Autoimmune Disease

UPDATED ON: 6 Feb 2024, 14:34 PM

Medically Reviewed by

Overview
Causes
Key Facts
Symptoms
Diagnosis
Treatment
Articles
FAQs

What is Autoimmune Disease?

A robust immune system protects the body from diseases and infections, yet when it malfunctions, it mistakenly targets healthy cells, tissues, and organs, which we know as autoimmune diseases. These attacks can impair bodily functions and pose life-threatening risks.

Autoimmune diseases occur when the body’s immune system mistakenly attacks its own tissues, mistaking them for harmful pathogens. This can lead to inflammation, pain, and damage to various organs and systems within the body. There are over 80 known autoimmune diseases, including rheumatoid arthritis, lupus, multiple sclerosis, type 1 diabetes, and celiac disease, among others. The exact causes of autoimmune diseases are not fully understood, but they likely involve a combination of genetic predisposition and environmental factors. Factors such as infections, certain medications, and hormonal imbalances may trigger the onset of autoimmune diseases in susceptible individuals. Early diagnosis is crucial in reducing the impact of this disease; therefore, it is advisable to seek medical attention if you notice any symptoms.

Types of autoimmune disease

Autoimmune diseases are a group of disorders characterised by an abnormal immune response directed against the body’s tissues. There are over 80 known autoimmune diseases, each affecting different organs and tissues. Here’s an overview of some of the major types:

1. Rheumatoid arthritis (RA)

RA primarily affects the joints, causing inflammation, pain, and eventual joint damage. The immune system attacks the synovium (the lining of the membranes that surround the joints), leading to swelling and stiffness.

2. Systemic lupus erythematosus (SLE)

SLE is a chronic autoimmune disease that can affect various parts of the body, including the skin, joints, kidneys, heart, lungs, and brain. Its symptoms can vary widely and may include fatigue, joint pain, skin rashes, fever, and organ damage.

3. Multiple sclerosis (MS)

MS affects the central nervous system, including the brain and spinal cord. The immune system attacks the protective covering of nerve fibers (myelin), leading to disruptions in nerve signaling and various neurological symptoms such as weakness, numbness, and coordination problems.

4. Type 1 diabetes

Type 1 diabetes is characterised by the destruction of insulin-producing beta cells in the pancreas by the immune system. This results in a lack of insulin production, leading to high blood sugar levels and the need for lifelong insulin therapy.

5. Celiac disease

It is an autoimmune disorder triggered by the ingestion of gluten, a protein found in wheat, barley, and rye. The immune system attacks the small intestine, leading to inflammation and damage to the intestinal lining, which impairs nutrient absorption.

6. Hashimoto’s thyroiditis

Hashimoto’s thyroiditis is a condition where the immune system attacks the thyroid gland, leading to inflammation and eventual destruction of thyroid tissue. This results in an underactive thyroid (hypothyroidism), leading to symptoms such as fatigue, weight gain, and sensitivity to cold.

7. Graves’ disease

Graves’ disease is the most common cause of hyperthyroidism. It occurs when the immune system produces antibodies that stimulate the thyroid gland to produce excessive amounts of thyroid hormone. Its symptoms may include weight loss, rapid heartbeat, anxiety, and heat intolerance.

8. Inflammatory Bowel Disease (IBD)

IBD includes conditions such as Crohn’s disease and ulcerative colitis, which involve chronic inflammation of the digestive tract. The exact cause is unknown, but it is believed to involve an abnormal immune response to gut bacteria in genetically predisposed individuals.

9. Psoriasis

Psoriasis is a chronic autoimmune condition that primarily affects the skin, causing red, scaly patches to develop. The immune system triggers inflammation, leading to the rapid turnover of skin cells.

10. Sjogren’s syndrome

Sjogren’s syndrome primarily affects the body’s moisture-producing glands, leading to symptoms such as dry eyes and dry mouth. The immune system attacks these glands, resulting in decreased production of tears and saliva.

11. Vitiligo

Vitiligo is a skin disorder characterised by the loss of pigment in certain areas of the skin, resulting in white patches. It is caused by the immune system attacking and destroying melanocytes, the cells that produce pigment in the skin.

12. Addison’s disease

Addison’s disease occurs when the immune system attacks the adrenal glands, which are responsible for producing hormones such as cortisol and aldosterone. This leads to insufficient hormone production, resulting in symptoms such as fatigue, weight loss, low blood pressure, and electrolyte imbalances.

13. Autoimmune hepatitis

Autoimmune hepatitis is a chronic liver inflammation caused by the immune system attacking liver cells. It can lead to liver damage, cirrhosis, and in severe cases, liver failure.

14. Pernicious anaemia

Pernicious anemia is a condition where the body is unable to absorb enough vitamin B12 from the diet. It is caused by the immune system attacking cells in the stomach that produce a protein called intrinsic factor, which is necessary for vitamin B12 absorption.

15. Myasthenia gravis

Myasthenia gravis is a neuromuscular disorder characterised by muscle weakness and fatigue, particularly in the muscles that control eye and eyelid movement, facial expression, chewing, swallowing, and speaking. It is caused by antibodies blocking or destroying receptors for the neurotransmitter acetylcholine at the neuromuscular junction.

These are just a few examples of autoimmune diseases, and each condition has its unique characteristics, symptoms, and treatment approaches.

Causes of Autoimmune Disease

Genetic, environmental, hormonal, and lifestyle factors all play a role in the development of autoimmune diseases. Here are 8 most common symptoms of autoimmune disease:

1. Family history: There’s often a genetic component to autoimmune diseases. Certain genes can make individuals more susceptible to developing autoimmune conditions. However, having these genes doesn’t mean that someone will develop an autoimmune disease; it merely increases the risk.

2. Environmental factors: External factors such as infections, exposure to certain chemicals (like pollutants or toxins), and even dietary factors can trigger autoimmune responses. For example, infections like the Epstein-Barr virus, cytomegalovirus, and certain bacteria have been linked to the development of autoimmune diseases.

3. Hormonal imbalances: Hormonal changes or imbalances can also contribute to the development of autoimmune diseases. For instance, conditions such as lupus and rheumatoid arthritis are more common in women, suggesting a hormonal influence.

4. Immune system dysregulation: In autoimmune diseases, the immune system mistakenly attacks healthy cells and tissues. This dysregulation of the immune system can be caused by various factors, including genetic predisposition, environmental triggers, and imbalances in immune cell function.

5. Stress: Chronic stress can weaken the immune system and trigger inflammation, which may contribute to the development or exacerbation of autoimmune diseases. Stress management techniques and lifestyle changes can help mitigate this risk factor.

6. Diet and lifestyle: Certain dietary factors, such as a high-sugar or high-fat diet, may promote inflammation and contribute to autoimmune responses. Additionally, lifestyle choices such as smoking and excessive alcohol consumption can also increase the risk of developing autoimmune diseases.

7. Microbiome dysbiosis: The gut microbiome plays a crucial role in regulating immune function. Imbalances or dysbiosis in the gut microbiota can lead to immune system dysfunction and contribute to the development of autoimmune diseases.

8. Sex hormones: Females have a higher risk of autoimmune disorders than males. They tend to strike during a female’s reproductive age, the time between the first menstrual cycle and menopause.

Key Facts About Autoimmune Disease

Major Symptoms	Fatigue Muscle weakness Joint pain and swelling Fever Feeling unwell Hair fall Sensitivity to cold and heat Unexplained weight loss Skin rashes Dizziness Numbness and tingling in hands and feet
Necessary Health Tests	Medical history Physical examination Laboratory tests such as: -Autoantibody testing -Specific organ function tests -Inflammatory markers -Complete blood count (CBC) -Comprehensive metabolic panel (CMP) Specific organ function tests Imaging studies such as X-rays, ultrasounds, CT scans, or MRI scans Biopsy
Treatment	Anti-inflammatory medications Corticosteroids Disease-modifying antirheumatic drugs (DMARDs) Biologic agents Immunosuppressants Monoclonal antibodies Intravenous immunoglobulin (IVIG) Lifestyle modifications Physical therapy and rehabilitation Surgery

Symptoms of Autoimmune Disease

Symptoms of autoimmune diseases can vary widely depending on the specific condition and the organs or systems affected. Common symptoms of autoimmune disease include:

Fatigue: Persistent tiredness and lack of energy, often not relieved by rest.
Joint pain or swelling: Inflammation and discomfort in the joints, sometimes accompanied by swelling and stiffness.
Muscle weakness: Reduced strength and endurance in muscles, leading to difficulties in movement and physical activities.
Fever: Elevated body temperature, often indicating underlying inflammation or infection.
Discomfort: A sense of unease, discomfort, or overall feeling of being unwell.
Skin rashes: Abnormalities in skin texture, colour, or appearance, which can vary from mild irritation to severe lesions.
Hair loss: Thinning or loss of hair, which may occur in patches or more diffusely.
Sensitivity to cold or heat: Heightened sensitivity to temperature changes, often affecting circulation and comfort.
Unexplained weight changes: Significant fluctuations in body weight without changes in diet or exercise habits.
Organ-specific symptoms: Depending on the autoimmune condition, individuals may experience symptoms related to specific organs or systems, such as respiratory issues, gastrointestinal disturbances, or neurological impairments.

Diagnosis of Autoimmune Disease

Diagnosis of autoimmune diseases involves a comprehensive approach that includes medical history, physical examination, and laboratory tests. Here’s a detailed breakdown:

1. Medical history: The doctor begins by taking a detailed medical history, which includes asking about symptoms, their duration and severity, family history of autoimmune diseases, any past medical conditions, medications, and environmental exposures.

2. Physical examination: A thorough physical examination is conducted to look for signs and symptoms associated with autoimmune diseases. This may involve examining the skin, joints, eyes, mouth, and other organs, depending on the suspected autoimmune condition.

3. Laboratory tests: Various blood tests are used to diagnose autoimmune diseases. These tests may include:

Autoantibody testing: This involves checking for antibodies that target the body’s tissues. Examples include antinuclear antibodies (ANA), rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP), anti-double-stranded DNA (anti-dsDNA), and anti-neutrophil cytoplasmic antibodies (ANCA).
Inflammatory markers: Tests such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) measure inflammation levels in the body, which can be elevated in autoimmune diseases.
Complete blood count (CBC): This measures various blood cell counts and can detect abnormalities such as anaemia or abnormal white blood cell counts.
Comprehensive metabolic panel (CMP): This panel of tests assesses organ function and electrolyte levels, which can be affected by certain autoimmune diseases.
Specific organ function tests: Depending on the suspected autoimmune disease, additional tests may be done to assess the function of specific organs. For example, liver function tests for autoimmune hepatitis or thyroid function tests for autoimmune thyroid diseases.

4. Imaging studies: In some cases, imaging studies such as X-rays, ultrasound, CT scans, or MRI scans may be ordered to evaluate organ involvement or damage caused by autoimmune diseases. For example, joint X-rays may be done in rheumatoid arthritis to assess for joint damage.

5. Biopsy: In certain situations, a biopsy of affected tissue may be necessary to confirm the diagnosis of an autoimmune disease. This involves removing a small sample of tissue for microscopic examination to look for characteristic features of autoimmune diseases, such as inflammation or tissue damage.

6. Consultation with specialists: Depending on the suspected autoimmune disease and its organ involvement, consultation with specialists such as rheumatologists, dermatologists, gastroenterologists, or endocrinologists may be necessary to aid in diagnosis and management.

Early and accurate diagnosis is crucial for initiating appropriate treatment and preventing complications associated with autoimmune diseases.

Treatment of Autoimmune Disease

Treatment of autoimmune diseases typically involves a combination of medications and lifestyle changes aimed at managing symptoms, reducing inflammation, and suppressing the immune system’s abnormal response. Here are various treatment options:

1. Anti-inflammatory medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help relieve pain and inflammation associated with autoimmune diseases like rheumatoid arthritis or lupus.

2. Corticosteroids: These powerful anti-inflammatory drugs, such as prednisone, are often used to quickly suppress inflammation during disease flares. However, long-term use can lead to significant side effects, so they’re usually prescribed at the lowest effective dose for the shortest duration possible.

3. Disease-modifying antirheumatic drugs (DMARDs): These medications target the underlying disease process in autoimmune diseases like rheumatoid arthritis. Examples include methotrexate, hydroxychloroquine, and sulfasalazine. They help reduce joint damage and slow disease progression.

4. Biologic agents: Biologic drugs, such as TNF-alpha inhibitors, interleukin inhibitors, and B-cell inhibitors, target specific components of the immune system involved in autoimmune responses. These drugs are often used when traditional DMARDs fail to provide adequate control of the disease.

5. Immunosuppressants: Drugs like azathioprine, cyclophosphamide, and mycophenolate mofetil suppress the immune system’s activity, helping to reduce inflammation and prevent damage to organs in conditions like lupus, multiple sclerosis, or inflammatory bowel disease.

6. Monoclonal antibodies: These drugs are engineered to target specific cells or proteins involved in autoimmune diseases. For example, rituximab targets B cells in diseases like rheumatoid arthritis and lupus, while ustekinumab targets specific cytokines in conditions like psoriasis and psoriatic arthritis.

7. Intravenous immunoglobulin (IVIG): In some autoimmune diseases, IVIG may be used to help regulate the immune system by providing a high dose of antibodies sourced from donated blood plasma.

8. Lifestyle modifications: Alongside medications, lifestyle changes such as maintaining a healthy diet, regular exercise, stress management, and adequate sleep can help manage symptoms and improve overall well-being.

9. Physical therapy and rehabilitation: For autoimmune diseases that affect mobility or cause joint damage, physical therapy can help improve strength, flexibility, and function, while occupational therapy can assist with adapting daily activities to reduce strain on affected joints.

10. Surgery: In cases where autoimmune diseases cause irreversible damage to organs or tissues, surgery may be necessary to repair or replace damaged structures. Examples include joint replacement surgery for severe arthritis or organ transplants for end-stage organ failure.

Autoimmune Disease Related FAQs

What are the 5 most common symptoms of autoimmune disease?

The most common symptoms of autoimmune disease include persistent fatigue, joint pain, and swelling, skin rashes or unusual skin changes, digestive issues, such as abdominal pain or diarrhoea, and recurrent fevers or unexplained weight loss.

Which autoimmune disease is considered the most severe?

Some autoimmune diseases, such as systemic lupus erythematosus (SLE) or systemic sclerosis (scleroderma), are often considered among the most serious due to their potential to affect multiple organs and systems in the body, leading to significant morbidity and mortality if not properly managed.

What are the common triggers for autoimmune diseases?

Genes, hormonal changes, stress, and lifestyle environmental factors such as viruses, bacteria, or toxins, can trigger autoimmune disease.

Can you live a long life with an autoimmune disease?

Yes, with proper management and treatment, many people with autoimmune diseases can live long and fulfilling lives. Make sure you follow your doctor’s advice.