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Autoimmune disorders

 

An autoimmune disorder occurs when the body's immune system attacks and destroys healthy body tissue by mistake. There are more than 80 types of autoimmune disorders.

Causes

The blood cells in the body's immune system help protect against harmful substances. Examples include bacteria, viruses, toxins , cancer cells, and blood and tissue from outside the body. These substances contain antigens. The immune system produces antibodies against these antigens that enable it to destroy these harmful substances.

When you have an autoimmune disorder, your immune system does not distinguish between healthy tissue and antigens. As a result, the body sets off a reaction that destroys normal tissues.

The exact cause of autoimmune disorders is unknown. One theory is that some microorganisms (such as bacteria or viruses) or drugs may trigger changes that confuse the immune system. This may happen more often in people who have genes that make them more prone to autoimmune disorders.

An autoimmune disorder may result in:

  • The destruction of body tissue
  • Abnormal growth of an organ
  • Changes in organ function

An autoimmune disorder may affect one or more organ or tissue types. Areas often affected by autoimmune disorders include:

  • Blood vessels
  • Connective tissues
  • Endocrine glands such as the thyroid or pancreas
  • Joints
  • Muscles
  • Red blood cells
  • Skin

A person may have more than one autoimmune disorder at the same time. Common autoimmune disorders include:

  • Addison disease
  • Celiac disease - sprue (gluten-sensitive enteropathy)
  • Dermatomyositis
  • Graves disease
  • Hashimoto thyroiditis
  • Multiple sclerosis
  • Myasthenia gravis
  • Pernicious anemia
  • Reactive arthritis
  • Rheumatoid arthritis
  • Sjögren syndrome
  • Systemic lupus erythematosus
  • Type I diabetes

Symptoms

 

Symptoms will vary based on the type and location of the faulty immune response. Common symptoms include:

  • Fatigue
  • Fever
  • General ill-feeling (malaise)
  • Joint pain
  • Rash

 

Exams and Tests

 

The health care provider will do a physical exam. Signs depend on the type of disease.

Tests that may be done to diagnose an autoimmune disorder include:

  • Antinuclear antibody tests
  • Autoantibody tests
  • CBC
  • Comprehensive metabolic panel
  • C-reactive protein (CRP)
  • Erythrocyte sedimentation rate (ESR)
  • Urinalysis

 

Treatment

 

The goals of treatment are to:

  • Reduce symptoms
  • Control the autoimmune process
  • Maintain the body's ability to fight disease

Treatments will depend on your disease and symptoms. Types of treatments include:

  • Supplements to replace a substance that the body lacks, such as thyroid hormone, vitamin B12, or insulin, due to the autoimmune disease
  • Blood transfusions if blood is affected
  • Physical therapy to help with movement if the bones, joints, or muscles are affected

Many people take medicines to reduce the immune system's abnormal response. These are often called immunosuppressive medicines. Examples include corticosteroids (such as prednisone) and nonsteroid drugs such as azathioprine, cyclophosphamide, mycophenolate, sirolimus, or tacrolimus. Targeted drugs called tumor necrosis factor (TFN) blockers can be used for some diseases.

 

Outlook (Prognosis)

 

The outcome depends on the disease. Most autoimmune diseases are chronic , but many can be controlled with treatment.

Symptoms of autoimmune disorders can come and go. When symptoms get worse, it is called a flare-up.

 

Possible Complications

 

Complications depend on the disease. Medicines used to suppress the immune system can cause severe side effects, such as higher risk of infections.

 

When to Contact a Medical Professional

 

Call your health care provider if you develop symptoms of an autoimmune disorder.

 

Prevention

 

There is no known prevention for most autoimmune disorders.

 

 

Open References

References

Bylund DJ, Nakamura RM. Organ-specific autoimmune diseases. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods . 22nd ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 53.

Kono DH, Theofilopoulos AN. Autoimmunity. In: Firestein GS, Budd RC, Gabriel SE, et al, eds. Kelley's Textbook of Rheumatology . 9th ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 20.

 
  • Graves' disease

    Graves' disease - illustration

    Graves disease is an autoimmune disorder that involves overactivity of the thyroid gland (hyperthyroidism). Hallmarks of the condition are bulging eyes (exophthalmos), heat intolerance, increased energy, difficulty sleeping, diarrhea, and anxiety.

    Graves' disease

    illustration

  • Hashimoto's disease (chronic thyroiditis)

    Hashimoto's disease (chronic thyroiditis) - illustration

    Chronic thyroiditis (Hashimoto's disease) is a slowly developing persistent inflammation of the thyroid which frequently leads to hypothyroidism, a decreased function of the thyroid gland. Middle-aged women are most commonly affected.

    Hashimoto's disease (chronic thyroiditis)

    illustration

  • Multiple sclerosis

    Multiple sclerosis - illustration

    Multiple sclerosis is a central nervous system disorder marked by decreased nerve function with initial inflammation of the protective myelin nerve covering and eventual scarring. Symptoms and severity of symptoms vary widely and may progress into episodes of crisis alternating with episodes of remission.

    Multiple sclerosis

    illustration

  • Rheumatoid arthritis

    Rheumatoid arthritis - illustration

    Rheumatoid arthritis is an autoimmune disease in which the body's immune system attacks itself. The pattern of joints affected is usually symmetrical, involves the hands and other joints and is worse in the morning. Rheumatoid arthritis is also a systemic disease, involving other body organs, whereas osteoarthritis is limited to the joints. Over time, both forms of arthritis can be crippling.

    Rheumatoid arthritis

    illustration

  • Rheumatoid arthritis

    Rheumatoid arthritis - illustration

    Rheumatoid arthritis is a systemic autoimmune disease which initially attacks the synovium, a connective tissue membrane that lines the cavity between joints and secretes a lubricating fluid.

    Rheumatoid arthritis

    illustration

  • Systemic lupus erythematosus

    Systemic lupus erythematosus - illustration

    Systemic lupus erythematosus is a chronic inflammatory autoimmune disorder which may affect many organ systems including the skin, joints and internal organs. The disease may be mild or severe and life-threatening. African-Americans and Asians are disproportionately affected.

    Systemic lupus erythematosus

    illustration

  • Synovial fluid

    Synovial fluid - illustration

    The synovial membrane is the inner membrane of tissue that lines a joint. The synovial membrane secretes synovial fluid which serves to lubricate the joint.

    Synovial fluid

    illustration

  • Rheumatoid arthritis

    Rheumatoid arthritis - illustration

    Rheumatoid arthritis is another form of arthritis. The body’s own immune system attacks a joint’s synovial membrane, which secretes fluid and lines the joint. The synovium becomes inflamed, produces excess fluid, and the cartilage becomes rough and pitted.    

    Rheumatoid arthritis

    illustration

  • Antibodies

    Antibodies - illustration

    Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens.

    Antibodies

    illustration

    • Graves' disease

      Graves' disease - illustration

      Graves disease is an autoimmune disorder that involves overactivity of the thyroid gland (hyperthyroidism). Hallmarks of the condition are bulging eyes (exophthalmos), heat intolerance, increased energy, difficulty sleeping, diarrhea, and anxiety.

      Graves' disease

      illustration

    • Hashimoto's disease (chronic thyroiditis)

      Hashimoto's disease (chronic thyroiditis) - illustration

      Chronic thyroiditis (Hashimoto's disease) is a slowly developing persistent inflammation of the thyroid which frequently leads to hypothyroidism, a decreased function of the thyroid gland. Middle-aged women are most commonly affected.

      Hashimoto's disease (chronic thyroiditis)

      illustration

    • Multiple sclerosis

      Multiple sclerosis - illustration

      Multiple sclerosis is a central nervous system disorder marked by decreased nerve function with initial inflammation of the protective myelin nerve covering and eventual scarring. Symptoms and severity of symptoms vary widely and may progress into episodes of crisis alternating with episodes of remission.

      Multiple sclerosis

      illustration

    • Rheumatoid arthritis

      Rheumatoid arthritis - illustration

      Rheumatoid arthritis is an autoimmune disease in which the body's immune system attacks itself. The pattern of joints affected is usually symmetrical, involves the hands and other joints and is worse in the morning. Rheumatoid arthritis is also a systemic disease, involving other body organs, whereas osteoarthritis is limited to the joints. Over time, both forms of arthritis can be crippling.

      Rheumatoid arthritis

      illustration

    • Rheumatoid arthritis

      Rheumatoid arthritis - illustration

      Rheumatoid arthritis is a systemic autoimmune disease which initially attacks the synovium, a connective tissue membrane that lines the cavity between joints and secretes a lubricating fluid.

      Rheumatoid arthritis

      illustration

    • Systemic lupus erythematosus

      Systemic lupus erythematosus - illustration

      Systemic lupus erythematosus is a chronic inflammatory autoimmune disorder which may affect many organ systems including the skin, joints and internal organs. The disease may be mild or severe and life-threatening. African-Americans and Asians are disproportionately affected.

      Systemic lupus erythematosus

      illustration

    • Synovial fluid

      Synovial fluid - illustration

      The synovial membrane is the inner membrane of tissue that lines a joint. The synovial membrane secretes synovial fluid which serves to lubricate the joint.

      Synovial fluid

      illustration

    • Rheumatoid arthritis

      Rheumatoid arthritis - illustration

      Rheumatoid arthritis is another form of arthritis. The body’s own immune system attacks a joint’s synovial membrane, which secretes fluid and lines the joint. The synovium becomes inflamed, produces excess fluid, and the cartilage becomes rough and pitted.    

      Rheumatoid arthritis

      illustration

    • Antibodies

      Antibodies - illustration

      Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens.

      Antibodies

      illustration

    A Closer Look

     

      Talking to your MD

       

        Self Care

         

          Tests for Autoimmune disorders

           
           

          Review Date: 4/30/2015

          Reviewed By: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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