AN OVERVIEW ON AUTOIMMUNE DISEASES By Dr Rahees K Kokkallur

AN OVERVIEW ON AUTOIMMUNE DISEASES

By

Dr Rahees K Kokkallur

All wars are against Humanity. If a war started in human body it is called autoimmune diseases. The Body has its own Immune system to fight against the germs, pathogens and organisms that attack body. But what will occur when this immune system, that is the soldiers of Human body attack tissues and cells?, autoimmune disease is such a state.  Auto immune diseases are first identified by a Japanese researcher Hashimoto Hakaru. He found the autoimmune nature of thyroiditis and it is called as Hashimoto thyroiditis. The latest studies are shown that many diseases which have called as unknown etiology, has a connection with autoimmune mechanism. Many researchers close their research work with adding a new disease to the list of autoimmune diseases!

Patients suffering from auto immune disease are submitted for immune suppressive therapy. Main drawbacks of immune suppressive therapy are recurrent infection, loss of bone marrow, osteoporosis, organ damages especially liver, kidney and pancreas. There is chance of development of cancer in patients under immune-suppressive therapy. Most of autoimmune diseases are having multi system disorders. List of auto immune disease is endless. But following autoimmune diseases are common in Homoeopathic clinics.

1.       Alopecia areata

2.       Ankylosing spondylitis

3.       Auto immune hepatitis

4.       Crohn’s Disease

5.       Diabetes mellitus type 1

6.       Good pasture's syndrome

7.       Graves' disease

8.       Guillain-Barré syndrome (GBS)

9.       Hashimoto's thyroiditis

10.   Irritable Bowel Syndrome-SUSPECTED

11.   Myasthenia gravis

12.   Narcolepsy

13.   Pemphigus vulgaris

14.   Polymyositis

15.   Primary biliary cirrhosis

16.   Psoriasis

17.   Psoriatic Arthritis

18.   Rheumatoid arthritis

19.   Sjögren's syndrome

20.   Systemic Lupus erythematosus

21.   Temporal arteritis (also known as "giant cell arteritis")

22.   Ulcerative Colitis

Alopecia areata

Mainly alopecia areata, universalis, alopecia  totalis, alopecia areata barabae only affecting beard, etc. are common clinica presentation. In alopecia the Immune mechanism work against the follicles of hair. The peculiarity is that it will affect only black hair follicle, so thought that autoimmune action related with melanin production mechanism. In alopecia areata there is small black spots seen in hair loosed area, it is due to the destruction of hair in hair follicle while its formation.

Ankylosing spondylitis

This is the most common chronic arthritis seen. It is the chronic inflammatory arthritis of autoimmune nature mainly affecting spine and sacroiliac joint. Complication of this disease includes fusion of spine, bamboo spine. It is a gradually appearing disease. Most important problem in AS is diagnosing because average onset to diagnosing lag time has been estimated to be approximately 8.5 to 11.4 year. In AS X-ray is the commonly using diagnostic technique. But the bone change that appears in X-ray will take 8-10years to develop. That means its signs and symptoms will start showing years back before its changes appear in X-ray. Another diagnosing technique is HLAB27 gene, which is positive in 90% of AS Patients, but it will be positive in 5% of normal people too. Like other inflammatory diseases C-reactive protein and ESR will be increase in acute phase.

Auto immune hepatitis

Autoimmune hepatitis is less common. In autoimmune hepatitis Anti-Nuclear Antibody  (ANA), anti-Smooth Muscle antibody, Liver-Kidney Microsomal antibody (LKM-1,LKM-2,LKM-3), anti-soluble liver antigen and Anti-Mitochondrial antibody will be present in Blood.

Diabetes mellitus type 1

In autoimmune diabetes mellitus immune system work against beta cells of pancreas and cause insulin deficiency, there by develop diabetes mellitus. Anti-Insulin Antibody & Anti Islet cell antibody will be positive in auto immune DM.

Good pasture's syndrome

This is an autoimmune disease characterized by glomerulonephritis and hemorrhaging of lung.Good pasture’s antibody cause this autoimmune disease. This antibody present in kidney and Lungs.

Graves' disease

Here autoantibody (TSHR-Ab) activates TSH receptor of thyroid gland and produce more thyroid hormone.

Guillain-Barré syndrome (GBS)

This is an acute inflammatory demyelinating polyneuropathy. The disease is mainly affecting peripheral nerve system. This also listed under autoimmune disorder.

Hashimoto's thyroiditis

This is the first discovered autoimmune disease. Japanese Researcher Hashimoto Hakaru discovered antibodies against thyroid gland. In this disease antibodies formed against thyroid gland will destry thyroid. This disease is commonly misdiagnose as chronic fatigue syndrome, depression, anxiety disorder, etc. hashimoto’s thyroiditis can be diagnosed by testing T3,T4, TSH, Anti-thyroid antibody, Thyroid peroxidase antibody.

Myasthenia gravis

This disease characterized by muscular weakness and fatigability. In MG the acetylcholine receptor mechanism of neuro-muscular junction is affected by circulating autoantibodies and cause impairments in neuro-muscular transmission of impulses.

Narcolepsy

Narcolepsy is a chronic sleep disorder. In narcolepsy patient sleeps while studying, while doing their jobs, sleep in inappropriate time. They will go to REM (Rapid Eye Movement) sleep within 10minutes, but in a normal person it will take about 90 minutes to go to REM sleep.

Pemphigus vulgaris

It is a chronic inflammatory and very painful bullous lesions affecting skin. Autoantibodies form against desmoglein 1 and desmoglein 3, resulting in loss of adhesion between keratinocytes in the epidermis, resulting in bullous painful lesions.

Polymyositis

Polymyositis is infection of multiple muscles of the body.

Primary biliary cirrhosis

This disease characterized by the destruction of small bile ducts of liver. It can be diagnosed by Liver Function Tests, and by identifying the presence of Anti-nuclear antibody and anti-mitochondrial antibody.

Psoriasis

Psoriasis is multi-system autoimmune disease.

Rheumatoid arthritis

RA is very common multi-system autoimmune disorder.  Mainly affects joints, skin, Lungs, Kidney, Heart and blood vessels, etc. Blood test reveals presence of RA Factor, ACCP, but absence of  RA Factor or ACCP does not rule out the Rheumatoid arthritis. Presence of RA factor not confirms rheumatoid arthritis too.  X-ray and other imagine study can also be used for diagnosis of Rheumatoid arthritis.

Sjögren's syndrome

Here autoantibodies attack exocrine gland such as salivary gland and tear gland. Dryness in mouth and eye is the main symptoms. In blood examination ANA (Anti-nuclear antibody) may be seen. In SS ANA patterns are SSB/La.

Systemic Lupus erythematosus

SLE is autoimmune diseases that affect any part of the body. Now a days SLE is a common disease in clinical practice .  Anti-nuclear antibody and Anti-ds DNA Antibody is almost specific to SLE, but it is positive only in 70% of SLE cases, but it will be positive in only 0.5% of people without SLE. American College of Rheumatology established 11 criteria for diagnosing SLE, in which presence of 4 can suggestive of SLE. The 11 criterias are:

1. Malar rash (rash on cheeks).
2. Discoid rash (red, scaly patches on skin that cause scarring).
3. Serositis: Pleurisy (inflammation of the membrane around the lungs) or pericarditis (inflammation of the membrane around the heart).
4. Oral ulcers (includes oral or nasopharyngeal ulcers).
5. Arthritis: nonerosive arthritis of two or more peripheral joints, with tenderness, swelling, or effusion.
6. Photosensitivity (exposure to ultraviolet light causes rash, or other symptoms of SLE flareups).
7. Blood—hematologic disorder—hemolytic anemia (low red blood cell count) or leukopenia (white blood cell count<4000/µl), lymphopenia (<1500/µl) or thrombocytopenia (<100000/µl) in the absence of offending drug. Hypocomplementemia is also seen, due to either consumption of C3 and C4 by immune complex-induced inflammation or to congenitally complement deficiency, which may predispose to SLE.
8. Renal disorder: More than 0.5 g per day protein in urine or cellular casts seen in urine under a microscope.
9. Antinuclear antibody test positive
10. Immunologic disorder: Positive anti-Smith, anti-ds DNA, antiphospholipid antibody, and/or false positive serological test for syphilis. Presence of anti-ss DNA in 70% of cases (though also positive with rheumatic disease and healthy persons).
11. Neurologic disorder: Seizures or psychosis.

Temporal arteritis (also known as "giant cell arteritis")

It is an autoimmune inflammatory disease of vessels of head.

Ulcerative Colitis and Crohn’s Disease

Both are chronic inflammatory autoimmune disease of intestinal tract. The main differences are:-

symptoms	Crohns disease	Ulcerative Colitis
Stool	Often porridge-like, sometimes steatorrhea	Often mucus-like and with blood
Fistula	Common	Seldom
Terminal ileum involvement	Common	Seldom
Colon involvement	Usually	Always
Rectum involvement	Seldom	Usually
Distribution	Patchy areas of inflammation	Continuous areas of ulcer
Endoscopy	Deep geographic or serpiginous ulcers	Continuous ulcers
Depth of inflammation	May be transmural, deep in to tissues	Shallow or mucosal
Stenosis	Common	Seldom
Colon cancer risk	Slight	significant

These are the common autoimmune diseases prevailing in our country. Day by day diseases are falling under the fold of autoimmune disease. One should use his logic to interpret the autoimmune nature of disease before switching over to the treatment. A modern trend is to list all unexplainable health problems under autoimmune disease. An auto immune disease should confirm only by laboratory investigation for an antibody. Scope of homoeopathy shall get an extra millage as new disease comes to the fold of autoimmune diseases.  

Dr Rahees K Kokkallur

MINHANS HOMEOPATHIC MULTI SPECIALITY CLINIC

Markaz Building

Opp. Town Hall

Koyilandy, Kozhikode

Ph: +91 496 606 6 606

Mob: +91 9446 30 5562

Email: drraheesk@gmail.com