Autoimmune disease has many faces. But it is not external enemies such as viruses, bacteria, benign or malignant growths that are at work, but the body’s own defenses.
What is an autoimmune disease?
Autoimmune disease is a condition in which the body’s defense system attacks its own structures, such as cells and tissues. Autoimmune disease is a collective term for about 60 autoimmune diseases such as Crohn’s disease, ulcerative colitis, rheumatoid arthritis, Wegener’s disease, etc. They are differentiated according to the following criteria:
Organ-specific immune diseases:
Excessive reactions of the immune system attack specific organs and destroy their tissues. This form is the most widespread. Systemic autoimmune diseases:
This form is not limited to specific organs, but affects inflammatory diseases in the body, such as rheumatism. 5 – 10 % of those affected have systemic disease. Intermediate autoimmune diseases:
These diseases may be a mixed form between the first two or a transitional stage from one to the next.
Causes
In addition to a hereditary predisposition, environmental factors mostly play a role. Autoimmune diseases have been found to be increasing rapidly. One is toxins. Smokers and people exposed to mineral oil and silicone dust at work are more likely to be affected by rheumatoid arthritis. In case of genetic disposition, the risk of disease increases about 16 times. Plasticizers in cosmetics are considered to be the cause of skin diseases such as lupus erythematosus. Our diet favors inflammatory bowel diseases such as celiac disease. One cause is suspected to be an early baby diet with cereal porridge. Many sufferers report that stress promotes or triggers relapses. One of the newer theories is that the immune system is “bored” because it no longer has to deal sufficiently with external enemies due to vaccinations, medications and hygiene, and therefore seeks out new, endogenous attack surfaces.
Typical and common autoimmune diseases
- Atherosclerosis
- Psoriasis
- Gastritis
- Hashimoto’s thyroiditis
- Sjögren’s syndrome
- Bechterew’s disease
- Arthritis
- Vitiligo (white spot disease)
- Diabetes mellitus with type 1 diabetes
- Crohn’s disease (chronic inflammation of the intestine)
- Systemic lupus erythematosus (SLE)
Symptoms, complaints and signs
Depending on its type, autoimmune disease can cause a range of symptoms. Most forms cause harmless symptoms at the beginning, such as itching, skin rashes and fatigue. A loss of libido and tingling in the hands and feet are also typical. Psoriasis is manifested by skin redness, itching and scaling. In gastritis, symptoms include stomach pain, loss of appetite, nausea, belching, and flatulence. Ankylosing spondylitis is manifested by inflammatory back pain and morning stiffness, while autoimmune diseases of the joints may be associated with swelling, warm extremities, and joint pain. Autoimmune diseases of the eyes, such as bulbar neuritis, cause visual disturbances and even blindness. Diseases caused by the immune system can therefore manifest themselves through a wide variety of symptoms and complaints, depending on the disease and the stage it is in. For this reason, most autoimmune diseases cannot be recognized on the basis of individual symptoms. A diagnosis is usually only possible after determining the cause and various physical examinations. However, psoriasis, arthritis, inflammation of the gastric mucosa and diabetes mellitus can be diagnosed on the basis of the clear symptoms without extensive examinations.
Diagnosis and course
Affected individuals initially report diffuse symptoms that are easily misdiagnosed by physicians or are not recognized until late in the course of the autoimmune disease. They are such harmless symptoms as itching, rash, a leaden fatigue, tingling in the hands and feet, loss of libido, etc. Even the right diagnosis does not guarantee the right treatment. At the same time, experts emphasize the importance of early treatment for certain diseases. Joint rheumatism, for example, can be brought to a complete halt with timely treatment.Most autoimmune diseases progress in relapses. Smaller or larger periods of time may pass between them. No one can predict this. The diagnosis is usually made by determining the blood values. Here, the first indications of an autoimmune disease may be recognizable, e.g. elevated blood values. A screening test may provide antibody evidence.
Complications
A variety of complications can occur during the course of an autoimmune disease and during treatment. In the case of allergies, for example, chronic rashes and other secondary diseases may result, while in severe autoimmune diseases the risks can range from gastrointestinal problems (Crohn’s disease) to muscle paralysis and permanent sensory disturbances (multiple sclerosis). Almost always, complications increase as the underlying disease progresses. Often, further secondary complaints develop, which, however, can be effectively treated with the onset of therapy. Further complications always depend on the type of autoimmune disease. For example, rheumatic fever can lead to various heart diseases such as heart failure and atrial fibrillation, while an allergy can progress without any symptoms at all. In the case of hyperthyroidism or hypothyroidism, the risks go from
typical symptoms such as altered blood pressure or weight loss. In Graves’ disease and Crohn’s disease, joint inflammation and other inflammatory processes can lead to paralysis, secondary diseases and further complications. Due to the diversity of diseases and symptoms, only a physician can answer in detail which complications are to be expected with an autoimmune disease.
Treatment and therapy
To date, there is no treatment method that can bring an immune system that is out of whack back on track, especially in light of the fact that there are no specific causes of autoimmune disease. Therefore, there is no causal treatment as with other diseases, but rather therapy is based on symptoms. Anti-inflammatory or immune-supporting drugs are administered. It always makes sense to involve a specialist in the treatment, e.g. a dermatologist, internist, neurologist or similar. The goal of treatment is to dampen the excessive reaction of the immune system without completely eliminating it. Cortisone is considered one of the most important drugs, but it leads to numerous side effects and interactions when used continuously, so researchers are striving to develop more specific drugs. A new form of therapy, especially for systemic autoimmune diseases, is stem cell transplantation. This is designed to give the body a “fresh start” again, dampening the overreaction and protecting affected organs.
Outlook and prognosis
The prognosis for autoimmune disease can be highly variable and depends, among other things, on which organs are affected and whether the condition is systematic and progressive. There is no causal cure for an autoimmune disease in any case. Depending on the time of diagnosis and the exact nature of the autoimmune disease, the prognosis is also favorable. It is particularly favorable if the diagnosis is made early and the affected area can be stabilized or its function replaced by medication. This is true, for example, of the pancreas. It can be removed if it fails completely, and its function is compensated for by medication. Many affected persons have a normal life expectancy and can live without major restrictions. They merely have a weakened immune system due to the medication. The prognosis is generally less favorable if the nerves or vital organs are affected. The therapy of an autoimmune disease also allows different prognoses. Cortisone as the drug of choice carries the risk of triggering Cushing’s syndrome with ongoing treatment duration. Other immunosuppressants also carry different risks, but weighing the costs and benefits must be done on an individual basis. One curative approach is to destroy the immune system and then perform a stem cell transplant. However, this procedure is associated with significant risks (high mortality rate, susceptibility to infections, defensive reactions, etc.) and should therefore be considered as a last resort.
Prevention
For classical diseases, the goal is to strengthen a weakened immune system so that it can successfully mount a defense.In autoimmune diseases, the immune system is not weakened but directed against the patient’s own body. Since no exact cause is known, targeted prevention is difficult. But a balanced diet, sufficient exercise and a stress-reduced life can have a positive effect and strengthen the general well-being.
Aftercare
An autoimmune disease accompanies most individuals throughout their lives. A causal cure is not possible. Science has not progressed far enough for this. Therefore, follow-up care cannot aim to prevent recurrence. A patient can expect long-term treatment. After a diagnosis, the aim is to prevent complications and make the patient’s daily life easier. Sufferers must be prepared for regular routine examinations. These serve primarily to document the progress of the disease and to adjust the therapy. Specialists support the treatment depending on the type of symptoms. Blood tests are common. Based on the values determined, doctors can determine at an early stage which parts of the body are at risk. Patients take medication that is tailored to their needs. This reduces the typical and specific symptoms of their autoimmune disease. In severe cases, aftercare also aims to involve family members. The aim is to spread the burden of everyday life over as many shoulders as possible. The professional situation should also be discussed. To date, no general preventive measures are known that can minimize the effects of the autoimmune disease. In general, however, adequate exercise, a healthy diet, and a stable environment can make life easier for those affected.
Here’s what you can do yourself
An autoimmune disease is associated with multiple processes. Everyday life is often difficult for sufferers to manage during relapses. Normal daily tasks are more difficult or impossible to accomplish. It is important for patients to be able to live in a stable and understanding environment. Difficulties often arise in connection with performing work activities. Open discussion in advance is helpful, depending on the industry and employer – this can minimize various absences or problems. A balanced amount of physical exercise and sufficient recovery periods is important for the organism and the body’s metabolism. Endurance sports such as swimming are recommended. The joint and muscle pains that regularly occur as autoimmune accompanying symptoms can become much more bearable or disappear completely in the water, making exercise more fun. Ultimately, finding the right sport is an individual thing. Sports such as Modern Arnis should also be considered. Additionally, taking nutritional supplements and homeopathy is helpful, especially for autoimmune processes. Which remedies are considered depends primarily on the autoimmune disease in question. Affected individuals can seek advice from a physician or pharmacy.
