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autoimmune disorders Alternative Names
autoimmune conditions
Definition
In an autoimmune disorder, a person's immune system begins to attack his or her own body. Examples of these disorders include: - multiple sclerosis, in which the body attacks parts of the nervous system
- myaesthenia gravis, which causes severe muscle weakness
- type I diabetes
- rheumatoid arthritis, in which the body attacks the joints
- systemic lupus erythematosus, in which the body attacks connective tissue in joints and also the kidneys
- dermatomyositis, which affects the skin and muscles
- scleroderma, which involves the skin, gut, and other structures
- Sjogren's syndrome, which causes dry eyes and mouth
- Crohn's disease, which causes inflammation in the bowels
- ulcerative colitis, which also causes inflammation in the bowels
- psoriasis, which involves the skin
- Grave's disease, which affects the thyroid gland
- autoimmune haemolytic anaemia, in which the immune system destroys a person's red blood cells
Overlap or mixed connective tissue disorder, involves symptoms of more than one of these disorders. There are many other examples of autoimmune disorders as well.
What is going on in the body?
The job of the immune system is to protect the body from foreign substances. It is the immune system that fights off infections caused by bacteria or viruses. Sometimes a person's body may be seen as "foreign" by the immune system. When this happens, the immune system attacks the body itself. This can lead to problems ranging from a skin rash to death. Any organ in the body can be affected. As a group, these disorders affect women more often than men. They usually affect women during their childbearing years.
What are the signs and symptoms of the condition?
The symptoms of an autoimmune disorder depends on the specific disease and the organ or tissue that is affected. For example, systemic lupus erythematosus may cause kidney failure, arthritis, and a skin rash on the face. Autoimmune haemolytic anaemia causes anaemia, or low red blood cell counts. General symptoms of autoimmune disorders may include: - low-grade fever
- feeling as though one has "the flu"
- fatigue or tiring easily
What are the causes and risks of the condition?
Autoimmune disorders may run in families. Some of these diseases may begin or get worse after a viral infection. Sunlight can also act as a trigger and may worsen the course of some of these disorders, such as systemic lupus erythematosus. Other things that may affect the immune system and the course of these disorders include ageing, chronic stress, hormones and pregnancy. Certain medications or cancers, such as leukaemia, may cause these disorders in some cases.
What can be done to prevent the condition?
There are no known ways to prevent these disorders. Avoiding the triggers can help prevent symptoms from getting worse.
How is the condition diagnosed?
Many of these disorders are diagnosed based on symptoms, a physical examination and the results of blood tests. These diseases can be difficult to diagnose, especially early on. Sometimes the symptoms of one disease overlap with those of 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 can then be tested and examined in the laboratory. A biopsy sample can be taken from almost 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 joints seen on joint x-rays can help make the diagnosis of rheumatoid arthritis in some cases.
What are the long-term effects of the condition?
The long-term effects vary with each disorder. Long-term effects of these disorders include destruction of tissue or a lack of function of part of the body. For example, kidney failure is a fairly common problem in persons with severe lupus. Those with severe rheumatoid arthritis may not be able to tie their shoes due to the damage to the joints in their hands. Many persons with these disorders are also at a higher risk of infections.
These disorders are often long-term. The courses they take are hard to predict. In severe cases, serious disability and death can occur.
What are the risks to others?
Autoimmune disorders are not contagious.
What are the treatments for the condition?
The goal of treatment in these disorders is to reduce symptoms and prevent damage to the organs in the body. This is done by controlling the immune system and the inflammation that it causes. Many of the medications used to treat autoimmune disorders suppress the immune system. That is, they keep the immune system from attacking the body. However, this also reduces the body's ability to fight off infections.
Treatments to reduce symptoms may include: - non-steroidal anti-inflammatory drugs (NSAIDs), including aspirin or ibuprofen, to treat fever, joint aches, and muscle aches
- corticosteroids, or steroids, help reduce inflammation and are often used on a short-term basis to get a person through an sudden episode or flare-up
- drugs to suppress the immune system, such as methotrexate, azathioprine, and cyclophosphamide, which help to reduce inflammation and organ damage
In some cases, other treatments may be needed. For example, surgery may be needed for blockage of the bowels, which may occur in Crohn's disease. Blood transfusions may be needed in severe cases of autoimmune haemolytic anaemia. Medications may be needed to treat the muscle spasms that can develop with multiple sclerosis.
What are the side effects of the treatments?
The drugs used to treat these disorders have many side effects. The side effects include the following: - NSAIDs can cause stomach upset, stomach bleeding, headaches, and a decrease in kidney function.
- Corticosteroids may cause weight gain, high blood pressure, acne, easy bruising, bone loss or osteoporosis, increased blood sugar, an increased risk of infection and muscle weakness.
- Medications that suppress the immune system may cause an increased risk of infection, stomach upset and liver or kidney damage.
Surgery carries a risk of bleeding, infection, and reaction to any analgesics used. Blood transfusions carry a risk of allergic reactions and infections. Other medications may cause allergic reactions, stomach upset, headaches and other effects.
What happens after treatment for the condition?
These disorders are often long-term diseases with symptoms that can come and go over time. The outcome varies with each disorder. Many can be controlled with 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 examinations. This helps the doctor monitor the disorder and watch for complications. Frequent blood tests may help monitor the disorder as well.
Author: Gail Hendrickson, RN, BS
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request |
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