Autoimmune Conditions Autoimmune Disorders

An autoimmune disorder is one in which a person’s immune systembegins to attack his or herown body. The immune system creates antibodies against its own tissues.Virtually every part of the body is susceptible to an autoimmune disorder. Thefollowing are some diseases and conditions that are believed to have anautoimmune component:

• autoimmune hemolytic anemia, in which the immune system destroys a person’s red bloodcells
• autoimmune hepatitis,which causes inflammation of the liver
• Berger’s disease,alsoknown as IgA nephropathy, which causes kidney damage
• chronic fatiguesyndrome, which causes feelings of malaise, or a vague feeling ofillness
• Crohn’s disease, which causes inflammation in the bowels
• dermatomyositis, which affects the skin and muscles
• fibromyalgia,which causes chronic pain and stiffness in the muscles
• Graves’ disease, which affects the thyroid gland
• Hashimoto’sthyroiditis, which is a chronic inflammation of the thyroidgland
• idiopathic thrombocytopeniapurpura, which causes low platelet counts and interferes withnormal blood clotting
• lichen planus, whichaffects the skin, eyes, and linings of the mouth and genitals
• multiple sclerosis, in which the body attacks partsof the nervous system
• myasthenia gravis, which causes severe muscle weakness
• psoriasis, which causes skin lesions and itching
• rheumatic fever,which causes damage to body organs, including the heart, following a strepinfection
• rheumatoid arthritis, in which the body attacks thejoints
• scleroderma, which involves the skin, gut, and other structures
• Sjogren syndrome, which causes dry eyes and mouth
• systemic lupus erythematosus, in which the bodyattacks connective tissue in joints and also in the kidneys
• type 1 diabetes, a condition in which the individual doesn’tproduce enough insulin
• ulcerative colitis, which also causes inflammation in thebowels
• vitiligo, whichcauses a decrease in skin pigments

What is going on in the body?

The job of the immune system is to protect the body from foreign substances. Itis the immune system that fights off infections caused by bacteria or viruses.Sometimes a person’s own tissues may be seen as “foreign” by the immune system.When this happens, the immune system attacks the body itself. This response isknown as an autoimmune disorder.

What are the causes and risks of the condition?

Some autoimmune disorders, such as psoriasis, run in families and may have a geneticcomponent. Although no one knows for sure what causes an autoimmune response,some triggers have been identified. These triggers, which may bring on aflare-up of the disorder or worsening of symptoms, include the following:

• aging
• cancers, such asleukemia
• hormones
• medications
• pregnancy
• stress
• sunlight
• viral infection, such as a cold or flu

New research findings suggest that autoimmune disordersmay be triggered by a transfer of cells between the fetus and the mother duringpregnancy. The studyinvolved women with scleroderma, an autoimmune disorder involving the skin. These womenhave more fetal cells in their blood decades after a pregnancy than women whodon’t have scleroderma. While further research is needed to substantiate thesefindings, the study does offer an explanation for the much higher incidence ofautoimmune disorders in women than in men.

What are the signs and symptoms of the condition?

The symptoms of an autoimmune disorder depend on the specific disease and theorgan or tissue that is affected. For example, systemic lupus erythematosus maycause kidney failure, arthritis, and a skin rash on the face. Autoimmunehemolytic anemia causes anemia, or low red blood cell counts. Generalsymptoms of autoimmune disorders may include:

• low-grade fever
• malaise, which isa vague feeling of illness
• fatigue, or tiring easily

How is the condition diagnosed?

Many autoimmune disorders are diagnosed based on symptoms, a physical exam, andthe results of blood tests. These diseases can be difficult to diagnose,especially early on. Sometimes the symptoms of one disease overlap with thoseof another. In these cases, an overlap or “mixed” disease may be present.

Some autoimmune disorders need other tests to make the diagnosis. A biopsy sample,or small piece of tissue, can be removed from an affected area. This tissue canthen be tested and examined in the lab. A biopsy sample can be taken fromalmost any part of the body, including the skin, kidney, liver, or intestines.

Special X-ray tests may need to be done. For example, changes in the jointsseen on joint X-rays can help make the diagnosis of rheumatoid arthritis in some cases.

What can be done to prevent the condition?

No ways are known to prevent autoimmune disorders. Avoiding the triggerscan help prevent symptoms from getting worse.

What are the long-term effects of the condition?

The long-term effects vary with each disorder. Long-term effects of thesedisorders include destruction of tissue or a function loss in part of thebody. For example, kidney failure is a fairly common problem in persons withsevere systemic lupuserythematosus. Those with severe rheumatoid arthritis may not be able to tie their shoesdueto the damage in the joints of their hands. Many persons with autoimmunedisorders are also at a higher risk of infections.

Autoimmune disorders are often long-term. The courses they take are hard topredict. In severe cases, serious disability and death can occur.

What are the risks to others?

Autoimmune disorders are not contagious and pose no risk to others.

What are the treatments for the condition?

The goal of treatment in autoimmune disorders is to reduce symptoms and preventdamage to the organs in the body. This is done by controlling the immune systemand the inflammation that it causes. Many of the medications used to treatautoimmune disorders suppress the immune system. That is, they keep the immunesystem from attacking the body. However, this also reduces the body’s abilityto fight off infections.

Treatments to reduce symptoms may include:

• nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin oribuprofen, to relieve fever,joint pain, and muscleaches
• corticosteroids, or steroids, help reduce inflammation. Thesemedications are often used on a short-term basis to get a person through asudden episode or flare-up.
• medications to suppress the immune system, such as methotrexate,azathioprine, and cyclophosphamide, which help to reduce inflammation and organdamage

In some cases, other treatments may be needed. For example, surgery may beneeded for blockage of the bowels, which may occur in Crohn’s disease. Blood transfusionsmay be needed in severe cases of autoimmune hemolytic anemia. Insulin is givento individuals with type 1diabetes to control blood glucose levels.

Many research studies are currently under way todevelop or test treatments for autoimmune disorders. These studies include:

• examining the role of interferon in selected disorders. Beta interferon,forexample, has been approved for the treatment of multiple sclerosis and is being tested in otherautoimmune disorders as well.
• studying the use of stem cells, which are a type of cell that can grow intodifferent cell types
• using new antibodies to modify the way T cells encourage the body to attackits own tissues

Although autoimmune disorders cannot be cured, there are steps an individualcan take to improve his or her quality of life. These steps include thefollowing:

• understanding and following the treatment plan developed in conjunctionwith the healthcare provider
• avoiding, whenever feasible, triggers such as sunlight or viralinfections
• identifying stressors and using stress-management techniques to lower his or her stress level
• balancing the need for activity, rest, and sleep
• eating a healthy diet, as recommended by the healthcare provider. If nospecial diet is recommended, individuals should follow the food guide pyramid.
• joining a support group for a specific disorder, such as chronic fatigue syndrome

What are the side effects of the treatments?

Medications used to treat autoimmune disorders have many sideeffects. The side effects include:

• stomach upset, stomach bleeding, headaches,and a decrease in kidney function caused by NSAIDs
• weight gain, high blood pressure,acne,easy bruising, bone loss known as osteoporosis, increased bloodglucose, an increased risk of infection, and muscle weakness,which may be caused by corticosteroids
• an increased risk of infection, stomach upset, and liver or kidneydamage which may be caused by medications that suppress the immune system

Surgery carries a risk of bleeding, infection, and allergic reaction to anesthesia. Bloodtransfusions carry a risk of allergic reactions and infections.

What happens after treatment for the condition?

Autoimmune disorders are often long-term diseases with symptoms that can comeand go over time. The outcome varies with each disorder. Many can be controlledwith treatment. A person may need treatment for the rest of his or her life.Specific treatments are often related to the body damage that occurs.

How is the condition monitored?

A person with an autoimmune disorder should have frequent physical exams. Thishelps the healthcare provider monitor the disorder and watch for complications.Frequent blood tests may help monitor the disorder as well. Any new orworsening symptoms should be reported to the healthcare provider.