We are the combination of four hospitals: the General Hospital, the Children’s Hospital, the Women’s Hospital and the Traumatology, Rehabilitation and Burns Hospital. We are part of the Vall d’Hebron Barcelona Hospital Campus: a world-leading health park where healthcare plays a crucial role.
Below we will list the departments and units that form part of Vall d’Hebron Hospital and the main diseases that we treat. We will also make recommendations based on advice backed up by scientific evidence that has been shown to be effective in guaranteeing well-being and quality of life.
Vols saber com serà la teva estada a l’Hospital Universitari Vall d’Hebron? Aquí trobaràs tota la informació.
Immunotherapy has revolutionised the treatment of some cancers in recent years. The immune system's job is to recognise and eliminate tumour cells, which prevents the appearance of tumours. However, when the tumour cells evade the immune system or it is not able to contain the tumour, that is when the cancer becomes apparent. The principle underlying immunotherapy is over-activating the immune system so that it can act against tumour cells. Nevertheless, this over-activation of the immune system can favour the appearance of inflammatory autoimmune diseases such as arthritis or myositis.
These adverse effects of immunotherapy, called immune-related adverse events (irAE), can manifest in any organ in the body. In rheumatology, the most common effects are joint issues with pain and swelling (arthritis) and inflammation in the muscles in the form of myositis. Other presentations include dry eye syndrome (dry eyes with a feeling of having "sand" in them), inflammation of vessels (vasculitis), or even kidney problems (nephritis).
These effects can occur in any patient being treated with immunotherapy, but it is more commonly seen in relation to the medications nivolumab, pembrolizumab, and ipilimumab. Diagnosing it requires an evaluation by a rheumatologist, who will take the symptoms into account, along with the analytical and imaging results, to make a more precise diagnosis.
Treatment is complex, as the immunotherapy must be continued due to the cancer. The oncologist and rheumatologist must carry out a joint evaluation to decide on the best treatment. The most commonly used treatments are anti-inflammatory agents and glucocorticoids, although in more severe cases, treatment with biological drugs (such as TNF-alpha inhibitors) can be considered.
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