After the rain, the sun will reappear. There is life. After the pain, the joy will still be here. – Walt Disney

Autoimmune rheumatic diseases (RMDs) are a diverse group of diseases that commonly affect the joints, but can also affect the muscles, other tissues and internal organs. There are more than 200 different RMDs, affecting both children and adults. 

They are usually caused by problems of the immune system, inflammation, infections or gradual deterioration of joints, muscle and bones. Many of these diseases are long term and worsen over time. They are typically painful and limit some functions and in severe cases can result in significant disability, having a major impact on both quality of life and life expectancy. 

Causes and Risk Factors: 

The exact cause is not known and is proposed to be multifactorial. Most autoimmune disease have genetic risk factors and environmental triggers which dysregulate the immune system. The immune system starts attacking the joints & other structures.

Women get autoimmune diseases far more often than men, and it is estimated that over 65% of patients are women. A family history of an autoimmune disorder may increase the chances of developing one.
 
Signs & Symptoms: 

The most common symptom is pain in the joints, which can be mild to severe causing disability. The pain can be associated with stiffness of the joints, which is worse in the morning on waking up. Some may have pain and stiffness in the entire body too, and at times there can be swelling of the affected joints also. 

In ankylosing spondylitis, the joints of the spine are affected and back pain and stiffness are the predominant symptoms. Arthritis damages the surface of the joint and at times the underlying bone. If not treated, the disease progresses and causes destruction of the joint that can result in deformities. 

Some forms of arthritis are classified as systemic when inflammation can cause damage to virtually any bodily organ or system, including the heart, lungs, kidneys, eyes, blood vessels and skin. Also known as systemic lupus erythematosus or SLE, lupus is a serious inflammatory disease that affects the skin, joints and internal organs, and in severe cases can be fatal. 

Diagnosis: 

The diagnosis is based on the symptoms, examination including detailed assessment of the joints for signs such as joint swelling, limited range of motion, and a crunching or grinding sensation.  Simple x-rays will usually confirm a diagnosis of osteoarthritis. Blood tests include the baseline tests and special tests for antibodies. 

For those with clinical features suggestive of Lupus, ANA (antinuclear antibody) is an important screening test. If the ANA returns positive, more specific tests are required to establish the diagnosis, assess the severity and quantify the treatment. For rheumatoid arthritis, rheumatoid factor and antibodies to cyclic citrullinated peptides (anti-CCP) are the specific antibody tests. 

Treatment Options: 

Though there isn’t yet a cure for autoimmune rheumatic diseases, the earlier the treatment, the better and most effective it is. Medications include NSAIDs and oral, intramuscular, or intra-articular corticosteroids for controlling pain and inflammation. Ideally, NSAIDs and corticosteroids are used only for short-term management. 

 Disease-modifying antirheumatic drugs (DMARDs) are the mainstay of treatment. The main aim of treatment is to control the disease and prevent joint and organ damage. 

After the disease is controlled, medication dosages may be cautiously reduced, however, patients will require frequent monitoring as the medicines need to be promptly increased in case the disease flares up. Consult the Medcare Rheumatology department to know the best treatment option for all types of rheumatic diseases. 

FAQs:الأسئلة الشائعة:
  • Can high stress levels increase my risk of getting autoimmune diseases?

    A: Yes, recent research has found that people with stress related disorders are more likely to suffer from autoimmune diseases.

  • Are there any distinct symptoms of lupus?

    A: Unfortunately, no. Lupus can affect many different parts of the body, and symptoms differ from person to person. Some symptoms of lupus include: 

    • Red rash across the nose and cheeks, resembling the shape of a butterfly. 
    • Pain or swelling in the joints.
    • Unexplained fever.
    • Chest pain when deep breathing. 
    • Swollen glands. 
    • Extreme fatigue all the time. 
    • Unusual hair loss. 
    • Sensitivity to the sun. 
    • Low blood count. 
    • Depression, trouble thinking, or memory problems. 
    • Other symptoms are mouth sores, unexplained seizures (convulsions), hallucinations, repeated miscarriages, and kidney problems. 

    As the symptoms vary a lot, lupus can be difficult to diagnose.

  • Is lupus more prevalent in women as compared to men?

    A: It is estimated that lupus occurs 10 times more often in women than in men, however men too have the potential of getting lupus.  

    Scientists believe that a) the higher levels of oestrogen in women may be responsible for the severity of the disease or is a possible catalyst for developing the disease itself and b) the presence of androgens may offer some protection so low levels of androgen in men may be connected to the development of the disease in males.

    Women are thought to respond more aggressively to self-antigens as their immune system is stronger and more responsive than that of men. This makes them more vulnerable to autoimmune diseases.

  • What are the chances of flares when you are diagnosed with lupus?

    A: Lupus is a disease of flares and remissions. Lupus flare-ups can be mild, or they can be severe. At least 75 percent of people with lupus have arthritis and skin rashes. Half have kidney problems. Lupus patients are also more vulnerable to infection than most people.