Autoimmune Diseases

by admin-blog-kh | August 1, 2019 9:53 am

Causes, Symptoms, Types, Diagnosis and Treatment

Introduction

Our immune system is one of the body’s most important defence mechanisms. It protects us from infections caused by viruses, bacteria and other harmful organisms. But what happens when this defence system mistakenly turns against the body itself?

This is what happens in an autoimmune disease.

Autoimmune diseases occur when the immune system mistakenly attacks healthy cells, tissues or organs. Depending on which part of the body is affected, an autoimmune condition can cause problems involving the joints, skin, thyroid, digestive system, muscles, nerves, blood vessels or several organs at the same time.

There are more than 80 recognised autoimmune diseases, and they can affect people of different ages. Some are relatively common, such as autoimmune thyroid diseases and rheumatoid arthritis, while others are rare.

Autoimmune diseases can sometimes be difficult to identify because their symptoms may resemble those of many other conditions. Persistent tiredness, joint pain, unexplained rashes or recurring symptoms should not always be dismissed as stress, ageing or a busy lifestyle.

Early diagnosis and appropriate treatment can help control symptoms, prevent complications and improve quality of life.

What is an autoimmune disease?

An autoimmune disease is a condition in which the body’s immune system mistakenly identifies its own healthy cells or tissues as harmful and launches an immune response against them.

Normally, the immune system can distinguish between the body’s own cells and foreign substances such as bacteria and viruses. In an autoimmune disease, this recognition process becomes abnormal.

The resulting immune response can cause inflammation and, depending on the condition, damage to tissues or organs.

Some autoimmune diseases affect mainly one organ or tissue, while others can affect several parts of the body.

For example:

• Type 1 diabetes occurs when the immune system attacks the insulin-producing cells of the pancreas.
• Hashimoto’s thyroiditis affects the thyroid gland.
• Rheumatoid arthritis primarily affects the joints but can also affect other organs.
• Vitiligo affects the pigment-producing cells of the skin.
• Multiple sclerosis affects the central nervous system.
• Systemic lupus erythematosus (lupus) can affect several organs[19], including the skin, joints, kidneys, heart and lungs.

There is no single autoimmune disease. It is a broad group of conditions with different symptoms, causes and treatments.

How does the immune system normally work?

Think of the immune system as the body’s security system.

When harmful organisms enter the body, immune cells recognise them as foreign and work to eliminate them. The immune system also has mechanisms that help it avoid attacking the body’s own healthy tissues.

In autoimmune disease, this self-recognition process does not work properly.

The immune system may produce autoantibodies or activate immune cells that target the body’s own tissues.

The result may be inflammation, tissue damage or changes in the normal function of an organ.

What causes autoimmune diseases?

There is no single cause for most autoimmune diseases.

Research suggests that autoimmune diseases may develop through a combination of genetic susceptibility and environmental factors.

A person may have certain genes that make them more susceptible, but having such genes does not necessarily mean that they will develop an autoimmune disease.

Possible factors associated with autoimmune disease include:

1. Genetic factors

   Autoimmune diseases can sometimes run in families. Having a close relative with an autoimmune condition may increase a person’s susceptibility.

   However, autoimmune diseases are not necessarily inherited directly from parent to child.

2. Environmental triggers

   Certain environmental exposures may contribute to the development of autoimmune disease in susceptible individuals.

   These may include particular infections, smoking and other environmental factors, depending on the disease.

3. Hormonal factors

   Many autoimmune diseases occur more frequently in women than in men. Hormonal and other biological differences may contribute to this difference.

4. Infections

   Some infections have been associated with triggering or worsening autoimmune responses in susceptible individuals. However, an infection does not automatically mean that a person will develop an autoimmune disease.

5. Certain medicines or exposures

   In some cases, specific medicines or environmental exposures can trigger an autoimmune-like condition or worsen an existing disease. This varies considerably between conditions.

   It is therefore important not to stop prescribed medication without discussing it with a doctor.

Who is at risk of autoimmune diseases?

Autoimmune diseases can affect anyone, including children and older adults.

However, certain factors may increase the likelihood of developing some autoimmune conditions.

These include:

• A family history of autoimmune disease
• Being female, for several autoimmune conditions
• Having one autoimmune disease, which may increase the likelihood of developing another
• Certain genetic factors
• Particular environmental exposures
• Certain infections or other triggers

Importantly, having a risk factor does not mean that a person will definitely develop an autoimmune disease.

Types of autoimmune diseases

There are many autoimmune diseases, and they can affect different organs and systems.

Autoimmune diseases affecting the thyroid

Hashimoto’s thyroiditis can damage the thyroid and may eventually result in an underactive thyroid.

Graves’ disease causes the immune system to stimulate the thyroid excessively, resulting in an overactive thyroid.

Symptoms may include changes in weight, tiredness, palpitations, sensitivity to heat or cold and changes in bowel habits.

Rheumatoid arthritis

Rheumatoid arthritis is an autoimmune disease[20] that mainly affects the joints.

It can cause:

• Joint pain
• Swelling
• Stiffness, particularly in the morning
• Reduced movement
• Fatigue

It may also affect organs outside the joints in some people.

Systemic lupus erythematosus

Commonly known as lupus, this condition can affect multiple parts of the body.

Symptoms may include:

• Joint pain
• Fatigue
• Skin rashes
• Fever
• Sensitivity to sunlight
• Kidney problems
• Other organ involvement

The symptoms and severity can vary considerably from person to person.

Psoriasis and psoriatic arthritis

Psoriasis is an immune-mediated inflammatory skin condition[21] that causes patches of thickened, scaly skin.

Some people with psoriasis also develop psoriatic arthritis, which causes joint pain and inflammation.

Vitiligo

Vitiligo occurs when pigment-producing cells are destroyed, resulting in areas of skin losing their colour.

The condition is not contagious.

Type 1 diabetes

In Type 1 diabetes, the immune system attacks insulin-producing beta cells in the pancreas.

As a result, the body produces little or no insulin and requires insulin replacement.

Multiple sclerosis

Multiple sclerosis affects the central nervous system[22].

Symptoms can vary and may include visual problems, weakness, numbness, balance difficulties and problems with coordination.

Sjögren’s disease

Sjögren’s disease commonly affects glands responsible for producing moisture[23].

Dry eyes and dry mouth are characteristic symptoms, although other parts of the body may also be affected.

Myasthenia gravis

Myasthenia gravis affects communication between nerves and muscles and can cause muscle weakness.

The weakness may affect the eyes, face, swallowing muscles or other muscles.

Inflammatory bowel disease

Some forms of inflammatory bowel disease, including Crohn’s disease[24] and ulcerative colitis, involve abnormal immune activity in the digestive tract.

Symptoms can include abdominal pain, diarrhoea, blood in stools and weight loss.

Common symptoms of autoimmune diseases

There is no single set of symptoms that applies to every autoimmune disease.

Symptoms depend on the organ or tissues affected.

Some commonly reported symptoms include:

• Persistent or unusual fatigue
• Joint pain or swelling
• Muscle pain or weakness
• Recurring low-grade fever
• Skin rashes
• Unexplained changes in weight
• Swollen glands
• Digestive problems
• Abdominal pain[25]
• Recurrent mouth ulcers
• Dry eyes or dry mouth
• Hair loss
• Numbness or tingling
• Changes in vision
• Unexplained weakness

Symptoms may also come and go.

A person may feel relatively well for several weeks or months and then experience a period when symptoms become more noticeable.

However, these symptoms are not specific to autoimmune diseases. Infections, nutritional deficiencies, thyroid disorders, hormonal problems, sleep problems and many other conditions can cause similar complaints.

That is why self-diagnosis is not advisable.

Why are autoimmune diseases difficult to diagnose?

Diagnosing an autoimmune disease can sometimes take time.

One reason is that many autoimmune conditions share common symptoms.

For example, fatigue and joint pain may occur in autoimmune diseases but can also be caused by anaemia, thyroid disorders, infections, vitamin deficiencies, sleep problems and other conditions.

There is also no single blood test that can diagnose all autoimmune diseases.

Doctors generally consider:

• Symptoms and how long they have been present
• Physical examination
• Personal medical history
• Family history
• Blood and urine tests
• Imaging studies when required
• Disease-specific investigations

In some cases, consultation with a specialist such as a rheumatologist[27], endocrinologist[28], dermatologist, neurologist or gastroenterologist may be recommended.

How are autoimmune diseases diagnosed?

Depending on the symptoms, doctors may recommend several investigations.

Blood tests

These may include:

• Complete blood count (CBC)
• ESR
• C-reactive protein (CRP)
• Thyroid function tests
• ANA (antinuclear antibody)
• Rheumatoid factor (RF)
• Anti-CCP antibodies
• Disease-specific autoantibody tests

Not everyone with an autoimmune disease will have the same test results.

What does a positive ANA mean?

This is an important point for patients.

A positive ANA test does not automatically mean that a person has an autoimmune disease.

Some healthy people can have detectable auto antibodies. Doctors therefore interpret antibody results together with symptoms, examination findings and other investigations.

Similarly, a negative result does not necessarily rule out every autoimmune condition.

The meaning of a test result depends on the individual patient and the disease being considered.

How are autoimmune diseases treated?

Treatment depends on the specific autoimmune disease, the organs involved and how severe the condition is.

The main goals are to:

• Control abnormal immune activity
• Reduce inflammation
• Relieve symptoms
• Prevent organ or tissue damage
• Maintain normal function
• Improve quality of life

Treatment may include:

Medicines to control inflammation

Corticosteroids and other anti-inflammatory medicines may be prescribed for certain conditions.

Immunosuppressive medicines

Some autoimmune diseases require medicines that reduce or modify abnormal immune activity.

These medicines need medical supervision because suppressing the immune system can increase susceptibility to certain infections.

Biologic and targeted therapies

For selected autoimmune diseases, biologic medicines and targeted therapies can act on specific pathways involved in inflammation.

Replacement therapy

Some autoimmune diseases damage an organ that produces an essential hormone or substance.

For example:

• Thyroid hormone may be required in Hashimoto’s thyroiditis when the thyroid becomes underactive.
• Insulin is required in Type 1 diabetes.
• Vitamin B12 replacement may be needed in certain autoimmune conditions that interfere with its absorption.

Physiotherapy and rehabilitation

For autoimmune diseases affecting muscles, joints or nerves, physiotherapy and rehabilitation can help maintain mobility, strength and independence[29].

Can autoimmune diseases be cured?

Most autoimmune diseases are chronic conditions, although their course varies considerably.

Some can be controlled very effectively with treatment, and people may experience long periods with few or no symptoms.

The aim of treatment is usually to achieve good disease control, prevent complications and help the person maintain a normal and active life.

Research into autoimmune diseases is ongoing, and treatments continue to evolve.

It is important not to stop medication simply because symptoms have improved. Some autoimmune diseases can continue to cause damage even when symptoms are less noticeable.

Clinical Cases & Insights in Autoimmune Diseases

• Seronegative autoimmune encephalitis[30]
• Autoimmune encephalitis with anti-LGI1-antibody: A case report[31]
• Kauvery Hospital enables the recovery of a 14 year old girl with Autoimmune Encephalitis – The Hindu[32]
• Role of medical nutrition therapy in improving nutritional status in systemic lupus erythematosus: A case report[33]
• Morvan syndrome associated with CASPR2/LGI1 antibody positivity and thymoma successfully managed with plasmapheresis and radical thymectomy[34]
• Thymectomy for myasthenia gravis[35]

What is an autoimmune flare?

A flare is a period when symptoms of an autoimmune disease become more active or severe.

A person may experience:

• Increased joint pain
• Greater fatigue
• Skin rashes
• Swelling
• Fever
• Digestive symptoms
• Worsening of existing disease-specific symptoms

The triggers for flares vary between conditions and individuals.

Keeping a record of symptoms, medication, infections, sleep and other possible triggers can help patients and doctors understand patterns.

If symptoms suddenly become much worse, medical advice should be sought rather than assuming it is simply a flare.

Living with an autoimmune disease

Being diagnosed with an autoimmune disease can be stressful, particularly when symptoms fluctuate.

However, many people continue to lead fulfilling and active lives with appropriate treatment and monitoring.

Some helpful measures include:

Take medication as prescribed

Do not stop, restart or change medicines without speaking to your doctor.

Attend regular follow-ups

Some autoimmune diseases require regular monitoring of blood tests, organ function or medication side effects.

Maintain a balanced diet

A nutritious diet can support overall health[36]. There is no single “autoimmune diet” that cures all autoimmune diseases.

If you have a specific condition, a doctor or dietitian can advise whether any dietary modifications are appropriate.

Stay physically active

Appropriate physical activity can help maintain muscle strength, joint mobility, cardiovascular health and general wellbeing.

The type and intensity of exercise should be adjusted according to the disease and symptoms.

Get adequate sleep

Poor sleep can worsen fatigue and make it harder to cope with chronic symptoms.

Avoid smoking

Smoking can worsen inflammation and is particularly harmful in several autoimmune and inflammatory conditions.

Protect your mental wellbeing

Living with a chronic disease can affect mood and emotional wellbeing. Speak to your doctor if persistent anxiety, low mood or difficulty coping becomes a concern.

When should you see a doctor?

You should consider consulting a doctor if you experience symptoms that are:

• Persistent or unexplained
• Repeatedly returning
• Associated with joint swelling
• Accompanied by unexplained rashes
• Associated with prolonged fatigue
• Causing unexplained weight loss or gain
• Associated with persistent digestive symptoms
• Causing unexplained muscle weakness
• Affecting your daily activities

You do not need to have several symptoms before seeking medical advice.

A doctor can determine whether your symptoms are related to an autoimmune disease or another, more common condition.

Myths and Facts about Autoimmune Diseases

Myth: Autoimmune disease means the immune system is weak.

Fact: The problem is not simply a “weak” immune system. Rather, the immune response is misdirected and attacks the body’s own tissues.

Myth: Autoimmune diseases are contagious.

Fact: Autoimmune diseases are not contagious and cannot be passed from one person to another like an infection.

Myth: A positive ANA means I definitely have an autoimmune disease.

Fact: Not necessarily. Some healthy people can have positive autoantibody tests. Results must be interpreted along with symptoms and other clinical findings.

Myth: Autoimmune diseases affect only older people.

Fact: Autoimmune diseases can occur at almost any age, including childhood and young adulthood.

Myth: If my symptoms disappear, I can stop my medication.

Fact: Some autoimmune diseases fluctuate between active periods and remission. Medication should only be changed or stopped after discussing it with your doctor.

Myth: Stress alone causes autoimmune disease.

Fact: Autoimmune diseases are complex and usually involve multiple factors, including genetic susceptibility and environmental influences. Stress may worsen symptoms or contribute to flares in some conditions, but it should not be considered the sole cause.

Did You Know?

1. Autoimmune disease can affect the thyroid

   If you have unexplained changes in weight, persistent tiredness, unusual sensitivity to heat or cold, palpitations or changes in bowel habits, thyroid disorders may be one of the conditions your doctor considers[38].

2. Joint pain is not always “just ageing”

   Persistent morning stiffness, swelling or pain affecting several joints may need medical evaluation. Conditions such as rheumatoid arthritis can affect younger and older adults alike.

3. Symptoms can be different from one person to another

   Two people with the same autoimmune disease may have very different symptoms. One person may mainly experience joint problems, while another may have skin, digestive or other organ involvement.

Frequently Asked Questions

Conclusion

Autoimmune diseases are a diverse group of conditions in which the immune system mistakenly attacks the body’s own healthy tissues. They can affect almost any part of the body and may cause symptoms ranging from fatigue and joint pain to skin changes, digestive problems, hormonal disturbances or neurological symptoms.

Because many of these symptoms are common to other health conditions, diagnosing an autoimmune disease may require careful evaluation and more than one investigation.

The good news is that many autoimmune diseases can be effectively managed with appropriate treatment and regular medical care.

If you have persistent, unexplained or recurring symptoms, do not assume that they are simply due to stress, ageing or lifestyle. Speaking to a doctor can help identify the cause and ensure that appropriate treatment is started when necessary.

If you are experiencing symptoms that concern you, consult a qualified healthcare professional for an appropriate evaluation and personalised medical advice[39].

This article is intended for general awareness and does not replace professional medical advice, diagnosis or treatment.

Article Updated on 25^th September 2026

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