Autoimmune diseases women should know about

AUTOIMMUNE diseases don’t discriminate. They can affect anyone. But while there is no logical explanation, countless people are affected by certain diseases which occur when their immune system starts attacking the healthy cells in their bodies. And research shows that up to 80 per cent of people afflicted with autoimmune conditions are women.

In light of this fact, Dr Keisha Buchanan, obstetrician-gynaecologist at ICON Medical Centre, sought to shed light on conditions that women need to watch very closely.

“There are about 80 types of autoimmune diseases of which systemic lupus erythematosus (SLE), Graves’ disease which affects the thyroid gland, rheumatoid arthritis, Type 1 diabetes, and inflammatory bowel disease are the most common. The antibodies associated with these conditions tend to be targeted at specific organs; for example, in the case of Type 1 diabetes, the pancreas is targeted, or a large group of organs such as in the case of systemic lupus erythematosis,” Dr Buchanan explained.

She noted that the development of these conditions is directly linked to predisposing factors such as genetics, since you are more likely to develop this condition if a close family member has it; environmental factors such as radiation, some medications like hydralazine and quinidine, as well as infections such as Epstein-Barr virus, which triggers injury to healthy tissues and can offset SLE.

Below, Dr Buchanan expands on conditions she wants women to look at more closely:

Systemic lupus erythematosis

“Systemic lupus erythematosis is marked by a wide variety of symptoms, as the abnormal antibodies produced can attack any organ. It also has other features such as photosensitivity rashes, mucosal ulcers such as ulcers in the mouth, hair loss, heart damage like pericarditis, arthritis and kidney damage. Also, if the cerebral vessels are affected, strokes can occur,” Dr Buchanan explained.

She said that in the case of pregnant women with SLE, the antibodies can cross over to the placenta and affect the baby’s heart functions, the most common change being irregular heartbeats. Dr Buchanan pointed out that while SLE may improve with pregnancy, it may flare up after delivery.

Graves’ disease

Women — and black women in particular, are prone to thyroid-related conditions. Dr Buchanan noted that Graves’ disease occurs when thyroid-stimulating antibodies attack the thyroid gland in the neck and cause an overactive thyroid gland. This condition is more common in women than men.

“An overactive thyroid causes symptoms such as anxiety, irregular periods, infertility, palpitations, rapid heartbeat, excessive sweating, weight loss, poor weight gain in pregnancy, diarrhoea, insomnia, and can ultimately trigger heart failure if not treated,” Dr Buchanan outlined.

She pointed out that women who have a family history of thyroid disease or have the above symptoms should consider getting tested for thyroid disease. A screening blood test called the TSH is usually done to diagnose the condition.

Type 1 diabetes

“Type 1 diabetes or insulin-dependent diabetes mellitus occurs when antibodies attack and destroy cells in the pancreas that secrete insulin. In this condition the person is dependent on insulin for survival,” Dr Buchanan explained.

Diabetes, which is marked by elevated blood glucose levels, is treated by insulin administration. If poorly managed or untreated, however, Dr Buchanan underscored that elevated blood sugars could result in organ damage such as kidney and nerve damage, and is the most common cause of blindness, a direct consequence of damage caused to the retina. Additionally, persistently elevated blood sugar can lead to nerve damage in an embryo, and caudal regression syndrome in a foetus that causes paralysis, cleft palate, heart and kidney damage.

“Proper management of diabetes is essential, and a normal blood sugar level will help to prevent damage to organs of the affected persons as well as the development of embryonic organ damage,” Dr Buchanan noted.

Inflammatory bowel disease (IBD)

Autoimmune antibodies can attack the intestines and trigger inflammatory bowel diseases such as Crohn’s disease. “These conditions are marked by bouts of constipation and at times diarrhoea, ulcers that extend from the mouth to the rectum, fissures, and narrowing of the intestines that can cause intestinal obstruction. Regurgitation and stomach burning are also related symptoms of the condition, but these are more common in pregnant women,” Dr Buchanan outlined.

She said that generalised symptoms such as tiredness, arthritis, inflammation of the eye and skin rashes are also seen in this condition. Dr Buchanan recommended dietary modification and the use of anti-inflammatory medications to treat the condition.

Rheumatoid arthritis

“Rheumatoid arthritis is one of the most common causes of arthritis. This condition affects the joints in the hands and feet; however, as the condition advances, it may affect the eyes, and may cause inflammation in the sac that the heart is in — the pericardium. This may restrict cardiac function and lead to heart failure. Also, increased scarring of the arteries may increase the risk of heart attack,” Dr Buchanan explained.

She also shared that scarring of the lungs over time can cause difficulty breathing. The condition is treated with anti-inflammatory medications and immune modulators. In some instances, however, steroids may be needed.

In general, Dr Buchanan noted that arthritis may not be the sign of any serious underlying medical conditions, noting that habits and lifestyle activities such as running, prolonged texting on cellphones, and hours of typing on computers can trigger joint pains in the wrist and feet respectively. These usually resolve with rest and anti-inflammatory medications. She recommended that continuous joint pains that last in excess of one week and continue for more than a month, need to be evaluated. Arthritis is one of the most common complaints that affect patients who are diagnosed with autoimmune diseases.

Dr Buchanan advised that women who have any of these conditions and are considering getting pregnant should confirm first with their doctor that their condition is under control, as well as to get guidelines on properly managing the condition throughout pregnancy. She pointed out that post-delivery care is very important since women afflicted with autoimmune conditions, while they may improve during pregnancy, can become worse after delivery.

She also added that for both men and women, once an autoimmune disease is diagnosed, then treatment should begin immediately because these conditions are not only incurable and chronic, but are also debilitating.