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Autoimmune Disorders

Alternate Names

  • autoimmune conditions

Definition

An autoimmune disorder is one in which a person's immune system creates antibodies that attack the tissues of his or her own body. Virtually every part of the body is susceptible to an autoimmune disorder.

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 own tissues may be seen as "foreign" by the immune system. When this happens, the immune system attacks the body itself. This response is known as an autoimmune disorder.

Risks

What are the causes and risks of the condition?

Some autoimmune disorders, such as psoriasis, run in families and may have a genetic component. Although no one knows for sure what causes an autoimmune response, some triggers have been identified.
These triggers, which may bring on a flare-up of the disorder or worsening of symptoms, include the following:
  • aging
  • cancers, such as leukemia
  • hormones
  • medications
  • pregnancy
  • stress
  • sunlight
  • viral infection, such as a cold or flu

Prevention

What can be done to prevent the condition?

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

Diagnosed

How is the condition diagnosed?

Many autoimmune disorders are diagnosed based on symptoms, a physical exam, 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 lab. 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.

Long Term Effects

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 function loss in part of the body. For example, kidney failure is a fairly common problem in persons with severe systemic lupus erythematosus. Those with severe rheumatoid arthritis may not be able to tie their shoes due to the damage in the joints of their hands.
Many persons with autoimmune disorders are also at a higher risk of infections. Autoimmune disorders are often long-term and take courses that hard to predict. In severe cases, serious disability and death can occur.

Other Risks

What are the risks to others?

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

Treatments

What are the treatments for the condition?

The goal of treatment in autoimmune 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 to keep it from attacking the body. However, this also reduces the body's ability to fight off infections.
Treatments to reduce symptoms may include:
  • nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin or ibuprofen (i.e., Advil, Motrin), to relieve fever, joint pain, and muscle aches
  • corticosteroids, or steroids, help reduce inflammation. These medications are often used on a short-term basis to get a person through a sudden episode or flare-up.
  • medications to suppress the immune system, such as methotrexate, azathioprine (i.e., Azasan, Imuran), and cyclophosphamide (i.e., Cytoxan), 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 hemolytic anemia. Insulin is given to individuals with type 1 diabetes to control blood glucose levels.
Many research studies are currently under way to develop or test treatments for autoimmune disorders. These studies include:
  • examining the role of interferon in selected disorders. Beta interferon, for example, has been approved for the treatment of multiple sclerosis and is being tested in other autoimmune disorders as well.
  • studying the use of stem cells, which are a type of cell that can grow into different cell types
  • using new antibodies to modify the way T cells encourage the body to attack its own tissues
Although autoimmune disorders cannot be cured, these steps can help an individual improve his or her quality of life:
  • understanding and following the treatment plan developed in conjunction with the healthcare provider
  • avoiding, whenever feasible, triggers such as sunlight or viral infections
  • identifying stressors and using stress-management techniques to lower one's stress level
  • balancing the need for activity, rest, and sleep
  • eating a healthy diet, as recommended by the healthcare provider. If no special diet is recommended, individuals should follow the food guide pyramid.
  • joining a support group for a specific disorder, such as chronic fatigue syndrome

Side Effects

What are the side effects of the treatments?

Medications used to treat autoimmune disorders have many side effects. 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 blood glucose, an increased risk of infection, and muscle weakness, which may be caused by corticosteroids
  • an increased risk of infection, stomach upset, and liver or kidney damage which may be caused by medications that suppress the immune system
Surgery can be complicated by bleeding, infection, and an allergic reaction to the anesthetic. Blood transfusions carry a risk of allergic reactions and infections.

After Treatment

What happens after treatment for the condition?

Autoimmune 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 treatments, which may be lifelong, and are specifically geared to minimize damage to the body.

Monitor

How is the condition monitored?

The healthcare provider should monitor a person with an autoimmune disorder with periodic physical exams and blood tests, and watch for complications. Any new or worsening symptoms should be reported to the healthcare provider.

Sources

"Understanding Autoimmune Disorders", [hyperLink url=" http://www.niaid.nih.gov/publications/autoimmune.htm" linkTitle="www.niaid.nih.gov/publications/autoimmune.htm"] www.niaid.nih.gov/publications/autoimmune.htm[/hyperLink]

The Merck Manual of Medical Information, Home edition, 1997

Professional Guide to Diseases, Sixth Edition. Springhouse: Springhouse Corporation, 1998

Tierney, Lawrence, editor, "Current Medical Diagnosis and Treatment, 39th edition", 2000

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