Presentation
Symptoms depend on type of reaction due to autoimmunity and its site. The common symptoms are fatigue, fever, malaise, joint pain, and rash. Anaphylaxis is characterized by dizziness, rash itching, breathless, tachycardia and lip swelling. Autoimmunity against blood components is characterized by fatigue, yellow urine, and fever. Involvement of lung is characterized by cough, fever and dyspnea [6].
Entire Body System
- Pain
Examples of symptoms related to the damage of a particular organ include a skin rash after sun exposure, joint pain and stiffness, and chest pain with heart and/or lung involvement. [verywellhealth.com]
Imagine your pain or discomfort. Imagine something that confronts this pain and watch it "destroy" the pain. [womenshealth.gov]
Others include skin rashes, vaginal dryness, joint pain, extended fatigue and swollen glands behind the jaw. [templehealth.org]
You have severe pain or swelling. You have a fever along with stiffness and pain. You have blood in your urine, bowel movement, or vomit. You have severe abdominal pain. You are confused or feel dizzy or faint. [drugs.com]
Other symptoms include swelling and redness at site of inflammation fatigue fever unexplained weight loss rashes muscle pain joint stiffness that improves with activity and gets worse with rest back pain at night that gets worse with rest and immobility [hormone.org]
- Weakness
Symptoms of Graves' disease can include bulging eyes as well as weight loss, nervousness, irritability, rapid heart rate, weakness, and brittle hair. [webmd.com]
Anemia results, often causing fatigue, weakness, and light-headedness. Nerves can be damaged, resulting in weakness and loss of sensation. [merckmanuals.com]
Signs of pernicious anemia include weakness, sore tongue, bleeding gums, and tingling in the extremities. [medical-dictionary.thefreedictionary.com]
People who have MS may experience weakness, trouble with balance and coordination, problems speaking and walking, paralysis, tremors, and numbness in the extremities. [everydayhealth.com]
- Weight Gain
It can be hard if you are taking a lot of prednisone, which causes weight gain, so working hard to maintain a healthy weight is important. Increasing your exercise is also really important in order to keep your heart and bones healthy. [ajmc.com]
While these medications can be effective at reducing some of the symptoms of the condition, because they suppress the entire immune system, they aren’t without many unwanted side effects: fatigue, weight gain, depression, increased infection rates and [maryvancenc.com]
Symptoms include fatigue, constipation, weight gain, depression, dry skin, and sensitivity to cold. Taking a daily oral synthetic thyroid hormone pill restores normal body functions. Myasthenia gravis. [webmd.com]
A number of studies have reported the negative health effects of consuming some processed foods, including increased risk of weight gain and heart disease. [medicalnewstoday.com]
Although there are sometimes no symptoms, Hashimoto's thyroiditis often results in a goiter (enlargement of the thyroid gland, which may be visible as a bulge in the neck), fatigue, weight gain, depression, muscle weakness, cold sensitivity, dry hair [everydayhealth.com]
- Falling
Shortly thereafter, the hair on the back of her head began to fall out. The first physician she saw suggested her symptoms were caused by stress from her recent wedding. His prescription: Take it easy. [prevention.com]
This fall AAMFT members will be sharing their unique perspectives, knowledge, and research findings in a crowdsourced effort to update our Therapy Topics. Check out the September 8 eNews for more information on how you can be involved! [aamft.org]
In general, autoimmune diseases often fall into one of two basic groups: Organ-specific disorders (also called localized) focus on one organ or a specific type of tissue: Addison's disease affects the adrenal glands autoimmune hepatitis affects the liver [childrenshospital.org]
There are many diseases that most people are familiar with that fall under the umbrella of autoimmune disorders, but they may not realize it. [blog.delimmune.com]
- Chronic Fatigue Syndrome
Chronic fatigue syndrome and fibromyalgia are not considered autoimmune diseases. This has been a source of confusion since some symptoms of chronic fatigue and fibromyalgia overlap with several autoimmune diseases. [verywellhealth.com]
Also suspected of having this as a component are chronic fatigue syndrome and fibromyalgia. [webmd.com]
Respiratoric
- Hemoptysis
We report a 73-year-old male who presented with cutaneous blistering, upper gastrointestinal bleeding, and hemoptysis. He later developed right flank pain secondary to a retroperitoneal hematoma. [ncbi.nlm.nih.gov]
Gastrointestinal
- Blood in Stool
Stools may appear black and tarry, which can indicate bleeding in the intestinal tract. Rarely, bleeding in the brain can cause altered mental status or death. White Blood Cells There are many different types of WBCs. [primaryimmune.org]
Jaw & Teeth
- Oral Ulcers
This can cause a variety of symptoms including: geographic tongue, an abnormal appearance of the tongue that can be mistaken for an oral yeast infection (thrush); gingivitis or inflammation of the gums; oral ulcers or canker sores; abdominal pain; diarrhea [primaryimmune.org]
Eyes
- Foreign Body Sensation
Ocular symptoms may include dry or red eyes, foreign-body sensation, pruritus, photophobia, pain, visual changes, and even complete loss of vision. [aafp.org]
- Prolapse
BACKGROUND: Polypropylene mesh has been used as a means of reinforcing weak tissues in women with pelvic organ prolapse and stress urinary incontinence. [ncbi.nlm.nih.gov]
Musculoskeletal
- Arthralgia
Most developed fever and arthralgias/arthritis. Other findings included serositis manifested by tachycardia, dyspnea and pleural effusions, headaches, and hair loss. [ncbi.nlm.nih.gov]
Patients presenting with DILE may experience fever, arthralgia, arthritis, myalgia, or serositis. [pharmacytimes.com]
- Myalgia
In each patient, autoimmune disease manifested as severe joint pains, myalgias, fever, rash, and proteinuria. [ncbi.nlm.nih.gov]
Patients presenting with DILE may experience fever, arthralgia, arthritis, myalgia, or serositis. [pharmacytimes.com]
Skin
- Alopecia
Development of diffuse BFHs has been associated with autoimmune disease and with the development of diffuse alopecia. Two women with autoimmune diseases had diffuse alopecia develop. [ncbi.nlm.nih.gov]
Types of autoimmune diseases include: Alopecia areata, Antiphospholipid antibody syndrome (aPL), Autoimmune hepatitis, Celiac disease, Diabetes type 1, Graves disease, Guillain-Barre syndrome, Hashimotos disease, Hemolytic anemia, Idiopathic thrombocytopenic [scitechnol.com]
[…] history of autoimmune disease People who have certain environmental exposures that could act as the trigger People of a particular race or ethnicity Many types of arthritis are considered autoimmune diseases, including: Other autoimmune diseases include alopecia [verywellhealth.com]
- Eczema
[…] that resulted in complete remission of his eczema. [ncbi.nlm.nih.gov]
Common Autoimmune Disease Symptoms Some of the most common autoimmune disease symptoms you should look out for include: Headaches Anxiety Brain fog Attention deficit problems Body rashes, red bumps on facial skin and red flaking skin Acne Rosacea Eczema [draxe.com]
Eczema Eczema, also known as atopic dermatitis, is generally a mild skin disease and is the most common skin disease in primary immunodeficiency diseases. [primaryimmune.org]
- Urticaria
[…] patients), ulcerative colitis (4 patients), conjunctivitis (4 patients), celiac disease (3 patients), systemic lupus erythematodes (2 patients), type I diabetes (2 patients), multiple sclerosis (2 patients), polymyalgia rheumatica (2 patients), and urticaria [glutenfreesociety.org]
Twentyeight (10.2%) patients with HT had gastrointestinal disorders (chronic atrophic gastritis and celiac disease), 19 (6.6%) had allergies (asthma, chronic urticaria, and rhinosinusitis), 12 (4.4%) had rheumatological disorders (rheumatoid arthritis [turkjem.org]
Think about a mosquito bite, an asthma attack, or Joe’s urticaria. [rebootwithjoe.com]
Pemphigoid gestationis often starts as an intensely itchy urticaria-like rash around the belly button and then may spread to involve the entire skin surface, but not mucous membranes. [dermnetnz.org]
[…] anhydrase antibodies; rheumatoid factor Autoimmune polyendocrine syndrome Accepted Unknown or multiple APS-1 see Addison's disease Autoimmune progesterone dermatitis Accepted Autoimmune thrombocytopenic purpura Accepted anti gpIIb-IIIa or 1b-IX Autoimmune urticaria [hi.wikipedia.org]
- Pruritus
Ocular symptoms may include dry or red eyes, foreign-body sensation, pruritus, photophobia, pain, visual changes, and even complete loss of vision. [aafp.org]
herpes gestationis; telf ta’ smigħ marbut ma’ otosklerosi English The following conditions have been reported to occur or deteriorate with both pregnancy and COC use, but the evidence of an association with COC use is inconclusive: jaundice and/or pruritus [mymemory.translated.net]
Neurologic
- Headache
Vasculitis — Rash, night sweats, headache, fever, weight loss, weakness or numbness, aches and pains, and fatigue result from this disease that inflames blood vessels. [templehealth.org]
Other findings included serositis manifested by tachycardia, dyspnea and pleural effusions, headaches, and hair loss. All had a positive antinuclear antibody (ANA), and the majority had double stranded (ds) DNA antibodies. [ncbi.nlm.nih.gov]
[…] gain If left un-repaired, it can lead to more severe health issues like inflammatory bowel disease, IBS, arthritis, eczema, psoriasis, depression, anxiety, migraine headaches, muscle pain and chronic fatigue. [draxe.com]
Ten individuals experienced general clinical symptoms, which included abdominal pain, diarrhea, and headache. [omicsonline.org]
Astrovirus infections are marked by symptoms such as diarrhea, vomiting, abdominal cramping, headache, fever, and mild dehydration. [contagionlive.com]
- Tremor
Common symptoms of MS include fatigue, weakness, numbness, vision loss, tremors, and depression. Psoriasis. [greatist.com]
People who have MS may experience weakness, trouble with balance and coordination, problems speaking and walking, paralysis, tremors, and numbness in the extremities. [everydayhealth.com]
Grave’s disease occurs when antibodies induce the thyroid to secrete too much thyroid hormone, which can lead to tremors, red skin and an irregular heartbeat. [labiotech.eu]
Though symptoms vary widely, here are a few signs of autoimmune disease: Joint pain, muscle pain or weakness or a tremor Weight loss, insomnia, heat intolerance or rapid heartbeat Recurrent rashes or hives, sun-sensitivity, a butterfly-shaped rash across [maryvancenc.com]
Tremor associated with chronic inflammatory demyelinating peripheral neuropathy: treatment with pregabalin. Clin Neuropharmacol. 2008;31(4):241-4. 39. Jellinger KA. Cell death mechanisms in Parkinson’s disease. J Neural Transm 2000;17:1. 40. [arastirmax.com]
- Seizure
[…] resulting from sensitivity to the sun (photosensitivity) Ulcers in the nose or mouth Two or more joints affected by arthritis with swelling, tenderness, or effusion Inflammation of the heart ( pericarditis ) or lungs (pleuritis) Neurological symptoms like seizures [emedicinehealth.com]
[…] of a seizure. [nejm.org]
These epileptic seizures are episodes that differ from short and approximately unnoticeable to long periods of strong shaking. Epilepsy is recognized by a long-term risk of recurrent seizures. [autoimmunediseases.imedpub.com]
Symptoms can range from fatigue and mild rashes to rare, serious side effects, like seizures. Diagnosis can be difficult, because many symptoms tend to come and go and are frequently nonspecific. [childrenshospital.org]
- Difficulty Concentrating
Your first symptoms of an autoimmune disease may be general, such as fatigue, low-grade fever, and difficulty concentrating, making autoimmune diseases difficult to diagnose at first. You also may feel depressed and consult a doctor for that. [webmd.com]
Many symptoms are not seen, and thus are “invisible” to those not close to the woman with the illness, such as fatigue or difficulty concentrating. [aamft.org]
Other common manifestations include: Joint and muscle pain with weakness Unexplained weight loss Recurrent skin sensitivities Difficulty concentrating Feeling fatigued and cold often White patches upon skin or mouth Abdominal pain with blood or mucus [massagemag.com]
- Guillain-Barré Syndrome
Autoimmune with no specific causal infectious agent identified: Sarcoidosis Guillain-Barré Syndrome / Acute Inflammatory Demyelinating Polyneuropathy (AIDP) Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) Vasculitis Polyarteritis Nodosa (PAN) [foundationforpn.org]
Wegener's granulomatosis Goodpasture's syndrome Accepted[1] II Anti-Basement Membrane Collagen Type IV Protein Graves' disease Accepted[1] II thyroid autoantibodies (TSHR-Ab) that activate the TSH-receptor (TSHR) Guillain-Barré syndrome (GBS) Accepted [hi.wikipedia.org]
This causes the body to go into overdrive, leading to symptoms including: A racing heart Anxiety Weight loss Feeling hot Sweating more than usual Guillain-Barré Syndrome Guillain-Barré syndrome (GBS) results from an immune system attack on the nervous [verywellhealth.com]
Balo’s Disease Graves’ Disease Guillain-Barré Syndrome Fact Sheet Autoimmune hepatitis Department of Dermatology: Autoimmune Diseases What is Lupus Endometriosis Systemic lupus erythematosus (SLE or lupus) Antiphospholipid Syndrome Antinuclear Antibodies [blog.delimmune.com]
Workup
The diagnosis can be done by physical exam and laboratory investigation. Important laboratory tests are antinuclear antibody tests, autoantibody tests, complete blood cound (CBC), comprehensive metabolic panel, C-reactive protein (CRP), Erythrocyte sedimentation rate (ESR) and urinalysis.
Chest X-ray and pulmonary function test may be required in case of lung involvement. Similarly, bone marrow biopsy or kidney biopsy may be done if required.
Kidney function test and renal function test may be required in advanced cases or the cases taking treatment for long period or for the cases like graft rejection [7].
Microbiology
- Candida
However, both groups do know that use and overuse of antibiotics has caused many, many Candida albicans (yeast) infections. [faim.org]
[…] rapidly to many people endemic disease a disease that is constantly present to a greater or lesser degree in people of a certain class or in people living in a particular location monilia disease an infection caused by fungi of the genus Monilia or Candida [vocabulary.com]
Fix leaky gut, eliminate allergenic foods and foods high in anti-nutrients (on the autoimmune protocol), and stool testing to determine if pathogenic bacterial infections, viral triggers, parasites, and/or candida are present. [maryvancenc.com]
Sugar will feed the growth of yeast, candida and bad bacteria, which will further damage your gut. Bad bacteria actually creates toxins called exotoxins that damage healthy cells and can eat a hole into your intestinal wall. [draxe.com]
If you can understand this chapter and the role of the immune system, you can understand how antigens (non-living toxins or nasty, hard to kill virus, mold, candida…) can be at the heart of cancer. [connersclinic.com]
Treatment
Symptomatic control, control of autoimmune reaction and maintainance of general immunity are the objectives of treatment. Mainstay of treatment is control of immune reaction by immunosuppressant drugs either corticosteroids like prednisone or non-steroids like tacrolimus, cyclophosphamide, sirolimus, mycophenolate or azathioprine. Further treatment depends on type of disease like hormones, hematinincs, blood transfusion or physiotherapy. Anaphylaxis is an emergency and requires prompt emergency services including oxygen, advanced life support measures, drugs like adrenaline [8].
Prognosis
Autoimmune diseases are chronic, characterized by remission and relapse or flare up. But clinical symptoms are well controlled by treatment [5].
Etiology
The reason that body fails to recognize between ‘self’ and ‘non-self ’may be immunologic, genetic or microbial. Mixed etiology may be possible. There is polyclonal activation of B-cells along with generation of self reacting B-Cells. This may be augmented by increased T helper cell activity. Genetic factors include increased expression of Class II HLA antigens on affected tissues. Infection with virus like Epstein–Barr virus (EBV) or bacteria like streptococcus and mycoplasma may trigger immune reaction against host tissue [2].
Epidemiology
In the United States autoimmune conditions are among the leading causes of death among women of young and middle-age. Incidence rates differ according to disease. Less than one case of systemic sclerosis is diagnosed per 100,000 person years whereas more than 20 cases of adult-onset rheumatoid arthritis are diagnosed per 100,000 person-years. Diseases like type I diabetes primarily occur in childhood and adolescence whereas myasthenia gravis or multiple sclerosis occurs in the mid-adult years. Rheumatoid arthritis, primary systemic vasculitis are diagnosed among older adults [3].
Pathophysiology
Once autoantibodies are formed against own tissue there may be one of four actions, i.e. anaphylactic, cytotoxic, immune complex or cell mediated. Anaphylaxis is characterized by releasing histamine locally or generally. Examples are asthma, hay fever and serum sickness. Examples of cytotoxic reaction are autoimmune hemolytic anemia, transfusion reaction, erthrobalstosis foetalis, idiopathic thrombocytopenic purpura (ITP) and myasthenia gravis. Examples of immune complex reaction are farmer’s lung, glomerulonephritis, collagen disease, Goodpasture syndrome and arthritis. Cell mediate reactions are leprosy and graft rejection [4].
Prevention
Since etiology of autoimmunity is immune-genetic prevention of these diseases is not possible. Only conditions precipitated by bacterial or viral infections are preventable by control of these infections [9].
Summary
Autoimmunity is a condition in which immune system of the body fails to recognize between ‘self’ and ‘non-self ’ and reacts by formation of antibodies against own tissues.
The condition maybe limited to one of the organ like in Goodpasture syndrome or may be may involve specific tissues of different organs like in systemic lupus erythematosus. Clinical symptoms depend on the type of tissue involved. Diagnosis is always done by the detection of autoantibodies against specific tissue and histopathology. Immunosuppressant drugs are important treating agent in these conditions [1].
Patient Information
- Definition: Autoimmunity is a condition in which immune system of the body fails to recognize between ‘self’ and ‘non-self ’ and reacts by formation of antibodies against own tissues. This condition may be limited to one of organ like in Goodpasture syndrome or maybe may involve specific tissues of different organs like in systemic lupus erythematosus. Clinical symptoms depend on type of tissue involved. Diagnosis is always done by detection of autoantibodies against specific tissue and histopathology. Immunosuppressant drugs are important treating agents in these conditions. Examples of the diseases are asthma, hay fever, serum sickness autoimmune hemolytic anemia and transfusion reaction, erthroblastosis fetalis, ITP, myasthenia gravis, farmer’s lung, glomerulonephritis, collagen disease, Goodpasture syndrome, arthritis, leprosy and graft rejection. Diseases like type I diabetes primarily occur in childhood and adolescence whereas myasthenia gravis, multiple sclerosis occurs in the mid-adult years. Rheumatoid arthritis and primary systemic vasculitis are diagnosed among older adults.
- Symptoms: Symptoms depend on type of reaction due to autoimmunity and its site. The common symptoms are fatigue, fever, malaise, joint pain, and rash. Anaphylaxis is characterized by dizziness, rash, itching, breathless, increased heart rate, lip swelling. Autoimmunity against blood component is characterized by fatigue, yellow urine, and fever. Involvement of lung is characterized by cough, fever, breathlessness.
- Diagnosis: The diagnosis can be done by physical exam and laboratory investigation including antinuclear antibody tests, autoantibody tests, complete blood count (CBC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and urinalysis. Chest X-ray and pulmonary function test may be required in case of lung involvement. Similarly, bone marrow biopsy or kidney biopsy may be done if required. Kidney function test and renal function test may be required in advanced cases or cases taking treatment for long period or for a cases like graft rejection.
- Treatment: Symptomatic control, control of autoimmune reaction and maintainance general immunity are the objectives of treatment. Mainstay of treatment is control of immune reaction by immunosuppressant drugs either corticosteroids like prednisone or non-steroids like tacrolimus, cyclophosphamide, sirolimus, mycophenolate or azathioprine. Further treatment depends on type of disease like hormones, hematinincs, blood transfusion, physiotherapy. Anaphylaxis is an emergency and requires prompt emergency services including oxygen, advanced life support measures, drugs like adrenaline. Since causes of autoimmunity are immune-genetic prevention of these diseases is not possible. Only conditions precipitated by bacterial or viral infections are preventable by control of these infections. Autoimmune diseases are chronic characterized by period of no symptom and flare up. But clinical symptoms are well controlled by treatment [10].
References
- Rose NR. Predictors of autoimmune disease: autoantibodies and beyond. Autoimmunity 2008; 41:419.
- Drachman DB. How to recognize an antibody-mediated autoimmune disease: Criteria. In: Immunologic Mechanisms in Neurologic and Psychiatric Disease, Waksman BH (Ed), Raven, New York 1990. p.183.
- Hartmann RC, Conley CL. Studies on the initiation of blood coagulation, III. The clotting properties of canine platelet-free plasma. J Clin Invest 1952; 31:685.
- Swanborg RH. Experimental autoimmune encephalomyelitis in rodents as a model for human demyelinating disease. Clin Immunol Immunopathol 1995; 77:4.
- Horak I, Löhler J, Ma A, Smith KA. Interleukin-2 deficient mice: a new model to study autoimmunity and self-tolerance. Immunol Rev 1995; 148:35.
- Mackay IR, Leskovsek NV, Rose NR. Cell damage and autoimmunity: a critical appraisal. J Autoimmun 2008; 30:5.
- Pendergraft WF 3rd, Preston GA, Shah RR, et al. Autoimmunity is triggered by cPR-3(105-201), a protein complementary to human autoantigen proteinase-3. Nat Med 2004; 10:72.
- Lee YH, Rho YH, Choi SJ, et al. The PTPN22 C1858T functional polymorphism and autoimmune diseases--a meta-analysis. Rheumatology (Oxford) 2007; 46:49.
- Emmi L, Romagnani S. Role of Th1 and Th2 cells in autoimmunity. In: The Autoimmune Diseases, Rose NR, Mackay IR (Eds), Academic Press, San Diego 2006. p.83.
- Oppermann M, Fritzsche J, Weber-Schoendorfer C, et al. A(H1N1)v2009: a controlled observational prospective cohort study on vaccine safety in pregnancy. Vaccine 2012; 30:4445.