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36 WWW.UNWLA.ORG “НАШЕ ЖИТТЯ”, КВІТЕНЬ 2017 A Look At Autoimmune Disorders by Ihor Magun, MD, FACP The body’s defense mechanism is the immune system, which protects us from disease and infection by mounting a response to an offending agent. The offending agent is recognized as being “foreign,” and by utilizing a complex system, the immune system provides an appropriate response, targeting only the “intruder” and thus preventing potential injury to normal cells, muscles, tissues, and organs. In persons with autoimmune disorders, this protective system loses the ability to distinguish between normal and foreign; for no apparent reason, it perceives normal cells, muscles, tissues, and organs as “foreign” and initiates an attack response. This leads to pain, inflammation, tissue destruction, and even irreversible damage. There is no simple reason why people develop an autoimmune disease. Potential factors include exposure to environmental hazards, viruses, or heredity. The condition can also be medication or drug induced. Sex hormones may play a role because autoimmune diseases are more prevalent in women than in men. There are over eighty types of autoimmune diseases. Many have similar symptoms. Some are very subtle; often the only initial symptom is muscle weakness, fatigue and possibly a low-grade fever, and it may take time to arrive at a diagnosis, a situation that frequently results in stress and frustration and delays treatment. The most common form of autoimmune disease is rheumatoid arthritis. The immune system cells target joints, and this induces swelling, inflammation, pain, and ultimately issues with movement. There is a characteristic cycling of inflammation followed by remission. This cycling produces characteristic deformities and fibrosis. A brief listing of other autoimmune disorders illustrates common patterns and serves as a reminder that symptoms are not always straightforward, either to patients or physicians. Once an actual diagnosis is established, all seems to be obvious, but hindsight doesn’t improve the situation. For this reason, it is critical to consider the possibility of an autoimmune disorder whenever a specific diagnosis seems elusive. Below is an overview of the most common autoimmune diseases: Type 1 diabetes. This autoimmune disease destroys insulin-producing cells of the pancreas, resulting in a lifetime need to inject insulin to survive. This type of damage occurs by young adulthood. Inflammatory bowel diseases. The most common of these are ulcerative colitis and Crohn’s disease. The cells attack the actual lining of the intestines, disrupting their normal function. This leads to loose stool, changes in bowel habits, and abdominal pain. It can also lead to weight loss and anemia. Celiac disease. This disease is characterized by an abnormal immune reaction to the ingestion of gluten. Lupus. In this disease, the autoimmune attack is directed at muscles and organs including the lungs, kidneys and nerves. Multiple sclerosis. In this disease, the immune system eats away at the protective coating of the nerves. This can lead to blindness, weakness, muscle spasms, and interferes with walking. Psoriasis. With this disease, skin cells are stimulated to respond rapidly to environmental factors, which leads to scaly, silvery patches on the skin. This disease is frequently associated with arthritic issues. Temporal arteritis is one of the more commonly encountered forms of autoimmune disease involving blood vessel. The result is inflammation in the blood vessels in the scalp-temple area. This is usually unilateral; if left untreated, it may lead to permanent blindness. The onset of symptoms may be rapid, and treatment needs to be initiated urgently. Thyroid issues, whether overactive (Graves’ disease) or underactive (Hashimoto’s thyroiditis) also fall into the immune system abnormality. On a more positive note, research has inspired an entire new treatment arsenal for autoimmune disorders. These agents, referred to as biologicals, work differently from traditional medication. Instead of decreasing inflammation, the new agents work to suppress the immune response. As a result, there is minimal inflammation, damage, and destruction. In short, if you can prevent the attack on normal cells and tissue, you also prevent many autoimmune disorders. Treatments need to be initiated sooner than later. These treatments are not for everyone; most are administered by injection (although many now are available in tablet form), are costly, and need to be taken for prolonged periods of time. This brief summary of autoimmune diseases is meant to inform not prescribe. But knowledge is power, and knowing about what ails you (or might ail you) might steer you in the right direction.
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