Simple, Important Questions & Answers about Autoimmune Diseases (II)December 19, 2018
How Are Autoimmune Diseases Diagnosed?
Autoimmune diseases often don’t show a clear pattern of symptoms at first. So diagnosing them can be hard. But with time, a diagnosis can usually be made by using:
- Medical history — The doctor will ask about your symptoms and how long you have had them. Your symptoms may not point to one disease. But they can be a starting point for your doctor. You should tell your doctor if you have a family member with autoimmune disease. You may not have the same disease as your family member. But having a family history of any autoimmune disease makes you more likely to have one.
- Physical exam — During the exam, the doctor will check for any signs. Inflamed joints, swollen lymph nodes, or discolored skin might give clues.
- Medical tests—Not one test will show that you have an autoimmune disease. But doctors may find clues in a blood sample. For example, people with lupus or rheumatoid arthritis often have certain autoantibodies in their blood. Autoantibodies are blood proteins formed against the body’s own parts.
Not all people with these diseases have these autoantibodies. And some people without autoimmune disease do have them. So, blood tests alone may not always help. But if a person has disease symptoms and autoantibodies, the doctor can be surer of a diagnosis.
The key is patience. Your doctor may be able to diagnose your condition quickly based on your history, exam, and test results. But the process often takes time. It may take several visits to find out exactly what’s wrong and the best way to treat it
How Are Autoimmune Diseases Treated?
Autoimmunity takes many forms. There are also many treatments for it. Treatment depends on the type of disease, how severe it is, and its symptoms. Generally, treatments have one of three goals:
- Relieving symptoms — If your symptoms bother you, your doctor may suggest treatments that give some relief. Relieving symptoms may be as simple as taking a drug for pain relief. It may also be as involved as having surgery.
- Preserving organ function — When autoimmune diseases threaten organs, treatment may be needed to prevent damage. Such treatments may include drugs to control an inflamed kidney in people with lupus. Insulin injections can regulate blood sugar in people with diabetes. These treatments don’t stop the disease. But they can save organ function. They can also help people live with disease complications.
- Targeting disease mechanisms — Some drugs may also be used to target how the disease works. In other words, they can suppress the immune system. These drugs include cyclophosphamide (Cytoxan*) and cyclosporine (Neoral and Sandimmune). The same immune-suppressing drug may be used for many diseases.
Your doctor may not prescribe a treatment. If your symptoms are mild, the risks of treatment may be worse than the symptoms. You may choose to put off treatment for now. But you should watch for signs that your disease is progressing. Visit your doctor regularly. You need to catch changes before they lead to serious damage.
What Types of Doctors Treat Autoimmune Diseases?
Treatments for autoimmune diseases vary. So do the types of doctors who provide them.
For some people, one doctor will be enough to manage their disease. Others may require a team approach. One doctor might coordinate and give care, and others would treat specific organ problems. For example, a person with lupus might be seen by a rheumatologist. But that person might also see a nephrologist for related kidney problems and a dermatologist for skin problems.
Specialists you may need to see include:
- A rheumatologist, who treats arthritis and other rheumatic diseases. These include scleroderma and systemic lupus erythematosus (lupus or SLE).
- An endocrinologist, who treats gland and hormone problems. These include diabetes and thyroid disease.
- A neurologist, who treats nerve problems. These include multiple sclerosis and myasthenia gravis.
- A hematologist, who treats diseases that affect the blood. These include pernicious anemia and autoimmune hemolytic anemia.
- A gastroenterologist, who treats problems with the digestive system. These include Crohn’s disease and ulcerative colitis.
- A dermatologist, who treats problems of the skin, hair, and nails. These include psoriasis, pemphigus/ pemphigoid, and alopecia areata.
- A nephrologist, who treats kidney problems. These include glomerulonephritis, inflamed kidneys associated with lupus.
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
National Institutes of Health
U.S. Department of Health and Human Services
Public Health Service