When one's body attacks: Autoimmune diseases affect approximately 50 million in U.S.

A dialysis machine filters Dennis Nelson's blood.
Story by Jamie Lampros
(Standard-Examiner correspondent)
Mon, Apr 30, 2012
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Last June, Dennis Nelson started experiencing symptoms he thought were related to allergies.

The 54-year-old Roy resident went hiking and couldn’t seem to get enough air. His doctor said he had some sinus issues and prescribed some medicine that seemed to take care of the problem.

“Then soon after, I started getting some migratory joint pain, but it only lasted about a week, so I didn’t think much of it,” Nelson said. “In October, the joint pain came back. This time, I knew something was wrong.”

The pain moved to a different joint every day or two and was so painful that Nelson was unable to work more than a couple of hours a day.

He returned to his doctor, who performed blood tests and a CT scan of his lungs. On Nov. 21, 2011, Nelson received a diagnosis: Wegener’s Granulomatosis, an autoimmune disease in which blood vessels become inflamed, making it hard for blood to flow throughout the body.

The disease mainly affects blood vessels in the nose, sinuses, ears, lungs and kidneys, which explains why doctors initially thought Nelson had a sinus infection and then pneumonia.

After his diagnosis, Nelson said, his health began to rapidly decline. At one point, he ended up in the emergency room with kidney failure.

The rheumatologist he was referred to, Dr. Kirstin Bacani at McKay-Dee Hospital, has been treating him with medication and kidney dialysis.

“If I don’t get my kidney function back, but my Wegener’s goes into remission, then we’ll start the process for a kidney transplant,” Nelson said.

According to the American Autoimmune Related Diseases Association, approximately 50 million Americans, or one in five people, are living with one of the more than 100 autoimmune diseases.

These disease include multiple sclerosis, rheumatoid arthritis, celiac disease, lupus, type 1 diabetes,

Crohn’s, Addison’s and vasculitis.

Some estimates say that 75 percent of those affected are women.

Attacking itself

The body has an immune system designed to protect against infections, said Bacani. The immune system recognizes foreign material such as viruses and bacteria, and generates a response to attack it and rid the body of infection.

“In autoimmune diseases, the immune system begins to attack the body’s own cells and tissues. The immune system’s tolerance is broken, in that the immune system fails to recognize the body’s own cells as ‘self’,” Bacani said.

Bacani said women tend to have higher rates of most rheumatologic diseases than men, and some are more common than others.

For example, she said, rheumatoid arthritis affects 41 per 100,000 people per year, whereas lupus affects 1.8 to 7.6 per 100,000 per year. About 1.5 million adults in the U.S. have rheumatoid arthritis, she said.

Genes, environment

Lakeview Hospital internal medicine’s Dr. Scott Southworth said every case of autoimmune disease is different, but oftentimes cases have common symptoms that include fever, sweats, joint pain or swelling, and chronic or persistent illness.

“Certain genetic factors increase risk,” he said. “There are families that exhibit a marked prevalence for autoimmune disease. Infections can trigger an autoimmune response. For example, heart damage in rheumatic fever is caused by antibodies to strep that attack the heart valves as if they were streptococcal organisms.”

Dr. Andrew Coles, a physician at Davis Hospital and Medical Center, said no one is sure why autoimmune diseases occur. While some tend to run in families and infections can trigger an onset, some environmental factors may also trigger the disease to start. That may include certain solvents and even sunlight.

On the rise

According to a recent study conducted by the National Institute of Environmental Health Sciences, an agency of the National Institutes of Health, autoimmune diseases are on the rise. The study, which tested people for antinuclear antibodies found in the blood, discovered 32 million Americans exhibiting auto-antibodies, the immune system that creates proteins to fight bacteria and infections.

“The study does not surprise us at AARDA, as we have known that the number of autoimmune diseases have been increasing significantly within the past decade,” said Virginia T. Ladd, president and executive director of AARDA. “What we don’t know is why.”

Not everyone who has a positive antinuclear antigen goes on to develop an autoimmune disease, according to the study, but researchers said the study sets the stage for future research as to why some go on to develop them and others do not. The study is the first in a series that will investigate changes in the blood test over time.

In the meantime, Nelson said his advice to others with autoimmune disease is to try to be as positive as possible.

“You will definitely have highs and lows. If you look around, you will see it can always be worse,” he said. “Don’t just stay home and feel sorry for yourself, but get out, stay active, serve others and enjoy your life.”

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