Autoimmune diseases are characterized by the abnormal response of the immune system. The immune system attacks the body and mistakenly destroys healthy cells, resulting in illnesses like lupus, rheumatoid arthritis, hemolytic anemia, and Crohn’s disease. These illnesses should be identified and treated as indicated by your doctor.
The diagnosis of an autoimmune disease is normally completed by evaluating signs and symptoms (which will vary from person to person) and by completing tests like immunologic bloodwork, DNA testing and imaging.
There are 8 common autoimmune diseases, each with their own symptoms and treatment plans. Learn more about them below:
1. System lupus erythematosus
Lupus, also known as systemic lupus erythematosus, is an autoimmune disease in which the defensive immune cells of the body attack healthy cells. It causes swelling in the joints, eyes, kidneys and skin. This disease happens due to genetic mutations that occur during fetal development, and therefore it is common for signs and symptoms of lupus to emerge in childhood.
Main symptoms: Symptoms of lupus appear as flare-ups; that is, a person can have periods where they have symptoms and other times where they are symptom-free. The emergence of symptoms is typically influenced by factors related to immune system interference, like with medication use or after prolonged sun exposure.
The most prominent symptom of lupus is the appearance of a large red spot on the face that resembles a butterfly. Other common symptoms include joint pain, excessive fatigue, and lesions in the mouth or nose. When symptoms emerge, the doctor or rheumatologist may order urine and blood testing to confirm a diagnosis. Results may show protein in the urine and blood count abnormalities, as well as the presence of antibodies in the blood.
How it’s treated: Treatment for lupus should be directed by your doctor or rheumatologist. Given there is no cure for lupus, the main goal of treatment is to relieve symptoms and prevent frequent or intense flare-ups. The doctor may prescribe anti-inflammatory medication, corticosteroids and immunosuppressants.
Learn more about how lupus is diagnosed and treated.
2. Rheumatoid arthritis
Rheumatoid arthritis is characterized by swelling and inflammation in the joints due to an inappropriate immune response (ie. the immune system attacks healthy joint cells). The cause of rheumatoid arthritis is still not well known, but it is believed that certain factors may influence the development of this disease (e.g.a viral or bacterial infection).
Main symptoms: Symptoms of rheumatoid arthritis, similarly to lupus, can appear and disappear with no explanation. The main symptoms are redness, swelling and pain in the affected joints. You may also notice stiffness and difficulty with moving the joint, fever, fatigue and general malaise.
How it’s treated: Treatment should be directed by a rheumatologist or family doctor. Typically, anti-inflammatories are prescribed to decrease inflammation and relieve symptoms. In addition, physiotherapy is recommended to maintain range of motion in the joints.
Learn more about other common symptoms of rheumatoid arthritis and how it is diagnosed.
3. Multiple sclerosis
Multiple sclerosis is characterized by the destruction of the myelin sheath, which is the lining of the neuron shaft that allows for transmission of electric impulses. The immune system attacks the myelin sheath, which compromises the functioning of the nervous system.
Main symptoms: The symptoms of multiple sclerosis are progressive, which means they will worsen overtime as the nervous system becomes more fragile. Common symptoms include muscle weakness, excessive fatigue, tingling in the arms and legs, difficulty walking, urinary or bowel incontinence, vision changes and memory loss. The more the disease worsens, the more dependent the person becomes on others for care, which greatly affects quality of life.
How it’s treated: Treatment of multiple sclerosis involves the use of medication to prevent worsening and to relieve symptoms. Medications commonly prescribed are anti-inflammatories, IV immunoglobulins, and corticosteroids. It also important to participate in routine sessions of physiotherapy so that muscles are stimulated on a regular basis. This will prevent total muscle atrophy.
4. Hashimoto’s disease
Hashimoto’s disease, or Hashimoto’s thyroiditis, is characterized by inflammation of the thyroid due to destruction of healthy thyroid cells by the immune system. This results in normal-to-increased activity in the thyroid at first, followed by very low activity, which results in hypothyroidism.
Main symptoms: Hashimoto’s disease symptoms are very similar to those of hypothyroidism. These symptoms include excessive fatigue, hair loss, cold and pale skin, cold intolerance, easy weight gain and muscular or joint pain.
Because symptoms of Hashimoto’s are similar to hypothyroidism, the endocrinologist may need to order additional testing to distinguish one from the other (ie. to see if the cause of hypothyroidism is auto-immune related or not). In addition to checking T3, T4 and TSH levels, the doctor may also order thyroid peroxidase antibody testing (or anti-TPO testing). Anti-TPO is an antibody that is produced by the immune system and is typically elevated in Hashimoto’s disease.
How it’s treated: Treatment for Hashimoto’s is usually directed by an endocrinologist and is started when a person presents with symptoms. Oftentimes, the doctor will recommend hormone replacement therapy with levothyroxine for 6 months. Diet also plays a role in treatment: foods that are rich in iodine, zinc and selenium, for example, will promote optimal functioning of the thyroid.
Learn more about symptoms, causes and treatment of Hashimoto's Disease.
5. Hemolytic anemia
Hemolytic anemia occurs when the immune system begins to produce antibodies that destroy the hemoglobin found on blood cells, which results in anemia. This type of anemia is more common in young adults. It is not known what causes the production of these antibodies, or what directs them to attack hemoglobin, but it is believed that this immune system dysfunction is influenced by infections, use of certain medications, or the presence of another autoimmune disease.
Main symptoms: The symptoms of hemolytic anemia are caused by low hemoglobin levels in the blood, which lead to decreased circulating levels of oxygen. These low levels cause weakness, pallor, loss of appetite, headaches, brittle nails, memory loss, dry skin and general malaise.
Although it is often not possible to identify the cause of hemolytic anemia, it is important to rule out other illnesses that could be causing low hemoglobin. Tests that may be ordered include a complete blood count, a reticulocyte count, bilirubin testing and immunologic testing (e.g. Coombs test).
How it’s treated: The doctor's recommended treatment usually entails the use of medication like corticosteroids or immunosuppressants to regulate immune system response. In some cases, the doctor may recommend the removal of the spleen (a splenectomy), as this is where hemoglobin is destroyed by the immune system.
6. Vitiligo
Vitiligo is a condition characterized by the destruction of melanocytes, which are cells that are responsible for the production of melanin (which gives the skin color). The cause of vitiligo is still not well known, however it is usually associated with immune system dysfunction, which leads to destruction of melanocytes by immune cells.
Main symptoms: Due to destruction of melanocytes, it is common for several white spots to emerge on the skin. This is the most common characteristic of vitiligo. These spots most frequently appear in areas of the body that are prone to sun exposure, like the hands, arms, face and lips.
How it’s treated: Treatment should be directed by a dermatologist, as a vitiligo patient will need a skin care routine that protects their sensitive skin. Topical creams with corticosteroids or immunosuppressants may be prescribed, and treatments like phototherapy may be recommended.
7. Sjogren’s Syndrome
This syndrome is characterized by the production of antibodies that result in chronic and progressive inflammation of glands in the body (e.g. salivary glands or lacrimal glands). This results in dryness in normally moist mucosa.
Main symptoms: Due to dysfunction of moisturizing glands in the eyes and mouth, symptoms typically affect these specific areas. Common symptoms include dry eyes and mouth, difficulty swallowing, difficulty talking for prolonged periods, increased light sensitivity, eye redness and increased risk for infection.
This illness can occur due to changes to the immune system, or due to other autoimmune diseases like rheumatoid arthritis. lupus or scleroderma. Therefore, it is important for your doctor to order autoimmune testing to rule out any other autoimmune diseases so that appropriate treatment is completed.
How it’s treated: Treatment is aimed at relieving presenting symptoms and can include the use of artificial saliva spray or lubricating eye drops. Anti-inflammatories or immunosuppressants may also be prescribed.
8. Type 1 diabetes
Type 1 diabetes is also an autoimmune disease. It occurs due to the destruction of pancreatic cells that are responsible for insulin production by immune cells. With type 1 diabetes, pancreatic cells are unable to recognize circulating glucose levels, which results in glucose levels progressively rising in the blood. This disease is commonly seen in children and adolescents, but can also occur in young adults.
Main symptoms: The main symptoms of type 1 diabetes include urinary urgency, excessive hunger and weight loss with no apparent cause.
It is important for the doctor to order further testing (and not just fasting glucose and glycosylated hemoglobin), to distinguish Type 1 diabetes from Type 2, which presents very similarly.
How it’s treated: Because the pancreas is unable to regulate circulating glucose levels, the endocrinologist will likely prescribe insulin dosing that varies throughout the day, or otherwise recommend the use of an insulin pump.
