When Do Autoimmune Symptoms Add Up to Lupus?
How does lupus get started?
Your immune system’s sole function is to recognize agents that are not you, e.g., bacteria, viruses, fungi, cancer cells, and eliminate them from your body. When its actions are misdirected, your immune system may target your own tissues as if they were foreign invaders, resulting in an autoimmune disease. Systemic lupus erythematosus, or lupus — a disorder that can damage virtually every organ system in your body — is the archetypal autoimmune disease.
Unfortunately, while we can identify many of the immunologic markers that differentiate lupus from other autoimmune diseases, and while we can characterize the tissue damage caused by lupus, it’s still far from clear how or why lupus gets started. It is believed that when people with certain genetic backgrounds are exposed to one or more unknown environmental triggers (viruses, toxins, allergens, etc), the autoimmune cycle is set in motion.
If I have another autoimmune condition that’s causing lupus-like symptoms, is it possible that the list of symptoms could grow and develop into lupus? (For example, if I have rheumatoid arthritis or autoimmune thyroiditis and I’m exposed to the right “trigger,” could I then develop lupus?)
The genetic mechanisms that drive lupus (as well as other autoimmune disorders) are extremely complex. According to a study published in the October 2011 issue of PLoS Genetics, approximately 30 lupus “susceptibility genes” have been identified, and this is probably only a small fraction of the total. If you possess one or more of these genes, your risk for developing lupus is heightened.
It’s possible to suffer from another autoimmune disease, such as rheumatoid arthritis or thyroiditis, while simultaneously carrying susceptibility genes for lupus, and it appears that lupus genes can be triggered at any time. Indeed, many unfortunate individuals with autoimmune “overlap syndromes” have been described in the medical literature. In 2007, Romanian scientists reported the case of a 53-year-old woman whose autoimmune disease was characterized by signs, symptoms, and immunologic features of lupus, rheumatoid arthritis, polymyositis, and systemic sclerosis. Obviously, patients with such overlap syndromes face incredible challenges, and their physicians must be adaptable to a shifting clinical picture as new problems crop up.
Questions for your doctor:
- What complications most commonly affect people with my condition?
- What are the short- and long-term side effects of the medications I’ll be taking?
- How will my treatment change if my condition gets worse?
- Are there any lifestyle patterns I can adopt that will delay progression of my disease, and are there any specific behaviors I should avoid?
DS Cunninghame Graham, et al. Association of NCF2, IKZF1, IRF8, IFIH1, and TYK2 with Systemic Lupus Erythematosus. PLoS Genetics. 2011 October; 7(10): e1002341
D Radelescu, et al. A rare case of systemic autoimmune disease with intricate features of systemic sclerosis, lupus, polymyositis and rheumatoid arthritis. Overlap syndrome or mixed connective tissue disease? Acta Rheumatol Port. 2007;32(3):292-297
About the Author
Steve Christensen, MD – “Doom” to his close friends – was trained at the University of Utah School of Medicine. Since his premature retirement from medicine in 2003, Dr. Christensen has expanded his knowledge of alternative medicine: he is a certified herbalist; he has dabbled at the edges of Ayurvedism, shared ideas with Chinese physicians, rubbed shoulders with Native American healers and contemplated the healing powers of channeled energy.
This blog post was originally published by AutoimmuneMom.com, written by Steve Christensen, MD, and first published on Apr 4, 2012.
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