Can You Have Autoimmune Diseaseand Not Know
Angela Crowley, MD, is up-front about it. Accurately diagnosing an autoimmune disease can exist tricky.
"People on boilerplate see six doctors over a period of 4 years before they get a diagnosis."
This is considering, in general, autoimmune diseases tend to arrive unpredictably, bearded as other conditions, offering only confusing clues every bit to what they are.
Why Are Autoimmune Diseases So Mysterious?
1 reason is that the list of what'due south considered to be autoimmune is long and ranges from the very common to the extremely rare.
Did yous know? The following are all autoimmune diseases:
- Celiac disease
- Diabetes type i
- Multiple sclerosis (MS)
- Psoriasis
- Inflammatory bowel disease
While very different, all these disorders have one thing in common: They occur when a person's allowed organisation decides to attack healthy body cells. Instead of fighting infection with antibodies, the body produces autoantibodies. The body is essentially fighting itself.
Where and how this self-attack occurs determines the affliction and its symptoms. But the occurrence of these symptoms is non simple, clear or anticipated. Other situations brand diagnosis problematic:
Asymptomatic or Delayed Symptoms. You can accept osteoporosis, for example, and have no symptoms at all — simply getting diagnosed after a os fracture. Or with ankylosing spondylitis, the average diagnosis timeframe is 10 years — virtually how long it takes for the condition to be visible on an X-ray.
Mutual symptoms. Or y'all could take astringent joint hurting as a result of any number of autoimmune diseases, simply lack any other symptoms to assist doctors make up one's mind exactly which one you take. Vasculitis, for example, is systemic, which ways, along with causing inflammation of blood vessels, it tin cause hurting anywhere and everywhere in your torso.
Co-Conditions. Your celiac affliction or Grave's disease could lead to or simply testify upwards with rheumatoid arthritis; having both means one condition can mask the other.
Misconceptions. Yous might be in pain and avert seeing a doctor. "People ignore their pain, thinking they are too young to have arthritis, which isn't truthful," says Dr. Crowley. "Information technology can happen to kids. Rheumatoid arthritis and osteoarthritis are two unlike things."
Mimics. Dozens of diseases can look similar MS, for example, from lupus to other neurological weather condition. And it takes time to dominion out.
Uniqueness. Lupus in one person can evidence up with a set of symptoms completely different than the ones that evidence upwards in another person. Doctors can't rely on symptoms alone to determine the nature of the affecting disease.
Diagnosing Autoimmune Disease
Varied, numerous and inherently elusive, the diagnosis of autoimmune affliction can be tough detective work.
But what might seem daunting to others is precisely why Crowley became a rheumatologist. "I find information technology to exist fascinating. Everyone is unlike, then I'grand surprised and challenged daily. It's actually rewarding to be able to place a rare affliction and to be finally able to requite a patient an respond to symptoms and something that can help them. Or to find a rare presentation of a mutual affliction."
And so how does one diagnose if yous can't count on symptoms entirely?
Myth vs. Fact: Celiac Illness
The proliferation of gluten-free options at restaurants and grocery stores might expect like just another trend. Butceliac affliction is a serious autoimmune disease. And though sometimes treated as such, it is not an allergy ane tin can grow out of or ignore. If a person with celiac disease ingests gluten, she tin can trigger a number of symptoms, not all breadbasket-related; over fourth dimension, eating gluten can give ascension to more autoimmune diseases.
Diagnostic tests include, but are not express to:
- Antinuclear antibody (ANA) examination—the presence of autoantibodies does non automatically mean you lot have an autoimmune affliction, but a high level tin can indicate lupus, scleroderma, juvenile arthritis, others
- Comprehensive metabolic panel
- Tests associated with inflammation and arthritis
- Urinalysis
"Rheumatoid arthritis I can unremarkably diagnose in the commencement visit; it's ordinarily straightforward." Which is good, since it's very important to be diagnosed early. "The before we can care for information technology, the more probable it is that it will be easier to care for afterwards and you won't demand equally much medication."
Which is why Crowley is excited nigh the advances being made in the field.
The latest? "We have a new imaging technique, a new blazon of CT scan, to diagnose gout. We've never been able to exercise it with imaging before. I've had patients who didn't know it was gout until we used this technique. To diagnose gout y'all accept to expect at articulation fluid and encounter gout crystals, but there's not e'er a big collection of joint fluid to examine. Or you can look at uric acrid, but some people have loftier levels of uric acrid and no gout. You might suspect, from the symptoms and the blood tests, that the person has rheumatoid arthritis. Which is a problem, as rheumatoid arthritis and gout require very different treatments."
Only with the dual-energy 3D CT scan, diagnosis is straightforward. "The gout crystals wait green. Fun pictures," adds Crowley.
Flares & Triggers: Autoimmune Disease
While an ultimate crusade for autoimmune illness remains unknown, research has shown that:
- People can take a genetic propensity for an autoimmune disease
- A trigger can activate or turn on the gene
- Suspected triggers include environmental, chemical, sunlight, stress, drugs and infection factors
- These triggers can cause a disease to "flare" up
- These disorders can appear at whatever and all ages, making information technology difficult to pinpoint verbal causes
Another thing is clear to Crowley and others in the field. "In the last 2 decades, we've seen a significant increase in autoimmune diseases, and a lot of experts think information technology'southward the environment."
Specific enquiry has shown that tobacco use can plough on these genes, and gum disease can turn on rheumatoid arthritis genes.
But as with nigh aspects of autoimmune affliction, these are hints, not answers. "We suspect it'due south non just one thing, not ane sole cause."
No Quick Fixes: Treatments and Promise
There are no known cures for autoimmune diseases. Rheumatologists look to medications, supplements and concrete therapy for the relief of symptoms and suppression of the immune system.
Crowley says that's no reason to lose hope. "There is a lot of skilful inquiry going. We have a lot of not bad treatment options. I hot topic in research is trying to predict the correct treatment for each person. We have to practise trial and fault to see what can put someone in remission, but with more knowledge virtually disease features and genetics, we can narrow down the options and go straight to the most advisable medicine correct away."
Stress and Self-Care
Along with medication, Crowley advises her patients to practise good self-care. She knows living with an autoimmune affliction can be stressful. "People break downward into tears in my part at least once a day," she says.
But stress can make symptoms worse. "People get flared upwardly when stressed, so I tell people we can't set up the situations, but we can control the response. Good sleep and exercise are things we can work on. Tai chi and yoga are good for the body and listen (and in that location'southward free videos for these on YouTube)," and can aid manage symptoms. She likewise checks patients' vitamin D levels, which are of import for basic and the allowed arrangement.
Open up for Business organization: UVA Rheumatology on Pantops
You tin visit Crowley at her office on Pantops, where in that location's plenty of free parking and friendly staff. View clinic directions, hours, contact info.
And while at that place aren't published studies showing that diet benefits autoimmune diseases, she does encounter that diets can affect individuals, some of whom find that removing gluten, dairy, meat, sugars, fats and artificial ingredients aid.
Fifty-fifty without a cure, Crowley finds her work rewarding. "Nosotros can put someone in remission and take them from not existence able to practise much of anything to beingness able to return to piece of work and play ball with their kids. I become to develop relationships with people. It'southward a squad approach between usa and our patients."
And because an autoimmune disease can impact various parts of the body, Crowley as well teams up with doctors in other fields. She doesn't just treat one affair, she says. "We treat the person as a whole."
Do You Have an Autoimmune Disease?
It's hard to know without the care of a specialist like Crowley. If yous have inflammation, joint pain or other vague symptoms, see your primary care physician for a referral.
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Source: https://blog.uvahealth.com/2014/10/31/detective-work-autoimmune-disease/
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