Understanding Autoimmune Disease

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Our immune systems are there to help fight germs and other invaders in our bodies. In some people, however, the immune system produces antibodies that attack the body’s own tissues instead of fighting infections.

This is what happens when you have an autoimmune disease.

“Autoimmune disease can attack a variety of organs and it is important to see a specialist that focuses on the particular organ,” says Dr. Elana M. Oberstein, a rheumatology expert with the University of Miami Health System. As a rheumatologist, she sees patients with scleroderma, systemic lupus erythematosous – or lupus – and inflammatory myositis such as polymyositis and dermatomyositis.

Doctors diagnose an autoimmune disorder by looking at a patient’s recent symptoms, combined with laboratory data, such as blood and urine tests, along with additional imaging such as X-rays, ultrasound or MRI.

Different diseases, different specialists

“In the case of MS, a person should see a neurologist,” says Dr. Oberstein. “For Type 1 Diabetes or Hashimoto’s Thyroiditis, an endocrinologist is the specialist of choice.  For forms of autoimmune colitis, a gastrointestinal expert would treat it.

“Many times, a person may need a team of experts depending on the issue at hand.  For example, some rheumatologic autoimmune diseases such as rheumatoid arthritis may affect the lung.  Then, a rheumatologist will work closely with a pulmonologist..”

Remission and flare-ups

Specialists who treat autoimmune diseases think of them as being active or in remission.

When the disease “flares up”, patients may have various symptoms, says Dr. Oberstein. Lab tests will show that the activity and level of inflammation.

When the disease is in remission, the patient likely has no symptoms, and the information on a patient’s lab work are usually within normal limits.  During this time, the person may even be able to be on very low doses of medication or none at all.

“There are many different treatments available today to manage autoimmune disorders and allow people to have great quality of life,” Dr. Oberstein says. “As with any chronic disease, good health habits, such as managing stress, having a good diet and getting enough sleep help maximize health and our sense of well-being.”

Scientists are also trying to better understand why certain populations have a higher rate of autoimmune disease than others.  In addition, there are ongoing clinical trials that patients can enroll in that focus on new treatments.  You can find information on clinical trials from UHealth and at clinicaltrials.gov.

 

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Mary Jo Blackwood, RN, MPH, is a contributing writer for UMiami Health News. Based in St. Louis, MO, and Colorado, she has written medical articles and webpages for consumer publications and major university health centers.