RECAP ON AUTOIMMUNE DISEASES….

Hello hello, March is Autoimmune Disease Awareness Month. As we all know by now, I suffer from multiple autoimmune conditions therefore I believe I am best placed to enlighten you! Let’s get into the article:

DEFINITION: An autoimmune disease is a condition in which your immune system mistakenly attacks your body. The immune system normally guards against germs like bacteria and viruses. When it senses these foreign invaders, it sends out an army of fighter cells to attack them. Normally, the immune system can tell the difference between foreign cells and your own cells, but, with an autoimmune disease, the immune system mistakes part of your body- like your joints, organs or the skin – as foreign. It releases proteins called auto-antibodies that attack healthy cells. Some autoimmune disease target only one organ e.g. Type 1 diabetes damages the pancreas; Rheumatoid arthritis attacks the joints; Graves disease attacks the thyroid whilst others like Systemic Lupus Erythematosus (SLE), affect the whole body.

Ideally, an autoimmune patient should have just one condition, but a few like me, have multiple autoimmune conditions. They are usually classified in order of their prevalence in the body. In my case, my primary autoimmune conditions are Lupus (SLE), Rheumatoid Arthritis (RA) and Stiff-Person Syndrome (SPS). Then the others, that is, Antiphospholipid Antibody Syndrome (APS), Mixed Connective Tissue Disease (MCTD), Polymyositis, Demyelinating Myelopathy, Myalgic Encephalomyelitis (ME) & Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) are classified as Secondary/Overlap Conditions. Multiple Autoimmune Syndrome is a condition in which patients have at least 3 distinct autoimmune conditions. The presence of multiple conditions can make diagnosis difficult to determine. However, once a diagnosis for one is determined, doctors are always on the lookout for symptoms that might point to an additional/overlap condition.

CAUSE: The cause is generally unknown. Some autoimmune conditions such as lupus and rheumatoid arthritis may run in families and certain cases may be triggered by infections or other environmental factors.

SIGNS & SYMPTOMS: An individual may also have more than one autoimmune disease simultaneously, and display symptoms of multiple diseases. Signs and symptoms presented, and the disease itself, can be influenced by various other factors such as age, hormones, and environmental factors. In general, the common symptoms are as:

• Fatigue
• Muscle aches
• Joint pain: Swelling & redness.
• Low-grade fever
• Trouble concentrating
• Numbness and tingling in the hands and feet
• Hair loss
• Rashes on different areas of the skin

Individual diseases can also have their own unique symptoms. For example, type 1 diabetes causes extreme thirst, weight loss, and fatigue. Inflammatory Bowel Disease (IBD) causes belly pain, bloating, and diarrhea. With autoimmune diseases like psoriasis or RA, symptoms may come and go. A period of sudden appearing or worsening of symptoms is called a flare-up. A period when the symptoms decrease or disappear is called remission.

DIAGNOSTIC PROCESS: No single test can diagnose most autoimmune diseases. Your doctor will use a combination of tests and a review of your symptoms and physical examination to diagnose you. These tests are:

Antinuclear Antibody (ANA): A test used to identify abnormal proteins, known as antinuclear antibodies, produced when the body attacks its own tissues. It may test positive in several disorders. This test is most useful for diagnosing Systemic Lupus Erythematosus, having a 95% positive test rate.

Complete Blood Count: A test taking measurements on maturity levels, count, and size of blood cells. Targeted cells include: red blood cells, white blood cells, hemoglobin, hematocrit, and platelets. Based on increased or decreased numbers in these counts, underlying medical conditions may be present; typically, autoimmune disease is represented by low white blood cell count . For proper diagnosis, further testing is needed.

Complement: A test used to measure levels of a protein group of the immune system called Complement, within the blood. if complement is found in low levels, this may be an indication of disease activity.

C-Reactive protein: Is a protein made in the liver that generally increases with inflammation, and may be high in autoimmune disease.

Erythrocyte Sedimentation Rate (ESR): This test measures the rate at which a patient’s blood cells descend in a test tube. More rapid descents may indicate inflammation, a common symptom of autoimmune disease.

TREATMENT: Treatment depends on the type and severity of the condition; Non-steroidal Anti-Inflammatory Drugs (NSAIDs) and immunosuppressants are often used. In other cases, Glucocorticoids & Disease-modifying anti-rheumatic drugs (DMARDs) are added to modify treatment.

NSAIDs drugs are members of a drug class that reduces pain, decreases fever, prevents blood clots and in higher doses, decreases inflammation.eg Ibuprofen, Diclofenac & high-dose aspirin.

Immunosuppressant drugs are a class of drugs that suppress or reduce the strength of the body’s immune system. With an autoimmune disease, the immune system attacks the body’s own tissue. Because immunosuppressant drugs weaken the immune system, they suppress this reaction. This helps reduce the impact of the autoimmune disease on the body. There are different types of immunosuppressants:

1. Corticosteroids e.g. Prednisone
2. IMDH Inhibitors e.g. Azathioprine & Mycophenolate
3. Biologics e.g. Rituximab & Humeral

Glucocorticoids are a class of steroid hormones used to reduce inflammation. E.g. Methyl prednisone.

Disease-modifying anti-rheumatic drugs (DMARDs) act by altering the underlying disease rather than treating symptoms to decrease the damaging tissue and organ effects of the inflammatory autoimmune response. E.g. Hydroxychloquine (HCQS) & Methotrexate.

Other standard treatment methods include:

• Vitamin or hormone supplements for what the body is lacking due to the disease (insulin, vitamin B12, thyroid hormone, etc.)
• Blood transfusions if the disease is blood related
• Physical/Hydro therapy if the disease impacts bones, joints, or muscles.

Because these drugs aim to reduce the immune response against the body’s own tissues, there are side effects of these traditional treatment methods, such as being more vulnerable to infections that can potentially be life threatening. There are new advancements in medicine for the treatment of autoimmune diseases that are currently being researched, developed, and used today, especially when traditional treatment options fail. 

Other methods of easing pain include therapeutic body massages, reflexology & regular exercising.

SPECIALISTS: See a doctor if you have symptoms of an autoimmune disease. You might need to visit a specialist, depending on the type of disease you have:

• Rheumatologists treat joint diseases, like rheumatoid arthritis as well as other autoimmune diseases like Sjögren’s syndrome and Lupus.
• Nephrologist. A doctor who treats kidney problems, such as inflamed kidneys caused by lupus
• Neurologist. A doctor who treats nerve problems such as multiple sclerosis and myasthenia gravis.
• Gastroenterologists treat diseases of the gastrointestinal tract, such as Celiac and Crohn’s disease.
• Endocrinologists treat conditions of the glands & hormones, including Graves’ disease, Hashimoto’s thyroiditis, and Addison’s disease.
• Dermatologists treat skin conditions, such as psoriasis.
• Hematologist. A doctor who treats diseases that affect blood, such as some forms of anemia.
• Physical therapist. A health care worker who uses proper types of physical activity to help patients with stiffness, weakness, and restricted body movement.
• Occupational therapist. A health care worker who can find ways to make activities of daily living easier for you, despite your pain and other health problems. This could be teaching you new ways of doing things or how to use special devices.
• Speech therapist. A health care worker who can help people with speech problems from illness such as multiple sclerosis.
• Audiologist. A health care worker who can help people with hearing problems, including inner ear damage from autoimmune diseases.
• Counselor for emotional support. A health care worker who is specially trained to help you to find ways to cope with your illness. You can work through your feelings of anger, fear, denial, and frustration.

I hope that you have learnt more about autoimmune conditions. Kindly share this with a friend or family member and let’s keep the awareness train going! Let’s learn, educate and empower! Thank you and till the next post, love and light! 💜