[How to find a collagen-vascular disease patient in an early stage and when to let her/him visit a rheumatologist].

Collagen-vascular diseases could be defined as 'chronic', 'inflammatory', 'multiorgan diseases' 'with immunological derangement'. It is important to know that these diseases frequently involve locomotorium, skin, and vessels, of which symptoms or signs are easily sensed by patient herself or observed by herself or a doctor from her body surface. Even among routine laboratory findings, cytopenia, lymphocytopenia, inflammatory reactant level increase, serum total protein level increase could be indicative of these diseases. When considering a substantial number of patients with these diseases or with their subclinical status, routine medical check for rheumatoid factor or anti-nuclear antibody would be better recommended. In case that differential diagnosis is difficult or a strong intervention may be necessary, visiting a rheumatologist at least once would be a choice for early diagnosis or to avoid iatrogenic adverse events induced by irrelevant steroid, disease-modifying anti-rheumatic drug or immunosuppressant. Socio-economically, the early diagnosis and early treatment for these diseases would be very effective showing a good cost-performance.