Rheumatische Erkrankungen bei Migranten

Zusammenfassung

Die Zuwanderung von Menschen aus anderen Ländern oder sogar von anderen Kontinenten stellt uns als Rheumatologen vor neue Herausforderungen. Obwohl alle entzündlich-rheumatischen Erkrankungen die hierzulande vorkommen, auch in den Heimatländern der Immigranten existieren, sind die Häufigkeiten unterschiedlich. Bei uns seltene Krankheitsbilder wie familiäres Mittelmeerfieber (FMF) oder M. Behcet sind v. a. in Nordafrika und im Mittelmeerraum oft häufiger als Spondyloarthritiden oder gar die RA. Das FMF ist zudem mit dem Auftreten einer Spondyloarthritis assoziiert, die dann häufig HLA-B27 negativ ist. Ebenso gibt es eine Assoziation mit dem M. Behcet. Auch das Rheumatische Fieber kommt v. a. in den afrikanischen Ländern noch häufig vor, während es in Europa fast ausgerottet ist. Zu beachten sind auch mögliche Differenzialdiagnosen wie rheumatische Symptome bei genetisch determinierten Anämien, oder bei Infektionen wie HIV, der Tuberkulose und Parasitosen, die allesamt in den Herkunftsländern der Migranten viel häufiger sind, als in Nordwesteuropa.

Abstract

The immigration of people from other countries, even more so from other continents, is a challenge for rheumatologists. Diseases such as familial Mediterranean fever (FMF) or Behcet’s disease (BD) are rare in Western Europe, whereas in North Africa and the Mediterranean countries they are even more common than rheumatoid arthritis (RA) or spondyloarthritis (SPA). Furthermore, FMF is associated with spondyloarthritis, which is mostly HLA-B27 negative, and it is also associated with BD. Rheumatic fever is still common especially in African, but also in some Mediterranean countries, whereas it is almost eradicated in Europe. Possible differential diagnoses such as rheumatic symptoms in genetically determined anaemia, or infections such as HIV, tuberculosis or parasitosis need to be considered, as they are all relatively common in the countries of origin of most immigrants in contrast to Germany and Northwest Europe.

Schlüsselwörter

Migranten - entzündlich-rheumatische Erkrankungen - Häufigkeiten - Probleme - Besonderheiten

Key words

immigrants - inflammatory rheumatic diseases - prevalences

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