intensive care units of associated hospitals.
Patients are cared for in a day hospital envirnoment, and frequently stay at a close by hotel, which has accomodated our patients for many years according to their needs.
At Dimpna, climate control, private parking, our pleasure and experience in caring for people with problems of the nervous system set the scene for the comfort of those who trust in our care.