health

What are autoimmune diseases? A doctor explains everything you need to know.

Autoimmune diseases affect five per cent of Australians.

Yet awareness about what they actually are, and the different forms they take, is exceptionally low.

So what are autoimmune diseases, exactly?

Autoimmune disorders occur when a person’s immune system attacks their own body by mistake. There are around eighty different types of autoimmune diseases, some being fatal.

We spoke to Dr Preeya Maharaj, a GP based in Melbourne, to find out the facts about autoimmune disease.

What are autoimmune diseases?

Dr Maharaj explains autoimmune diseases to her patients as something that has made the immune system turn on the body and start attacking the tissues.

“In a nutshell, an autoimmune disease is where the body’s own immune system targets the body… the area targeted depends on the type of autoimmune disease,” Dr Maharaj says.

“The body’s own immune cells start to attack parts of the body – in rheumatoid arthritis for instance, the joints get affected, whereas in coeliac disease it’s the gut that gets targeted,” she added.

What are the different types of autoimmune diseases?

There are over 80 different forms of autoimmune diseases that target different organs in the body.

“Diseases like rheumatoid arthritis affect the joints, conditions like inflammatory bowel disease (such as ulcerative colitis) affect the bowel, and type 1 diabetes involves the pancreas being targeted resulting in the body being unable to produce insulin,” explains Dr Maharaj.

What is the process of diagnosis?

The diagnosis process for autoimmune diseases is complicated, but family history is always important.

“We always take a thorough history including an extensive family history. We know that autoimmune conditions can run in families and so we will always ask you about your family history in detail,” explains Dr Maharaj.

If the doctor has enough information to suspect a specific autoimmune disease, they will examine certain parts of the body that might be affected.

“Examination is also key – we look for certain features, according to the autoimmune disease we suspect. In rheumatoid arthritis for instance, we know certain joints in the hands tend to be affected most of the time, in psoriasis (an autoimmune disease involving the skin) we do a whole skin examination looking at the skin for signs of the rash (including the scalp),” says Dr Maharaj.

Blood tests are also incredibly useful, as they allow the doctor to examine the blood for antibodies, markers that indicate whether the body’s immune system has attacked the body.

“Blood tests are very helpful in diagnosis  and we often look for certain antibodies. Blood tests including inflammatory markers are very helpful when diagnosing autoimmune disease. The investigations we do varies according to the disease we suspect – in ulcerative colitis for instance, patients will usually undergo a colonoscopy (a test that looks inside the bowel and enables biopsies to be taken) and in rheumatoid arthritis we might also do X-rays to look at the joints more closely,” explains Dr Maharaj.

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What are the most common symptoms of an autoimmune disease?

Autoimmune disease symptoms vary in nature, depending on the specific disease they are suffering from.

“In rheumatoid arthritis patients will describe joint pain and swelling, in ulcerative colitis they will often complain of abdominal pain, diarrhoea and blood in the stools and in psoriasis they will often describe a thick plaque like rash,” Dr Maharaj explained.

The one common symptom of autoimmune conditions is fatigue, but since this is a non-specific symptom it is often unhelpful.

Are there any factors that make certain groups more at risk?

Women of a childbearing age are most commonly affected by autoimmune disease, but a family history makes one especially vulnerable.

“Autoimmune diseases also tend to run in families – we know that there may be a history of thyroid disease in the family, which means the patient is at risk of autoimmune disease too – not necessarily JUST thyroid disease but other autoimmune conditions as well,” explains Dr Maharaj.

Since they can’t currently be cured, how are autoimmune diseases managed?

Autoimmune disease treatment lies in management. They can’t be cured, but they can be effectively managed, says Dr Maharaj.

“We have lots of medications that work to suppress the immune system to stop the immune system from attacking the body’s own tissues – lots of these are very effective. We also often use high dose steroids (either given orally or intravenously) to manage flares of the disease (when the patient has a sudden flare in symptoms such as pain),” she explains.

“Anti inflammatory medications are also helpful in conditions like rheumatoid arthritis where pain and swelling of joints is an issue,” she added.

If you are concerned that you may have an autoimmune condition, consult your GP for a diagnosis. 

Preeya Alexander is a GP based in Melbourne, Australia. Follow her on Instagram and check out her blog The Wholesome Doctor

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