Autoimmune Disorders

Systemic Lupus Erythematosus

Systemic lupus is an autoimmune disease that is caused by the body’s natural defenses attacking healthy cells in the body. Inherited genetic tendencies, excessive stress, and viral illnesses can all produce autoimmune illness in patients.  Most patients with this disease complain of fatigue, joint pain, and a skin rash, often across the cheeks of the face. Pain and fever can also be noted. The heart, kidneys, blood cells, and nervous system can all be attacked by autoimmune blood factors.  

Diagnosis and Treatment

Diagnosis is made by physical exam and blood tests looking for signs of inflammation.  Kidney and liver function are often tested.  

Treatment options include non-steroidal anti-inflammatory medications, antimalarial medication for fatigue, joint pain, and skin rash; and corticosteroids for inflammation. Sometimes biologic immunosuppressive medications are used to treat more severe forms of this condition.

Scleroderma

Scleroderma is a chronic skin condition noted when too much collagen is produced and deposited in the kidneys, blood vessels, and skin. Collagen is a firm, inelastic protein that gives skin a shiny appearance and a feeling of increased thickness. Several syndromes including CREST disease, as well as other autoimmune diseases, are associated with scleroderma.  

Diagnosis and Treatment

Physical examination and blood tests, looking for inflammation as well as basic chemistries, are necessary for diagnosis. Scleroderma is largely a clinical diagnosis whose evaluation is augmented by these blood tests.

Treatment includes non-steroidal anti-inflammatory medications, exercise, physical therapy, and the use of steroids for extreme flare-ups of the disease.

Sjogren's Syndrome

Dry eyes, swollen glands, dry skin, and dry nasal passages associated with painful and stiff joint, are the symptoms of Sjogren’s syndrome. It is an autoimmune disorder characterized by white blood cells attacking the glands that make moisture for your body. Dry mouth contributes to dental cavities, gingivitis and yeast infections of the mouth. Dry eyes can burn and itch, and cornea damage can occur. About half of patient’s with this illness have other connective tissue disorders such as arthritis or lupus. The causes of this disorder are not clear, may include viral infection and genetic disease.

Diagnosis and Treatment

A series of laboratory tests to evaluate for inflammation are usually performed to assess this disease. Antibodies to the body’s tissues and immunoglobulins are often checked.  

Artificial tears, special drugs to increase tears, and medicines to increase saliva are all used in treatment of this disorder. Hydroxychloroquine is often used to treat joint pain. Steroids as well as methotrexate can also be used to treat this condition.

Dermatomyositis

Muscles that are aching and weak, associated with stiff joints and tenderness are the hallmark of dermatomyositis. Speech and swallowing difficulties can occur. Sometimes red and purple rashes are noted on the upper eyelids, cheeks, and nose of an affected individual. Red, rough knuckles, elbows and knees are also associated with this disorder. Often, fluid collections are noted around the patient’s eyes. Children with dermatomyositis may have areas of their skin filled with calcified masses. The disease can occur in childhood and adulthood. It is best described as an inflammatory and degenerative change of the muscles and skin, leading to achy and painful muscles.

Diagnosis and Treatment

Lab work is performed to assess kidney function and inflammation levels in the patient. An MRI can be performed to evaluate muscle tissue. Muscle and skin biopsies can be performed.

Medication includes immune globulin infusions, corticosteroids, and tacrolimus preparations. Antimalarial drugs can also be used. If the patient has skin calcification, the calcified lesions can be surgically removed. Physical therapy and exercises to improve muscle function can be of use. Medications can also be used to reduce pain, increase muscle function, and slow progression of the disease.