Autoimmune Disorders

WHAT IS AUTOIMMUNE DISORDER?
When your immune system works normally, specialised immune cells produce antibodies against invaders like bacteria and viruses but do not attack your own cells. This process can go wrong when immune cells fail to recognise “home” and produce auto-antibodies which attack your own normal healthy tissues. When this happens the result is called an autoimmune disorder, and how the disorder manifests depends on which part of the body is under attack.

Examples
There are many diseases caused by immune cells attacking specific tissues or organs: some are more common than others and include:

  • Systemic Lupus Erythematosus (SLE or Lupus) – a disorder where several parts of the body are attacked, particularly the skin and joints of the fingers, hands, wrists and knees; also muscles and some organs like the kidney can be affected.
  • Rheumatoid arthritis – this is caused by the immune system reacting to joint tissues and, like SLE, can sometimes affect other parts of the body.
  • Multiple sclerosis – occurs when the outer covering of nerve cells (myelin sheath) in the brain and spinal cord are attacked and replaced with scar tissue; the process disrupts nerve messages getting around the body and can hinder control over body functions such as walking and talking.
  • Autoimmune hypothyroidism – occurs when cells of the thyroid gland are attacked, preventing it producing normal amounts of thyroid hormone which can lead to a condition also called Hashimoto’s thyroiditis or Graves disease; a swelling or goitre in the neck.
  • Myasthenia Gravis – this is where muscle cells are attacked and cannot send messages that trigger muscle contractions, leading to muscle weakness all over the body.
  • Crohn’s disease – this is an inflammatory bowel disease affecting any part of the digestive system, usually the small and large intestine but also the mouth and stomach. It’s an overreaction of the immune system in the bowel, in response to a dietary factor or an infection.

WHAT CAUSES AN AUTOIMMUNE ATTACK?
It’s not known for sure what causes the body’s immune system to turn on itself; however a likely cause is thought to be an infection that triggers the immune system to react against certain body tissues. Other causes are reactions to chemicals and medications.

WHAT ARE THE SYMPTOMS?
Effects usually include inflammation, pain and swelling, which can also lead to problems in a specific unrelated organ such as the kidneys. General overall effects (systemic) include dizziness, fatigue and flu-like symptoms. Depression is a symptom common to several disorders. Autoimmune diseases are usually chronic, because they last a long time, often with periods of remission followed by flare-up. There are specific symptoms for each disorder and it’s usually a grouping of these symptoms that leads to a diagnosis.

  • Crohn’s disease – abdominal pain, diarrhoea, weight loss, blood in the stools, mouth ulcers.
  • Lupus – rash, particularly a butterfly effect around the cheeks and nose, sun sensitivity, joint pain, inflammation around the heart (pericarditis) and tissues lining the lungs (pleurisy).
  • Multiple sclerosis – numbness, loss of balance, problems with movement, paralysis, difficulty speaking.
  • Rheumatoid arthritis – sore swollen joints, especially in hands and fingers, with morning stiffness.
  • Hypothyroidism – general slowing down of body functions, causing you to feel tired, cold and weak; problems with concentration or memory; thinning hair and weight gain.
  • Myasthenia Gravis – muscle weakness causing drooping eyes, difficulty breathing, speaking and chewing.

 


PREVENTION AND TREATMENT

There is no cure for autoimmune disorders, and disease severity may vary.

1. Recognise the symptoms
Each autoimmune disorder has its own set of symptoms, although there are some general symptoms that are caused by a malfunction of the immune system and these should indicate that something is seriously wrong. If you have persistent symptoms of fever, tiredness, joint pain and swelling that cannot be explained, then you should seek medical advice.

2. Obtain a diagnosis
There are specific tests that will help your medical practitioner diagnose your condition. These include blood tests for certain chemicals that may indicate an autoimmune disorder (such as anti-nuclear antibody or C-reactive protein). X-rays are often used to detect internal problems and if needed a biopsy will be taken of the bowel and urine or stool samples collected for analysis.

3. Seek the right treatment
Treatment for any autoimmune disorder is aimed at reducing the immune system activity using anti-inflammatory drugs such as corticosteroids, and immunosuppressive drugs. Sometimes replacement therapy is needed, as is common with type 1 diabetes (also thought to be an autoimmune disease) and hypothyroidism, where insulin injections or thyroxin tablets respectively are needed to replace what the damaged pancreas and thyroid glands cannot produce. For Crohn’s disease, anti-diarrhoeal medication and antibiotics may be needed to control symptoms.

4. Make appropriate lifestyle changes
Although there is no cure for autoimmune disorders, you may be able to adapt your lifestyle to cope with the symptoms better. Diet is usually helpful, particularly for Crohn’s diease, where a high-fibre diet low in processed ingredients and supplemented with vitamins (which mightn’t be absorbed by the damaged intestines) will help.

Getting enough rest while getting regular exercise will help you keep going, along with reducing stress and giving up smoking. If your joints are affected, physiotherapy can help keep them mobile. If you have lupus, you may need to keep out of the sun as sensitivity to sunlight can make your symptoms worse.

5. Manage your disease
If you have periods of remission and flare, it is also important to recognise when your remission period is over and a disease flare is about to happen. The same symptoms should act as a warning and help you manage your disease more effectively.