What are Autoimmune Rheumatic Conditions?

Rheumatic conditions are defined as the diseases of connective tissue and medical disorders of the musculoskeletal or locomotor system. The word arthritis literally means joint inflammation (arth=joint, ritis=inflammation), and refers to more than 200 different diseases including:

  • Systemic Lupus Erythematosus
  • Rheumatoid arthritis
  • Inflammatory myositis
  • Sarcoidosis
  • Mixed connective tissue disease
  • Scleroderma/ systemic sclerosis
  • Vasculitis

Rheumatism means inflammation of the joints which results in pain and difficulty moving the joints. Inflammation is a reaction of the body that causes swelling, redness, pain, and loss of motion in an affected area. It is a major physical problem in the most serious forms of arthritis. Normally, inflammation is the way the body responds to an injury or to the presence of disease agents, such as viruses or bacteria. During this reaction, many cells of the body’s defence system (called the immune system) rush to the injured area to wipe out the cause of the problem, clean up damaged cells and repair tissues that have been hurt. Once the “battle” is won, the inflammation normally goes away and the area becomes healthy again, unfortunately this does not seem to stop in most autoimmune rheumatic diseases as the immune system goes haywire.

Most forms of rheumatic conditions are autoimmune in nature. In autoimmune diseases, the body’s defense mechanism – the immune system goes into overdrive and starts to attack certain body organs that it mistakenly considers as foreign to it.

Research scientists are still trying to fully understand how the immune system works to ascertain the cause of autoimmune rheumatic diseases. In certain diseases like lupus, triggers such as puberty, exposure to sunlight, menopause, childbirth, trauma, certain medications and viral infection have been identified.

Not just a disease for old people:

Arthritis is not just a disease of older people – it can affect people of all ages, including children and young adults.

It’s becoming a noticeably worrying phenomenon that a lot of patients diagnosed with autoimmune diseases are relatively young people. These young people are faced with the burden of having to adjust their lives to the new changes that these diseases come with. The transition from being a healthy self- dependent person to a limited or dependent person is one very challenging one. This aggravates the already daunting challenge that accompanies the occurrence of the disease.

It is not clear what causes rheumatic conditions and there is no cure at present. However, there is a lot that can be done to manage the condition and lead a full and active life.

Autoimmune conditions can affect various parts of the body and organs.

It is difficult to diagnosis. It can presents in many ways (have you been treated too many times for malaria and typhoid without improvement?)

Causes and Symptoms

Rheumatic conditions affect the movements you rely on for everyday activities and are usually chronic. This means that it can last on and off for a lifetime. There are over 200 different types of rheumatic conditions that can affect many different areas of the body. In addition to the joints, some forms of arthritis are associated with diseases of other tissues and organs in the body e.g. Rheumatoid arthritis, Systemic Lupus Erythematosus or Juvenile idiopathic arthritis.

Autoimmune rheumatic diseases can have many symptoms which take an irregular course of remissions (symptom-free cycles) and flare-ups. Symptoms may include extreme fatigue, joint and muscle pain, facial rashes, headaches, fever, sun sensitivity, hair loss, depression, mouth ulcers and eye problems. In its severe forms it can affect the brain or kidneys.

Symptoms include:

  • Flu like symptoms or extreme fatigue
  • Fever
  • Weight loss
  • Night sweats
  • Seizures
  • Joint pains and swellings
  • Muscle pain or weakness
  • Hair loss
  • Mouth ulcers
  • Rash ( across the cheeks and nose and other areas)
  • Headaches
  • Seizures
  • Recurrent miscarriages
  • Clots in the legs or lungs
  • Swelling of the feet or legs and around the eyes
  • Anaemia (low blood levels)
  • Fluid around the heart or lungs

People with autoimmune rheumatic conditions may often look perfectly healthy, but feel terrible.

Rheumatic conditions will impact the lives of family and friends of those affected severely . A positive outlook, maintaining a sense of humour, learning about the illness, participating in medical management and balancing of lifestyle are key to maintaining a healthy lifestyle and to help live a whole and fulfilled life.

Diagnosis:

Would depend on an:

  • Accurate history of the illness
  • Physical examination by the doctor and a
  • High index of suspicion

Investigations:

This would be varied probable depending on the system involved.

Full blood counts, kidney function tests, thyroid function tests, blood sugar levels.

Serological assays are antibody tests used for diagnosis and are unfortunately quite expensive locally in Ghana.

Imaging tests including x-rays, Ct scans and MRI scans.

Biopsies: that is taking of a piece of tissue for those with local or a particular organ involvement.

Treatment

The treatment of autoimmune diseases is typically with immunosuppressive medications, which are used to reduce the hyperactive immune reaction.

These immune modulatory  drugs include  steroids,  Cytotoxic  drugs which include low doses of chemotherapeutic drugs  like methotrexate and newer more targeted immune modulators called biologics e.g. Rituximab, TNF inhibitors etc.

Non immune therapy are used to replace for example certain hormones lost due loss of function of a gland for example thyroxine in thyroid disease, insulin in type 1 diabetes.

Anti inflammatory and analgesics e.g. NSAIDS

Palliative care

These diseases are long term or chronic diseases and a multidisciplinary approach to treatment is crucial involving counsellors, physiotherapists, Occupational therapists e

Who gets it?

Anyone can get it !

  • More than 50 million American adults (one in every five) have been diagnosed arthritis. We do not have comprehensive data from Ghana hence the need for more research as preliminary figures show an increasing incidence.
  • Rheumatic conditions affects over 300,000 children under the age of 18.
  • Two-thirds of people with Rheumatic conditions are younger than 65 years old although the prevalence increases with age.
  • People of all genders, ages and races can get Rheumatic conditions.
  • Rheumatic conditions affects more than 34 million Caucasians, more than 4.6 million African-Americans and 3.1 million Hispanics.
  • Rheumatic conditions causes work limitations for more than 40 percent of people with the disease.
  • However, women are more likely to get it these conditions than men. There are 2.5 times as many women as there are men with rheumatoid arthritis (RA).
  • The total annual cost of osteoarthritis (OA) per person living with it is approximately $5,700.

Now that you know, why don’t you save a life and spread the awareness.

Let’s get the facts and save a life.