A case of mistaken identity: Understanding lupus and other autoimmune diseases
The human body is a marvel. This is one of several reasons why doctors find it fascinating to practice medicine, a practice which becomes a lifelong process of learning and exercise in the skill and art of medicine. This practice, however, is not without its uncertainties. Despite the progress made towards understanding the human body, there remains much unknown. One such mystery is why the human body attacks itself. Autoimmune diseases are an example of this phenomenon.
Autoimmune diseases
The immune system is the body’s defense mechanism. It functions to protect the body from infection and other “invasions” of the body. It is made up of tissues, organs, cells, and proteins called antibodies. These specialized proteins attack and destroy substances called antigens (i.e. viruses, bacteria, toxins) that they recognize as foreign and different from the body’s normal healthy tissue. When working properly, this defense system helps to prevent infection and keep us healthy. However, when the immune system malfunctions, it starts to recognize self-tissue in the body as foreign, like it would a virus or bacteria, and tries to destroy it. This case of mistaken identity is the basis for autoimmune disease. This abnormal activity leads to tissue damage, such as inflammation and various symptoms. The exact cause of autoimmune disease is unknown, although genetics are believed to play an important role.
Lupus
Known as systemic lupus erythematosus (SLE), lupus is classified as an autoimmune disease. In the case of lupus, the immune system may attack multiple tissues in the body, most commonly the skin, kidneys and joints. An estimated 1.5 million people in the U.S. have lupus. This disease disproportionately affects African American women, who also tend to develop the disease at an earlier age (15-45) and have more severe disease. Like many other health conditions, health disparities, or preventable differences in health and health care that are linked to racial, social, economic and environmental conditions, these factors continue to play a major role in the medical care of African American women with lupus and how well they do compared to others.
Lupus symptoms
Symptoms vary depending on the person and organ or tissues involved.
Most common symptoms are skin rash (“butterfly” appearance across nose, other rash), hair loss, achy/swollen joints, extreme tiredness, fever, sensitivity to light/sun, pain.
Symptoms may come and go, similar to other autoimmune diseases.
Diagnosis
Diagnosis is often challenging; lupus is known in the medical community as “the great imitator” because it may mimic other illnesses or diseases.
Typical adult consults three to five physicians before diagnosis.
Average of two to three years before diagnosis is confirmed.
There is no single lab test to diagnose lupus.
Diagnosis is made by taking a good medical history, including symptoms, family history, physical and laboratory examination.
Other autoimmune diseases
Multiple sclerosis—nervous system (brain, nerves)
Graves’ disease/Hashimoto’s thyroiditis—thyroid gland
Autoimmune hepatitis—liver
Crohn’s/ulcerative colitis—digestive tract
Psoriasis—skin
Rheumatoid arthritis—joints
Treatment
Treatment is based on controlling symptoms and stopping progression of damage to tissues.
Anti-inflammatory medications such as non-steroidal anti-inflammatory drugs (i.e. ibuprofen) or steroids such as prednisone.
Medications that target the immune system (such as immunosuppressive drugs or chemotherapy drugs).
What you eat and how you live plays an important role in treatment. Using food as medicine, discuss with your doctor foods to limit or avoid that may trigger inflammation (i.e. sugar, animal products, processed foods) and increase foods with anti-inflammatory and immune support properties such as plant-based foods and foods high in omega-3 fatty acids (i.e. fish, nuts, flaxseed). Getting enough sleep, stress reduction, and being active also support your immune system and overall well-being.
Being diagnosed with a chronic medical illness can be overwhelming and may come with a feeling of loneliness and despair. It is important to seek help for dealing with these emotions as part of a holistic wellness plan of care. Many of us know someone with an autoimmune disease, and several celebrities have shared their diagnosis of lupus (i.e. Toni Braxton, Nick Cannon, Trick Daddy, Seal). This article was inspired by two young women who recently shared their story with me, both cases of mistaken identity of the body with one common goal: to live well and not let the disease define them.
Written by: Dr. Tamiko (Morgan) Foster
Previously printed in the Minnesota Spokesman-Recorder newspaper.
http://spokesman-recorder.com/