The term autoimmune diseases encompasses a variety of nearly 100 different chronic diseases of varying severity that can affect virtually every organ of the individual. This entire group of diseases affects the female sex much more. They are caused by a disproportionate reaction of the individual’s own defense cells (or immune cells) against the individual’s organs.
What diseases are included in the autoimmune diseases?
The following table lists the most frequent and the sex ratio:
What are the symptoms of an autoimmune disease?
The symptoms of suspicion, one or several, are multiple, among them:
- Asthenia (fatigue)
- Weight loss
- Hair loss
- Sun intolerance
- Joint pain
- Muscle pain and/or weakness
- Skin blemishes
- Eye discomfort
- Lack of tears and/or saliva
- Loss of strength Convulsions
- Repeated miscarriages
- Fetal loss
- Choking Headache, among others.
If one or more of the above symptoms are present, the probability of suffering an autoimmune disease increases.
What is the most appropriate treatment for an autoimmune disease?
Most people with autoimmune diseases manage to minimize their symptoms, joint pain, discomfort, fever and/or fatigue, with appropriate treatment. It is important to avoid triggers that may promote exacerbations of the disease. Moderate and regular physical exercise prevents muscle weakness and fatigue. Immunization protects against specific infections. It is important to avoid negative attitudes, bad habits (smoking, drinking alcohol, self-medication) and not following regular medical check-ups.
The pharmacological treatment will be adapted to the characteristics of each type of disease (age, sex, type, intensity, involvement of internal organs, pregnancy), being always an individualized treatment. The most commonly used are: non-steroidal anti-inflammatory drugs, steroidal anti-inflammatory drugs, antimalarial drugs, immunosuppressants or cytotoxic drugs, and immunomodulators. Recently, other drugs, known as “biologics,” use laboratory-modified antibodies to block the autoimmune inflammatory response. The physician specializing in autoimmune diseases will recommend the most appropriate drug(s) for each patient at any given time.
Can the patient relapse from autoimmune diseases?
When the patient follows the controls and treatment recommended by his or her autoimmune disease specialist, life expectancy at 15 years after diagnosis is over 90%, and most patients with autoimmune diseases will be able to lead a normal life. Only in times of “reactivation” of the disease can daily life be disrupted. Most affected patients will never need to be admitted to hospital, if they follow their doctor’s advice.
Studies and progress in this group of diseases are constant. The advances made in the last decade have been greater than those made in the previous 100 years. Therefore, it seems prudent and advisable to keep under control a disease that tomorrow can be cured.
What is Systemic Lupus Erythematosus (SLE)?
SLE is the most classic example of an autoimmune disease. It is an alteration of the immunological tolerance that promotes the appearance of multiple autoantibodies against different self-structures. Therefore, it can potentially affect any system or apparatus of the organism. As it is more frequent in the female sex and in the fertile age of life, this disease may coincide with the time when a woman becomes pregnant. SLE can also appear during pregnancy.
What is the evolution and prognosis of pregnancy in a patient with Lupus?
Overall, it is favorable. A minimum of 6 months of rest is recommended before trying to become pregnant. In the case of severe alterations of the kidney, heart and/or lung, it may be advisable to avoid pregnancy. Most of the drugs can continue to be administered during pregnancy, if they are necessary. If not, they will have to be replaced by others. In untreated women with inactive SLE, the onset of symptoms during pregnancy manifests itself in up to 50% of cases, being in general, easily solvable. In 10-20% of cases, the manifestations of SLE – active flare – are more serious and require more aggressive behavior. In exceptional cases, it is necessary to interrupt pregnancy.
It should not be forgotten that a pregnancy during SLE has two patients: the mother and the fetus. Therefore, we must keep both situations under control. The puerperium is a particularly delicate time for lupus patients. During the entire pregnancy the patient must be monitored clinically and biologically. The role of obstetricians in fetal monitoring is essential.