Wednesday, 19 April 2017

Lupus & It's Overlapping Friends: Part 1



Lupus is more than enough for anyone to have in their basket, but unfortunately for many of us, we have more than 'just' lupus, we often have other bad eggs to carry; i.e. 'overlap' disorders, which are from a group of similar connective tissue disorders. Such is the horrible bitchy thing about having an autoimmune disease. I have various overlap disorders, such as myositis, vasculitis and Raynaud's.

Lupus is an autoimmune disorder which causes the immune system to turn on the self-destruct button and attacks the body it is meant to protect. A healthy immune system should be able to tell the difference between healthy body tissue and foreign invaders like bacteria, toxins and other nasties. In autoimmune disorders, the body is unable to tell the difference between the healthy tissue and bugs etc, so it attacks everything it sees. The immune system is pretty savage on it's prey.



Molly's Fund Fighting Lupus says "Although lupus most often occurs alone, many people with lupus can also have symptoms characteristic of one or more of the other connective tissue diseases. When this occurs, a physician may use the term “overlap” to describe the illness. People affected with lupus may have none, one, or several of these well-recognized overlap diseases. These overlaps are, typically connective tissue diseases, or closely related group of disorders that affect the connective tissues of the body."

Here are just some of the overlap disorders that may occur with lupus:


Sjogren's


People with lupus may also have secondary Sjogren's, which is another autoimmune disorder that overlaps with lupus. Symptoms include dry eyes and mouth, vaginal dryness, joint pain and swelling, gastrointestinal problems, oral ulcers, eye and mouth infections, and it can also affect the lungs, liver, kidneys, skin and nervous system. There are two types of Sjogrens: Primary Sjogrens, which occurs on its own without any other illnesses, and Secondary Sjogren's, which is what affects people with other similar illnesses such as lupus or rheumatoid arthritis. Both types of Sjogren's produces the same symptoms. Symptoms include dry eyes and mouth, vaginal dryness, joint pain and swelling, gastrointestinal problems, oral ulcers, eye and mouth infections, and it can also affect the lungs, liver, kidneys, skin and nervous system.




Myositis


Myositis is an autoimmune disorder that attacks the muscles. Sometimes, people with lupus (including myself), may also have this disorder. Myositis literally means "inflammed muscles" and the main symptoms include muscle weakness and pain. The pain makes me feel like I am being burned inside out. On my bad days, I can barely lift my arms to brush to my hair and sometimes I am bed-ridden by it. Myositis sometimes causes problems with swallowing (dysphagia) and breathing. Steroids are commonly used to bring down the inflammation and in severe cases, patients may also need immune suppressant medication in conjunction with the steroids.

Rheumatoid arthritis

 

Rheumatoid arthritis often overlaps with lupus. The main symptoms are similar, with inflammation, sore, stiff, swollen and painful joints - but the difference is that RA causes bone erosion and deformity. Other symptoms, such as fevers, fatigue and weakness are common with both illnesses. Lupus is often misdiagnosed as RA due to the similarity of symptoms.




http://www.mygraphichunt.com/free-vector-joint-rheumatoid-arthritis-10881/

Fibromyalgia 


There are studies which suggest that about 25% of people who have lupus also have fibromyalgia. Fibromyalgia causes chronic pain throughout the body with various tender points on the body where the pain is particularly bad. Just like lupus, fibromyalgia produces a wide range of symptoms, which may also include insomnia, extreme fatigue, sore skin and painful sensations, depression, anxiety, weakness, brain fog and other cognitive problems and many more. Diagnosing fibromyalgia is difficult because there are currently no tests that can confirm a diagnosis (though progress is being made here), and just like lupus, the symptoms may mimic other illnesses. Drugs such as Pregabalin (Lyrica), Gabapentin and other anti seizure drugs may be prescribed. Other drugs that may be used to treat fibromyalgia include anti-depressants such as Amitriptyline (Elavil).



Vasculitis


Vasculitis literally means 'inflammation of the blood vessels', and just like lupus, it is an autoimmune disease. It can affect all sizes of blood vessels from tiny capilliaries to large blood vessels such as arteries and veins. The inflammation caused by vasculitis can potentially affect any of the the organs of the bod. There are a wide range of potential symptoms depending on which part of the body is being infected and these may include skin rashes, ulcers, gangrene, migraines, seizures, strokes, psychosis, depression, brain fog, cognitive disturbances, visual problems, vision loss, chest pain, breathlessness, heart attacks, infections and more. Vasculitis is treated similarly to lupus, depending on your case, with steroids and/or immune suppression and or/biologics.

Scleroderma

 

Scleroderma is another autoimmune disease which is described by the John Hopkins Scleroderma Center as "an autoimmune, rheumatic, and chronic disease that affects the body by hardening connective tissue. Scleroderma literally means hard skin." There are different types of scleroderma. "Other symptoms may include Raynauds, oesophageal dysfunction, swollen and painful joints, skin thickening and tightening, "and inflammation and scarring of many body parts leading to problems in the lungs, kidneys, heart, intestinal system and other areas"*. People with scleroderma are more likely to suffer from Raynaud's Phenomenon, which I discuss in a previous blog post. Scleroderma is typically treated with NSAIDs and Plaquenil. Methotrexate and other immune suppressants may help. Treatment depends on the severity of the disease and which parts of the body it affects.

A final note on Part 1 (of 2):


Molly's Fund Fighting Lupus adds: "It is important to be aware of the symptoms that may indicate the development of an overlap disease so that they can be properly managed and treated. The treatments for these syndromes are not typically the same as those for lupus; therefore they require separate care and medications."

For further information:


Sjogren's:
http://www.niams.nih.gov/Health_Info/Sjogrens_Syndrome

Scleroderma and Raynaud's:
http://www.hopkinsscleroderma.org/scleroderma/ 

*http://www.rheumatology.org/Practice/Clinical/Patients/Diseases_And_Conditions/Scleroderma_(also_known_as_systemic_sclerosis)/

Vasculitis: 
http://lupus.about.com/od/relatedconditions/a/Vasculitis.htm

Fibromyalgia: http://www.mollysfund.org/2014/11/fibromyalgia/

Myositis:

http://www.mollysfund.org/2015/02/myositis/

Rheumatoid Arthritis:
http://www.healthline.com/health-slideshow/lupus-and-ra#1

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