How do autoimmune diseases impact eye health. What are the common ocular manifestations of autoimmune disorders. Which autoimmune conditions are linked to vision problems. How can patients with autoimmune diseases protect their eyesight.

Understanding the Link Between Autoimmune Diseases and Vision Health

Autoimmune diseases can have far-reaching effects on the human body, including significant impacts on vision and eye health. With over 80 different autoimmune disorders identified, the potential ocular manifestations are diverse and complex. It’s crucial for individuals with autoimmune conditions to be aware of the risks their specific disorder poses to their eyesight and to seek prompt medical attention if they experience any changes in vision.

Dr. Alan H. Friedman, clinical professor of ophthalmology and pathology at the Mount Sinai School of Medicine, explains, “There are several areas of the eye that are involved in autoimmune disease. There are probably common building blocks, like proteins and sugars, that are involved, so that when one area of your body is affected, your eye can be affected also.”

Autoimmune Retinopathy: A Vascular Concern

One significant ocular manifestation of autoimmune disorders is autoimmune retinopathy. This condition primarily affects the blood vessels in the retina, located at the back of the eye. The immune system attacks and inflames these vessels, potentially leading to vision problems. Understanding this mechanism is crucial for early detection and treatment.

The Importance of Regular Eye Examinations for Autoimmune Patients

For individuals with autoimmune diseases, regular eye examinations are paramount. The American Academy of Ophthalmology recommends that all adults undergo an eye screening at age 40 if they haven’t seen an eye doctor previously. However, those with autoimmune conditions should not wait until this age milestone.

• Schedule an appointment with an ophthalmologist immediately if you haven’t had an eye exam in the past year.
• Discuss with your eye doctor how frequently you should be screened based on your specific condition.
• Consider more frequent screenings (up to every six months) if you experience vision health problems or are taking certain medications known to affect eyesight, such as Plaquenil (hydroxychloroquine).

Common Autoimmune Disorders Affecting Eye Health

Several autoimmune disorders have been linked to various ocular manifestations. Understanding these connections can help patients and healthcare providers be more vigilant about potential vision problems.

Behcet’s Disease

This rare autoimmune disorder is a leading cause of blindness in some developing countries. Eye symptoms may be accompanied by mouth and genital sores, making it a complex condition to manage.

Lupus

Lupus can cause eye inflammation, leading to a range of symptoms including:

• Blurred vision
• Headaches
• Sore eyes
• Dry eyes
• Sensitivity to light

Multiple Sclerosis (MS)

The connection between vision health and MS is so strong that eye doctors may be the first to suspect this autoimmune disorder. Dr. John Rose, director of the Center for Autoimmune Disease Research at Johns Hopkins University, notes that initial symptoms of MS often include optic neuritis. This condition involves gradual or sudden vision loss due to inflammation of the optic nerve.

Psoriasis

While primarily known for its effects on the skin, psoriasis can also impact eye health. Inflammation of the conjunctiva, the clear membrane covering the undersides of the eyelids and the whites of the eye, can cause redness and pain.

Rheumatoid Arthritis and Its Ocular Manifestations

Rheumatoid arthritis (RA) is an autoimmune condition that can have significant effects on eye health. Patients with RA may experience:

• Dryness of the eyes
• Inflammation of the white of the eye (sclera)
• Thinning of the cornea
• Other painful ocular conditions

These symptoms can significantly impact quality of life and require careful management by both rheumatologists and ophthalmologists.

Sjogren’s Syndrome: A Focus on Dry Eyes

Sjogren’s Syndrome is a chronic inflammatory condition that primarily affects the body’s moisture-producing glands. In the context of eye health, it can lead to severe dryness due to an autoimmune attack on the tear-producing glands. This dryness can cause discomfort, irritation, and potential damage to the ocular surface if left untreated.

Managing Dry Eyes in Sjogren’s Syndrome

Treatment for dry eyes in Sjogren’s Syndrome may include:

1. Artificial tears and lubricating eye drops
2. Prescription medications to increase tear production
3. Punctal plugs to prevent tear drainage
4. Lifestyle modifications to reduce eye strain and exposure to dry environments

Thyroid Diseases and Their Impact on Eye Health

Autoimmune disorders affecting thyroid function can have significant implications for eye health. Both hyperthyroid and hypothyroid conditions increase the risk of glaucoma, a condition characterized by high pressure inside the eye.

In hyperthyroid conditions such as Graves’ disease, tissues may build up around the eye, potentially increasing intraocular pressure. Conversely, in low-thyroid disorders, the eye may struggle to circulate its fluids effectively, causing pressure to build up from the inside.

Thyroid Eye Disease: A Closer Look

Thyroid eye disease, also known as Graves’ ophthalmopathy, is a specific condition that can occur in patients with autoimmune thyroid disorders. Symptoms may include:

• Bulging eyes (exophthalmos)
• Double vision
• Dry eyes
• Eyelid retraction
• Eye pain or pressure

Type 1 Diabetes: A Leading Cause of Blindness

Type 1 diabetes, an autoimmune disorder affecting insulin production, is one of the leading causes of blindness in the United States. Chronic poor blood sugar control can lead to damage of the small blood vessels in the retina, a condition known as diabetic retinopathy.

Preventing Diabetic Retinopathy

To reduce the risk of vision loss due to diabetic retinopathy, individuals with Type 1 diabetes should:

1. Maintain tight blood sugar control through medication and lifestyle management
2. Attend regular eye examinations, including dilated eye exams
3. Control blood pressure and cholesterol levels
4. Quit smoking, if applicable
5. Report any changes in vision to their healthcare provider immediately

Inflammatory Bowel Diseases and Ocular Manifestations

Ulcerative colitis and Crohn’s disease, collectively known as inflammatory bowel diseases (IBD), can have extra-intestinal manifestations, including effects on eye health. Approximately 5% of patients with IBD experience nonspecific inflammation of the eye.

Common Ocular Symptoms in IBD

Patients with ulcerative colitis or Crohn’s disease may experience:

• Uveitis (inflammation of the middle layer of the eye)
• Episcleritis (inflammation of the tissue between the conjunctiva and sclera)
• Dry eye syndrome
• Cataracts (as a side effect of long-term steroid use for IBD management)

Regular eye examinations are crucial for IBD patients to detect and manage these potential complications early.

Uveitis: An Autoimmune Condition of the Eye

Uveitis is an autoimmune disorder that directly affects the pigmented cells of the iris and sometimes the middle layers of the eye. This condition causes inflammation, which can lead to various symptoms and potential vision loss if left untreated.

Recognizing Uveitis Symptoms

Common symptoms of uveitis include:

• Blurred vision
• Floaters (small dark spots or lines in the field of vision)
• Redness of the eye
• Eye pain
• Light sensitivity

Uveitis can occur as an isolated condition or may be a symptom of another autoimmune disorder. Prompt diagnosis and treatment are essential to prevent long-term vision damage.

Protecting Vision Health in Autoimmune Disorders

For individuals living with autoimmune disorders, protecting vision health is paramount. Here are some key strategies to maintain optimal eye health:

1. Adhere to regular eye examination schedules as recommended by your healthcare provider
2. Report any changes in vision or eye discomfort promptly
3. Follow treatment plans for your autoimmune condition diligently
4. Maintain a healthy lifestyle, including a balanced diet rich in eye-healthy nutrients
5. Protect your eyes from UV radiation with appropriate sunglasses
6. Stay informed about the potential ocular manifestations of your specific autoimmune disorder
7. Communicate effectively between your rheumatologist, primary care physician, and ophthalmologist to ensure comprehensive care

The Role of Medications in Eye Health

Some medications used to treat autoimmune disorders can have side effects that impact vision. For example, Plaquenil (hydroxychloroquine), commonly used in the treatment of lupus and rheumatoid arthritis, can affect eyesight. It’s crucial to discuss potential ocular side effects with your healthcare provider and undergo recommended screening tests to monitor for any vision changes.

Advances in Research and Treatment

The field of autoimmune disease and its impact on eye health is an area of ongoing research. Scientists and clinicians are continuously working to develop new treatments and improve existing ones to better manage ocular manifestations of autoimmune disorders.

Emerging Therapies

Some promising areas of research include:

• Targeted biologics that can more precisely address specific autoimmune mechanisms
• Gene therapy approaches for certain inherited autoimmune conditions affecting the eyes
• Novel drug delivery systems to improve the efficacy of treatments for ocular inflammation
• Personalized medicine approaches that take into account individual genetic and environmental factors

These advancements offer hope for improved outcomes and quality of life for individuals living with autoimmune disorders that affect eye health.

The Importance of a Multidisciplinary Approach

Managing the ocular manifestations of autoimmune diseases often requires a multidisciplinary approach. This collaborative effort typically involves:

• Rheumatologists who manage the underlying autoimmune condition
• Ophthalmologists who specialize in autoimmune-related eye diseases
• Primary care physicians who coordinate overall health care
• Endocrinologists for thyroid-related eye conditions
• Neurologists for conditions like multiple sclerosis that affect the optic nerve

This team-based approach ensures comprehensive care that addresses both the systemic aspects of the autoimmune disorder and its specific ocular manifestations.

Patient Education and Self-Advocacy

Patients play a crucial role in managing their eye health when living with an autoimmune disorder. Key aspects of patient involvement include:

1. Learning about the potential ocular complications of their specific condition
2. Keeping detailed records of symptoms and changes in vision
3. Adhering to medication regimens and follow-up appointments
4. Communicating effectively with all members of their healthcare team
5. Seeking support from patient advocacy groups and online communities

By taking an active role in their care, patients can contribute significantly to better outcomes and improved quality of life.

Vision Problems and Autoimmune Disorders

Autoimmune disorders can affect every inch of your body, from your nerves and joints to your eyes.

But with more than 80 different autoimmune disorders in existence, it is difficult to catalog all the possible impacts on your vision.

You need to be informed about the risks that your specific autoimmune disorder poses to your vision and to seek assistance if you start to experience changes, such as cloudiness, blurriness, pain, dryness, or light sensitivity.

The impact of autoimmune disorders on your eyes can be lessened with appropriate medication.

“There are several areas of the eye that are involved in autoimmune disease,” says ophthalmologist Alan H. Friedman, MD, clinical professor of ophthalmology and pathology at the Mount Sinai School of Medicine in New York City. “There are probably common building blocks, like proteins and sugars, that are involved, so that when one area of your body is affected, your eye can be affected also. ”

On such problem is autoimmune retinopathy, which is “usually manifested as a vascular problem,” says Dr. Friedman. This means that the immune system attacks and inflames the blood vessels in the back of the eye, on the retina, which can affect vision.

Autoimmune Disorders: See Your Eye Doctor Regularly

One of the most important things you can do to protect your eyesight is to see your ophthalmologist regularly. The American Academy of Ophthalmology, a professional organization for eye doctors, advises all adults to get an eye screening at age 40 if they have not seen an eye doctor previously. If you have an autoimmune disease:

• You should not wait until age 40 for a vision health screening. See an ophthalmologist now if you have not been to one in the past year.
• Make sure you ask your eye doctor about how often you need to be screened.
• Get screened more frequently (even as much as every six months) if you have symptoms of vision health problems.
• You should also get frequent eye exams if you are taking certain autoimmune disorder medications for treatment, such as Plaquenil (hydroxchloroquine), which is known to affect eyesight.

Autoimmune Disorders Linked to Vision Health

There are many autoimmune disorders that affect the eye, including:

• Behcet disease. This rare autoimmune disorder is a leading cause of blindness in some developing countries. Eye symptoms may be accompanied by mouth and genital sores.
• Lupus. Eye inflammation is one of the many possible effects of lupus. Symptoms include blurred vision, headaches, sore eyes, dry eyes, and sensitivity to light.
• Multiple sclerosis (MS). The connection between vision health and this autoimmune disorder is so strong that eye doctors may be the first ones to suspect an autoimmune disorder, says John Rose, MD, director of the Center for Autoimmune Disease Research at Johns Hopkins University in Baltimore. Initial symptoms of MS often include optic neuritis, which is a gradual or sudden loss of vision due to inflammation of the optic nerve – the large nerve entering the back of the eye.
• Psoriasis. Inflammation of the conjunctiva (the clear membrane covering the undersides of your lids and the whites of your eye) can cause redness and pain in your eye.
• Reiter’s syndrome. In addition to causing joint inflammation, reactive arthritis can cause inflammation of the front part of your eye.
• Rheumatoid arthritis (RA). RA can cause dryness, inflammation of the white of the eye, thinning of the cornea, and other painful ocular conditions.
• Sjogren’s Syndrome. This chronic inflammatory condition can lead to dryness of the eye due to an autoimmune attack on the tear-producing glands.
• Thyroid diseases. Autoimmune disorders that result in either high or low thyroid function increase the risk of glaucoma (a condition of high pressure inside the eye). Research to understand this relationship is ongoing, but it is thought that with hyperthyroid conditions such as Graves’ disease, tissues build up around the eye and increase pressure in that way. With low-thyroid disorders, the eye may not be able to circulate its fluids effectively, causing pressure to build up from the inside.
• Type 1 diabetes. This autoimmune disorder is one of the leading causes of blindness in the United States, because chronic poor blood sugar control can cause damage to the small blood vessels in the back of the eyes.
• Ulcerative colitis and Crohn’s disease. About 5 percent of patients will have “nonspecific inflammation of the eye.”
• Uveitis. This is an autoimmune disorder that directly affects the pigmented cells of the iris in the eye, and sometimes the middle layers of the eye as well. It causes inflammation, which can lead to blurred vision, “floaters,” and redness of the eye. Uveitis can occur alone, or may be a symptom of another autoimmune disorder.

Vision Health and Autoimmune Disorder Treatments

Some medications for autoimmune disorders may have adverse effects on your vision health over the long term, including:

• Corticosteroids. Long-term use can cause cataracts and increase the risk of glaucoma.
• Antimalarials. Plaquenil can occasionally cause decreased vision.

If you have an autoimmune disease, you are probably alert to changes throughout your body — but don’t forget to take care of your eyes with regular screenings and attention to vision changes.

Neuromyelitis optica: MedlinePlus Genetics

Neuromyelitis optica is an autoimmune disorder that affects the nerves of the eyes and the central nervous system, which includes the brain and spinal cord. Autoimmune disorders occur when the immune system malfunctions and attacks the body’s own tissues and organs. In neuromyelitis optica, the autoimmune attack causes inflammation of the nerves, and the resulting damage leads to the signs and symptoms of the condition.

Neuromyelitis optica is characterized by optic neuritis, which is inflammation of the nerve that carries information from the eye to the brain (optic nerve). Optic neuritis causes eye pain and vision loss, which can occur in one or both eyes.

Neuromyelitis optica is also characterized by transverse myelitis, which is inflammation of the spinal cord. The inflammation associated with transverse myelitis damages the spinal cord, causing a lesion that often extends the length of three or more bones of the spine (vertebrae). In addition, myelin, which is the covering that protects nerves and promotes the efficient transmission of nerve impulses, can be damaged. Transverse myelitis causes weakness, numbness, and paralysis of the arms and legs. Other effects of spinal cord damage can include disturbances in sensations, loss of bladder and bowel control, uncontrollable hiccupping, and nausea. In addition, muscle weakness may make breathing difficult and can cause life-threatening respiratory failure in people with neuromyelitis optica.

There are two forms of neuromyelitis optica, the relapsing form and the monophasic form. The relapsing form is most common. This form is characterized by recurrent episodes of optic neuritis and transverse myelitis. These episodes can be months or years apart, and there is usually partial recovery between episodes. However, most affected individuals eventually develop permanent muscle weakness and vision impairment that persist even between episodes. For unknown reasons, approximately nine times more women than men have the relapsing form. The monophasic form, which is less common, causes a single episode of neuromyelitis optica that can last several months. People with this form of the condition can also have lasting muscle weakness or paralysis and vision loss. This form affects men and women equally. The onset of either form of neuromyelitis optica can occur anytime from childhood to adulthood, although the condition most frequently begins in a person’s forties.

Approximately one-quarter of individuals with neuromyelitis optica have signs or symptoms of another autoimmune disorder such as myasthenia gravis, systemic lupus erythematosus, or Sjögren syndrome. Some scientists believe that a condition described in Japanese patients as optic-spinal multiple sclerosis (or opticospinal multiple sclerosis) that affects the nerves of the eyes and central nervous system is the same as neuromyelitis optica.

Autoimmune Disorders and Your Eyes

When you have an autoimmune disease, your immune system damages healthy cells, including the ones in your eyes. Sometimes, the effect on your eyes can be so pronounced that an eye doctor can be the first one to suspect you have an autoimmune disorder.

Maybe you’ve been diagnosed with an autoimmune disorder and are wondering how it effects your eyes. Maybe you’ve noticed recurring eye problems and think a disorder might be to blame. In either case, understanding the relationship between autoimmune disease and eye health can help you know what to do to take care of your eyes.

1. Rheumatoid Arthritis

With rheumatoid arthritis, your immune system primarily attacks the lining of your joints, beginning with the joints in your fingers and toes. In response, the lining becomes inflamed, pushing down on and damaging the bone and cartilage it’s supposed to protect. The disorder can affect other parts of your body as well, including your eyes.

Dry eyes caused by the immune system attacking the tear ducts is the most common eye-related symptom associated with rheumatoid arthritis, but in some cases, the arthritis can directly attack the sclera, or white part, of the eye. The resulting inflammation (which is called “scleritis”) makes your eyes red, painful, and sensitive to light, and it can destroy your eye tissues if not treated.

An ophthalmologist can prescribe artificial tears to deal with the dry eye or anti-inflammatory drops to treat the scleritis.

2. Lupus

The immune system of those who suffer from lupus indiscriminately attacks any body tissues, including organs, joints, blood cells, and skin. Therefore, the symptoms associated with lupus are broad. If you have lupus, you’ll experience cycles of remission and flare-ups, and with each flare, different symptoms may present themselves.

Lupus can harm the eyes in a variety of ways, including by inflaming the eye tissues themselves, damaging the nerves that control movement and vision, and damaging the skin of the eyelids.

The most common eye issues experienced by people with lupus, however, are changes to the blood vessels in the retina. When the immune system attacks the circulatory system, not enough blood reaches the retinal blood vessels. The eye tries to fix the problem but simply creates more blood vessels, which also don’t have access to blood and so only restrict your vision further.

The primary method for dealing with retinal vasculitis is to treat the lupus itself. Lupus currently doesn’t have a cure, but its symptoms can be managed. Your doctor will likely prescribe anti-inflammatory medication to help restore blood flow.

If your optometrist diagnoses you with retinal vasculitis and you don’t have any known autoimmune disorder, talk to your general doctor about that possibility. Retinal vasculitis is associated with many autoimmune disorders and rarely presents on its own.

3. Psoriasis

Psoriasis causes an extreme buildup of skin cells on the surface of the skin. While skin cells generally have a month-long life cycle, those with psoriasis experience new cell growth every few days. This leads to patches of red, dry skin covered in scales. Environmental and lifestyle factors, such as stress, cold weather, skin injuries, and certain medications may cause the disorder to flare.

Psoriasis affects the skin all over your body, including your eyelids. You may develop red, scaly areas that cause pain when you open and close your eyes, or the skin may grow dry and crack. Since the skin around your eyes is so delicate, you’ll need to talk to your doctor about treatment options right away.

To treat the psoriasis on your eyes, your eye doctor might suggest using corticosteroids or eczema medication. You will need to be careful when applying any ointment or creams—they can cause damage if they come in contact with the eye itself.

4. Multiple Sclerosis

This autoimmune disorder specifically targets the brain and nervous system. The immune system attacks the nerves, which try to repair themselves with scar tissue. However, the scar tissue interrupts the signals traveling through the central nervous system, causing numbness, muscle weakness, lack of body control, pain, and reduced cognitive function.

In addition to all those symptoms, you may also suffer from vision problems. Vision problems may actually be one of the first signs that you have MS, which is one reason why regular eye exams are so important. A common initial indicator of MS is an inflammation of the optic nerve, known as optic neuritis, which restricts your vision by either blurring it or limiting it completely.

Other eye issues associated with MS include uncontrolled eye movements and double vision, due to weak muscles preventing your eyes from coordinating with each other. In every case, the symptoms usually resolve themselves during the course of general MS treatment, but your eye doctor might recommend corticosteroids as well.

Autoimmune disorders impact many aspects of your life, including your vision, but there are ways to overcome these eye problems and retain your sight. Make an appointment with All About Eyes to receive a professional examination and learn how to take care of your eyes.  

Do Immune Disorders Cause Dry Eyes?

Too many late nights. Too much screen time. Long flights. Menopause. Lots of things can cause your eyes to feel dry, gritty, and sore.

But dry eyes can also be related to a medical condition that affects your immune system like diabetes, lupus, or HIV. And sometimes dry eyes are the first sign of a deeper problem.

Inflammation Can Be a Root Cause

There are more than 80 autoimmune diseases. They’re called that because your immune system attacks your healthy tissue by mistake instead of invading germs and viruses. One thing all these diseases have in common is inflammation, which can lead to pain, swelling, and other trouble.

This inflammation can show up almost anywhere in your body. Sometimes that’s far away from a disease’s main target of, for example, your skin or your joints.

Inflammation can damage your tear glands, so they don’t make enough fluid. Or it can target oil glands in your eyelids; without oil, your tears evaporate too soon. Either way, your eyes get dry.

Type 1 and Type 2 Diabetes

Most people with diabetes know that it can cause eye problems like retinopathy, cataracts, and glaucoma. While infrequent, people with diabetes may have dry eyes, as well.

That’s because the nerve damage that causes you to lose feeling in your hands, legs, and feet — so you don’t notice cuts and sores — can also affect your eyes. Severe dryness that’s not treated can damage your cornea, the dome that covers the front part of your eye.

If you have diabetes, get your eyes checked regularly, perhaps every year, including the corneas. If you don’t have it and you have dry eyes, especially if your vision is blurry and you’re often thirsty, too, you may want to get tested for diabetes.

Rheumatoid Arthritis (RA)

This type of arthritis can target almost any part of your body, including your eyes. Some people with RA have a second autoimmune disease called Sjogren’s syndrome, which dries out both your eyes and mouth.

Lupus

Having lupus makes you more likely to get many eye problems, but the most common is dry eye. Inflammation damages your tear-making glands, so they can’t make enough moisture to keep your eyes healthy.

Graves’ Disease

The inflammation with this thyroid disease pulls and stretches the muscles around your eyes, so they bulge out a bit. When you can’t shut your eyes tight, your tears will evaporate too fast.

Treatment

How autoimmune problems are treated depends on the disease, but keeping inflammation under control is key. If you have very dry eyes, you may need long-term anti-inflammatory eye drops or punctal (tear duct) plugs to prevent drainage.

You can also do a lot on your own to ease symptoms:

• Use artificial tears during the day and ointments at night. (But eye drops that prevent redness make dryness worse.)
• Avoid sitting next to air conditioners and heaters.
• Use a humidifier in your bedroom at night.
• Don’t smoke.
• Take frequent screen breaks.
• Blink often.
• Eat more fish, or ask your doctor about taking fish oil pills. Omega-3 fatty acids in salmon, tuna, and sardines help block inflammation and may make your eyes feel better.

Sjogren’s syndrome: What is it?

By Marilyn Haddrill; with contributions and review by Robert L. Epstein, MD

Sjogren’s syndrome (pronounced SHOW-grins; also spelled Sjögren’s) is an autoimmune disease that attacks and destroys glands responsible for keeping the eyes, mouth and other parts of the body moist and lubricated. For this reason, dry eyes are a common symptom of Sjogren’s syndrome.

Men and women of any age or race can develop Sjogren’s syndrome, but it is most prevalent among Caucasian women, with onset usually beginning between ages 40 and 60. The Sjogren’s Syndrome Foundation (SSF) estimates that as many as 4 million Americans have the disease, and about 90 percent are women. As many as 3 million may be unaware they have the condition.

Because dry eyes are such a distinctive feature of Sjogren’s syndrome, many cases of the disease go unreported. It’s estimated that 1 in 10 dry eye patients also have Sjogren’s syndrome; and it can take up to four years or longer from onset of the disease to get an accurate diagnosis, according to researchers.

Causes of Sjogren’s syndrome

Sjogren’s syndrome is one of the more common autoimmune disorders. In these
diseases, a person’s white blood cells attack his or her own tissues and organs, damaging them.

Why abnormal immune responses develop and destroy a body’s own tissues is not clearly understood. Ordinarily, our immune system recognizes our own body parts as “friendly,” and becomes activated only to fight and destroy “foreign” substances or harmful organisms, such as viruses.

Abnormal immune responses may be inherited, or they may be related to prior viral or bacterial infections.

Sjogren’s syndrome can occur alone (primary Sjogren’s syndrome) or it can occur along with other autoimmune diseases, such as rheumatoid arthritis, lupus, celiac disease or scleroderma (secondary Sjogren’s syndrome).

How to know if you have Sjogren’s syndrome

Sjogren’s syndrome symptoms. Image: Sjogren’s Syndrome Foundation.

The classic symptoms of Sjogren’s syndrome are: dry eyes, dry mouth, fatigue and joint pain. Other symptoms may include:

• Contact lens discomfort

• Dry sinuses and frequent sinus infections or nosebleeds

• Sore mouth, tongue or throat

• Difficulty chewing or swallowing

• Dry or peeling lips

• Blepharitis

• Dry and sore skin

• Muscle pain without accompanying swelling

• Vaginal dryness

Other eye symptoms that can occur with Sjogren’s syndrome include blurred vision, a gritty or burning sensation and light sensitivity.

Your eye doctor
may perform a number of tests to confirm a diagnosis of Sjogren’s
syndrome. In one common test (called a Schirmer’s test), the tip of a
small strip of test paper is inserted under your lower eyelid to measure
the amount of tears you produce over a certain period of time (usually
five minutes).

Other tests may include use of dyes that color your
tears; your doctor will then examine your eyes with a microscope to see
how quickly your tears evaporate and whether any dryness-related damage
has occurred to your cornea or conjunctiva.

The
amount and quality of saliva produced in your mouth may also be
measured. Your doctor may order other related tests, including blood
tests. (Certain antibodies in the blood are commonly found in people
with Sjogren’s syndrome.)

A diagnostic test called Sjö (Bausch +
Lomb) offers an even more sensitive and specific means of detecting
Sjogren’s syndrome. In addition to checking for the traditional
antibodies commonly found in the bloodstream of patients with the
disease, the Sjö checks for three additional biomarkers that are
specific to Sjogren’s syndrome for greater diagnostic accuracy,
according to Bausch + Lomb.

How dry eye from Sjogren’s syndrome is treated

Dry eye resulting from Sjogren’s syndrome may require ongoing treatment with artificial tears, ointments or other remedies.

You may need lubricating eye drops or ointments to treat dry eye caused by Sjogren’s syndrome.

Because
many people with Sjogren’s syndrome have a problem with their tears
evaporating too quickly, oil- or lipid-based eye drops sometimes are
especially helpful. These drops help slow down tear evaporation so the
eyes can stay moist longer between blinks.

Your eye doctor also will check for a problem called meibomian (“my-BOH-me-un”) gland dysfunction (MGD), which is a leading cause of evaporative dry eye. In this condition, the glands in the eyelids that secrete oil (meibum) into the tear film become inflamed and obstructed. A decrease in the amount or quality of the meibum also may be involved. This oil is essential to keep tears from evaporating too quickly. Successfully treating MGD can help reduce Sjogren’s-related dry eye discomfort.

For pain or inflammation, you may also need to take nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen. If you have a severe case of Sjogren’s
syndrome, your doctor also may recommend immunosuppressant medications.

Side effects of Sjogren’s syndrome

Because chronic dry eye is one of the major symptoms of Sjogren’s syndrome, you must make sure your eyes are lubricated to avoid damage that can lead to scarring and
infection of the eye.

Sjogren’s syndrome destroys glands responsible for lubricating eyes and other parts of the body.

Sjogren’s syndrome also can cause dryness of the mouth that can lead to tooth decay or even loss of teeth. Use of mouth lubricants (artificial saliva) may be needed to keep the mouth
adequately moist and to assist in swallowing.

Also, people with Sjogren’s syndrome are more likely to develop lymphoma (cancer of the
lymphatic system, which contains white blood cells that play a major
role in fighting disease). Lymph nodes may become enlarged or swollen.

Sjogren’s syndrome also can lead to vasculitis (inflammation of blood vessels) that can cause problems throughout the body.

Pregnant women diagnosed with Sjogren’s syndrome should notify their doctors.
Certain proteins produced by the immune system that are capable of
attacking other potentially beneficial proteins in the body can be
passed along to infants.

How to prevent dry eye and other Sjogren’s syndrome symptoms

Using artificial tears and drinking plenty of water can alleviate symptoms of Sjogren’s syndrome.

There are no known ways to prevent Sjogren’s syndrome, but these steps may help ease symptoms:

• Drink more fluids, especially water.

• Chew sugarless gum or use hard candies to moisten your mouth.

• Regularly
  use artificial tears and ointments to keep your eyes moistened. (Your
  doctor can recommend the best brands for your needs.)

• Use saline spray for your nose.

• Install a humidifier to help reduce dry eyes, nose, mouth and skin.

• Tell your eye doctor about any drugs you are taking, because some, such as antihistamines for allergies, can cause dryness.

• Use vaginal lubricants if needed.

• Don’t smoke, and avoid alcohol.

Sjogren’s Syndrome resources

If you have Sjogren’s syndrome or know someone who does, additional
information — including access to support groups and patient seminars —
is available through the Sjogren’s Syndrome Foundation.

Notes and References

Sjogren’s Syndrome Foundation website. Accessed May 2015.

The epidemiology of Sjogren’s syndrome. Clinical Epidemiology. July 2014.

Prevalence and predictors of Sjogren’s syndrome in a prospective cohort of patients with aqueous-deficient dry eye. British Journal of Ophthalmology. December 2012.

Clinical manifestations and early diagnosis of Sjogren’s syndrome. Archives of Internal Medicine. July 2004.

Page published in March 2019

Page updated in October 2021

Autoimmune eye disease detection | Specsavers IE

Rheumatoid arthritis

The eye is composed of tissues that are similar to joints.³ As a result, many autoimmune diseases that affect joints also affect the eyes — such as rheumatoid arthritis. The most common eye-related symptom of rheumatoid arthritis is dryness, although more severe cases can cause inflammation in the white part (sclera) of your eyes, leading to scleritis.

Sjogren’s syndrome 

Sjogren’s syndrome is a chronic autoimmune disease that attacks the glands responsible for keeping the eyes, mouth and other parts of the body moist and lubricated. One impact of this is called meibomian gland dysfunction — a condition where the glands in the eyelids that secrete oil (meibum) to keep your eyes lubricated become inflamed and obstructed. When diagnosing Sjogren’s syndrome, ophthalmologists will look out for signs of severe dry eye syndrome, alongside blocked, inflamed glands.⁴ 

Bechet’s disease

This is a systemic autoimmune disease that causes blood vessel inflammation throughout the body — including the eyes. Approximately 70% of patients with Bechet’s disease will experience eye inflammation symptoms such as uveitis and retinal vasculitis (inflammation of the retinal blood vessels).⁵

Graves’ disease

Graves’ disease is a condition in which the immune system attacks the thyroid gland, leading to an overproduction of thyroid hormones. This has a number of effects on various parts of the body, including the eyes. Around 30% of patients with Graves’ disease show signs of Graves’ ophthalmology — the inflammation of muscles and tissues around the eyes which can result in bulging, puffy eyes.⁶

Multiple sclerosis

Multiple sclerosis (MS) is an autoimmune disease that affects the brain, spinal cord and optic nerve. Optic neuritis (inflammation of the optic nerve in the eye) is a common symptom of MS, and is typically one of the first signs of MS, which can be detected by an OCT scan. 

Those affected by optic neuritis usually experience symptoms in just one eye.7 Other eye symptoms associated with MS include nystagmus (rapid, uncontrolled movement of the eyes) and diplopia (double vision).⁷

Reiter’s syndrome

Reiter’s syndrome (also known as reactive arthritis) is a type of inflammatory arthritis that affects the joints, eyes, and urethra. Eye inflammation is a common symptom of Reiter’s syndrome, which can occur in the form of conjunctivitis and uveitis (inflammation of the middle layer of the eye).⁸  

Sarcoidosis

Sarcoidosis is a rare condition that causes small patches of red and swollen tissue, called granulomas, to develop in the organs of the body. It usually affects the lungs, skin and eyes. Sarcoidosis can affect people of any age, but usually starts in adults aged between 20 and 40. Sarcoidosis can occasionally occur in more than one family member, but there’s no evidence that the condition is inherited.⁹ The condition isn’t infectious, so it can’t be passed from person to person.

How Lupus Affects Your Eyes

Lupus is an autoimmune disease. Your immune system is your body’s defense against foreign invaders, like germs. When you have an autoimmune disease, your immune system mistakes normal parts of your body as foreign and attacks them. The attack takes the form of inflammation. 

With lupus, the inflammation can affect any part of your body, including your eyes. Other autoimmune diseases can also affect the eyes. They include rheumatoid arthritis (RA), multiple sclerosis (MS) and diabetes. Autoimmune eye symptoms can include dry eyes, red eyes, decreased vision, and even loss of vision. The eye problems can result from the disease and from the medications you use to treat it. 

The Skin Around Your Eyes

Skin is one of the most common areas that lupus attacks. Lupus can cause an itchy and scaly rash around your eyes and on your eyelids. This type of rash is discoid lupus. You could lose your eyelashes. You might get scar tissue along the edges of your eyelids. Eye symptoms include burning and itching. 

Sjogren’s syndrome is a common autoimmune condition seen with both lupus and RA. About 20% of people with lupus also have Sjogren’s syndrome. Dry eyes are the main symptom of Sjogren’s. Autoimmune inflammation of the tear glands causes this. 

Tear glands in people with Sjogren’s do not produce enough tears to keep the eyes moist and healthy. The eyes can become very dry, gritty, watery and itchy. Without treatment, the front surface of your eye can become scarred, and this can affect your vision. Artificial tears can prevent dryness and damage. 

Your sclera is the white part of your eye. Scleritis is inflammation of the sclera. It affects about 1% of people with lupus. It occurs more often in people with RA. If you have scleritis, you may have pain. The outer, white part of your eye can become red. Sometimes the sclera can have a yellow color. In some people, scleritis is the first sign of lupus.  

Inflammation of blood vessels is called vasculitis. Lupus inflammation often attacks blood vessels in the retina. That’s the structure in the back of your eye where nerve cells receive light and send images to your brain to create vision. If the blood vessels that supply your retina become inflamed, you can lose parts of your vision. In fact, vasculitis of the retina is the most common eye problem in lupus. It affects up to 1 of every 4 people with lupus. 

If lupus attacks the nerves that control eye movements, it can cause double vision, weak eye movements, or droopy eye lids. Lupus may also attack the optic nerve. That’s the main nerve that carries images back and forth between your eyes and your brain. Inflammation of the optic nerve can cause gradual or sudden loss of vision. MS is another autoimmune disease that causes inflammation of the optic nerve. 

Lupus drugs that suppress your immune system can increase your risk of eye infections. Also, doctors sometimes treat lupus with drugs for malaria—called antimalarials. These drugs may also damage your retina. In addition, strong anti-inflammatory drugs—called steroids—are commonly used to treat a flare-up of lupus. Steroids can cause glaucoma (pressure in your eye) or cataracts (clouding of the lens of your eye). 

Your treatment plan for lupus will help control most of these problems. An ophthalmologist needs to be part of your overall care plan. This is a doctor who treats eye conditions and diseases with both medication and surgery. Your ophthalmologist will do periodic checkups and treat the symptoms affecting your eyes, which will help protect your vision.

90,000 5 TYPES OF NONVISUAL DISEASES THAT CAN BE DETECTED THROUGH THE EYE

There are many diseases or systemic disorders that manifest through the visual system. In fact, an eye examination by an ophthalmologist can diagnose or detect signs of diseases that a priori are not directly related to the eye.

This is because the eyes often suffer from these systemic diseases. In other cases, visual symptoms are the first manifestation of systemic pathology and, therefore, can help in its early diagnosis.

Although they mainly affect the retina, other areas of the eye can be affected by systemic pathologies. Here are the 5 most common reasons:

1. Vascular diseases

The retina is the area of ​​the eye that contains many blood vessels. In this sense, examination of the fundus (retina) can reveal changes sometimes associated with systemic diseases, such as arterial hypertension (AH), which ultimately cause damage to the veins and arteries of the retina, leading to hypertensive retinopathy.

Dr. Anniken Bures: “Hypertensive retinopathy is a symptom of chronic damage to the blood vessels in the retina. This usually does not cause symptoms, but indicates a problem (hypertension) that could damage other veins and arteries and therefore cause damage to other organs. Therefore, there is no specific treatment for hypertensive retinopathy that goes beyond the control of arterial hypertension. ”

Therefore, it is very important to pay attention to the risk factors for HT, such as:

• overweight or obese
• hereditary factors
• bad habits such as smoking

How can these eye changes be detected? An examination of the retina or fundus is necessary.

2. Pathology of the endocrine system

• Diabetes can be diagnosed by examining the retina (fundus) because it has certain eye abnormalities. In this sense, diabetic retinopathy is probably one of the most common diseases caused by endocrine problems in ophthalmology. This is mainly due to eye damage caused by diabetes in the blood vessels and retinal tissues.

The main complication of diabetic retinopathy is macular edema, a disease that, although not affecting all diabetic patients, is the main cause of vision loss in this pathology.This is due to the fact that the central region of the retina (macula) becomes inflamed, filled with fluid and deformed, which leads to visual impairment.

Some people with diabetes (especially type 2) are diagnosed in an ophthalmologist’s office. Another endocrine system disorder that can affect vision is thyroid orbitopathy. This is usually due to hyperthyroidism causing bulging eyes (exophthalmos).

Various therapeutic strategies are used to treat thyroid orbitopathy:

• good control of the underlying disease (hyperthyroidism)
• eye drop treatment (mainly anti-inflammatory and eye lubricants)
• special operation aimed at the most severe cases, called orbital decompression

3.

Infectious diseases

Sometimes an eye diagnosis can indicate an infectious disease.

Some diseases that cause common infections and affect the eyes are:

• the most common are associated with herpes
• others are caused by a parasitic infection called toxoplasmosis.
• although syphilis and tuberculosis are less common, they also cause eye damage.

Although their symptoms are very diverse, at the ocular level, these diseases can manifest themselves as a foreign body sensation, in the case of herpetic keratitis, they manifest as herpes lesions that cannot be seen with the naked eye and which are determined by ophthalmological examination.On the other hand, other diseases such as toxoplasmosis can be diagnosed through inflammation of the choroid (area of ​​the retina).

4. Autoimmune pathology

These diseases are characterized by an error in the patient’s immune system that attacks healthy cells in the body as if they were pathogens.

Autoimmune diseases can affect various organs and tissues of the body, including the eyes. Some of them:

• rheumatoid arthritis
• psoriatic arthritis
• ankylosing spondylitis

The main eye damage in these three diseases is anterior uveitis, a relatively common eye disease characterized by inflammation of the iris and adjacent tissues and the main symptoms of which are as follows:

• eye pain
• blurred vision
• photophobia or discomfort in the light

Another autoimmune disease that affects vision is multiple sclerosis (MS), a degenerative neurological pathology that causes inflammation of the structures of the central nervous system.Consequently, many MS patients experience optic neuritis or optic nerve inflammation resulting in:

• pain associated with eye movement
• variable loss of vision

5. Neurological diseases

The eyes and brain are closely related, mainly due to the proximity of visual structures, such as the retina or optic nerve, to brain tissue.

• Cerebrovascular diseases such as stroke can cause eye conditions that can vary depending on the area of ​​the brain affected.At the ocular level, its presence can be suspected by symptoms such as:
• loss of vision
• loss of field of view
• double vision (diplopia)
• drooping of the eyelid (ptosis)
• strabismus
• Likewise, some brain tumors that do not show symptoms early as they grow, cause increased intracranial pressure. Although not very common, the presence of these tumors can be detected in consultation with an ophthalmologist when the retina (fundus) is examined or edema (accumulation of fluid) in the optic discs is found, called optic disc edema.

On the other hand, recent research is starting to identify eye changes that may be compatible with Alzheimer’s. Although this condition does not cause specific eye symptoms, new research appears to show abnormalities in a layer of nerve fibers in an area of ​​the optic nerve called the papilla. Although Alzheimer’s is still in the research phase, it will likely be diagnosed with eye tests such as OCT (optical coherence tomography) or angio-OCT in the not too distant future.

90,000 Uveitis in autoimmune diseases

GBU RO “Design Bureau named after NA Semashko

3 ophthalmology department

Doctor ophthalmologist Borodulina M.N.

In modern ophthalmology, uveitis refers to various types of intraocular inflammation – from iritis to chorioretinitis. Generalized inflammation is called panuveitis.

The role of the immune system

The eye is reliably protected by the immune system from the occurrence of infectious uveitis, but the components of the immune system can themselves provoke the inflammatory process.Its memory cells remain in the eye long enough to cause a recurrence of intraocular inflammation the next time it meets the pathogen.

In addition, the immune system is activated by molecular mimicry – the disguise of some microorganisms as their own cells of the human body. Chlamydia, Klebsiella, Yersinia have this feature. Exposure to external factors can also trigger pathological autoimmune reactions that affect organs and systems.

Uveitis in autoimmune diseases

Uveitis often accompanies human autoimmune diseases.Sometimes it is the debut of the disease. But more often it develops after the onset of systemic symptoms.

Uveitis in autoimmune pathology has its own characteristics:

More often it is an anterior variant, an acute course. An exception would be chronic uveitis in the case of juvenile rheumatoid arthritis in girls. Posterior and generalized variants may occur.

Characterized by bilateral lesions, in contrast to infectious diseases. The eyes can be affected asymmetrically, at different time intervals.

The type of course depends on the underlying pathology. Uveitis can be indolent or continuously recurrent. In ankylosing spondylitis, the recurrence rate is very variable.

The combination of uveitis with systemic symptoms – lesions of the skin, musculoskeletal system, lungs – should be alarming for a possible autoimmune disease. This should also be considered when uveitis does not respond to standard therapy.

Sarcoidosis

This disease is a systemic granulomatosis with a predominant involvement of the lungs and, to a lesser extent, the skin.More often women of young and middle age are ill. The incidence of eye damage can be as high as 40%.

Uveitis is more often anterior or generalized. Granulomas are found in the retina and choroid. They can also be present in the conjunctiva of the eyelids.

Symptoms of granulomatous uveitis in sarcoidosis:

• “flies” flashing before the eyes;
• decrease in visual acuity;
• pain

On examination, nodules and fatty precipitates are visible in the iris.

Complications of granulomatous uveitis are cataracts, glaucoma, hypotension and subatrophy of the eyeball. With posterior uveitis, neovascularization of the retina and optic nerve head often develops.

Ankylosing spondylitis

Ankylosing spondylitis is a disease of the musculoskeletal system that begins at a young age, at 20-30 years. In 96% of patients with laboratory tests, the HLA-B27 antigen is detected. It is believed that a complex of an antigen with microbial or other factors triggers the body’s autoimmune response.

Eye symptoms occur in 25% of cases. There is speculation that the intraocular response of the immune system is due to molecular mimicry.

Anterior uveitis develops, which is acute. Both eyes are almost always affected, but not at the same time. The identification of an active process in the eye is preceded by the appearance of pain and photophobia. Symptoms usually start 1 to 2 days earlier.

At biomicroscopic examination, anterior nongranulomatous uveitis is visible, hypopyon is infrequently determined.Fibrin accumulates in the anterior chamber, which leads to a significant decrease in vision. Fibrin layering leads to the formation of posterior adhesions. If the exacerbation continues for a long time, macular edema develops.

Complications of uveitis in ankylosing spondylitis are cataracts and secondary glaucoma.

Uveitis can recur frequently – every 3-4 weeks. But there are also cases of rare exacerbations – no more than once a year. Relapses of uveitis in ankylosing spondylitis are characterized by seasonality.

The severity of ocular lesions does not correlate with the severity of the underlying disease.

The main signs of a systemic disease are limitation of movement in the back and sacroiliitis.

Juvenile rheumatoid arthritis

This disease affects girls more often, the debut occurs at the age of two to eight years. The main symptom is inflammation of the joints.
The main mechanism of juvenile rheumatoid arthritis is considered to be molecular mimicry, in response to which autoimmune damage develops.

Uveitis usually accompanies mono- or oligoarthritis.If the disease proceeds with damage to all joints – polyarthritis, eyes rarely suffer.

Chronic uveitis develops in half of sick children by the age of six.

Most often, chronic eye diseases develop following joint damage, after the onset of juvenile rheumatoid arthritis. But there are also variants of the disease when uveitis is the first symptom of an autoimmune disease, and arthritis occurs after several months or even years.

The severity of eye damage is not related to the degree of arthritis.The juvenile form is characterized by a decrease or complete disappearance of articular changes in the process of growing up, while visual impairment persists for life.

In most girls, uveitis is chronic and asymptomatic, therefore it is very important for them regular observation by an ophthalmologist for timely detection of the disease.

Complications of chronic uveitis in juvenile arthritis include posterior synechiae, leading to an irregular pupil shape. Sometimes it gets infected.Also, ribbon-like dystrophy of the iris, cataracts, and hypotension of the eye may develop. Glaucoma occurs in 20% of cases. There may be significant inflammation in the vitreous body, macular edema with the formation of macular folds.

An important diagnostic criterion is the laboratory detection of antinuclear factor in the blood (observed in girls).

Crohn’s disease, ulcerative colitis

In these diseases, an autoimmune nature of the pathological process is assumed, all parts of the digestive system with symptoms of enteritis or colitis are affected.

Uveitis accompanies these diseases in 5-10% of cases. Uveitis is usually anterior nongranulomatous, is acute. In the cornea, you can see delicate precipitates, fibrin is determined in the anterior chamber of the eye.
Posterior synechiae in these diseases are infrequent and easily destroyed.

Of the eye symptoms in Crohn’s disease will occur:

• pain in the eye area;

Anterior uveitis may be accompanied by episcleritis, serous retinal detachment, optic neuritis.The main systemic symptom is diarrhea. Young and middle-aged people suffer.

Psoriasis

Psoriasis is a skin disease, the mechanism of development of which is not clear enough. The main role belongs to autoimmune processes. May be accompanied by arthritis. Uveitis in psoriasis usually occurs after or at the same time as arthritis develops. Probably, the mechanisms of organ damage are of the same type.

As in Crohn’s disease, uveitis is usually anterior, non-granulomatous.Examination reveals delicate corneal precipitates. The diagnosis is not difficult, since uveitis occurs on the background of phonepsoriatic arthritis.

This disease affects mostly men, the age group is from 20-25 to 40 years. Laboratory examination reveals a positive histological compatibility antigen HLA-B27.

The main symptom of the underlying disease is a specific skin lesion in the form of flaky spots.

Treatment of uveitis in autoimmune pathology

The main role in the treatment of uveitis in autoimmune pathology belongs to steroid hormones – prednisolone, methylprednisolone, dexametozone.They can be used subconjunctivally, periocularly, orally and parenterally. Pulse therapy is performed if necessary.

Hormone treatment should be administered with caution, taking into account the number of side effects and withdrawal symptoms, and monitored by a physician and, if necessary, an endocrinologist.

Impact of autoimmune diseases on oral health

Autoimmune diseases are diseases that result from the response of the human body’s immune system to its own tissues or organs.Most organs can be affected by these diseases, and although there are treatments to control their symptoms, autoimmune diseases are incurable today. Some of these diseases affect the oral cavity and have a negative impact on its health.

General information on autoimmune diseases

The immune system is designed to protect the body from invading microorganisms.When the immune system begins to attack the cells and tissues of its own body, an autoimmune disease develops. Many of these conditions have similar symptoms: fatigue, dizziness, and mild fever. According to the US Women’s Health Service, approximately 23.5 million US residents have at least one autoimmune disease, and women are at a higher risk of developing such diseases than men. Heredity and hormonal changes play an important role in the onset of the disease and its symptoms.Hormonal changes can lead to changes in symptoms, sometimes for the better and sometimes for the worse. Many autoimmune diseases have intraoral symptoms.

Disease affecting the salivary glands

Sjogren’s Syndrome is the second most common autoimmune disease according to the Medscape website. About 90 percent of patients suffering from this disease are women, about 3 percent of all women over 50 years old are affected by this disease.Some cases of Sjogren’s syndrome are accompanied by rheumatoid arthritis. This disease affects the glands that produce fluid, which causes dryness in the eyes, mouth, and other tissues of the body. People with this condition may have difficulty chewing and swallowing. In some people, saliva becomes a thick consistency, while in others, saliva stops producing altogether. Both symptoms impair taste and speech and contribute to the formation of cavities.In case of impaired salivation, the tongue may become like a cobblestone. In addition, the oral cavity of patients with Sjogren’s syndrome is often affected by a fungal infection – candidiasis. To minimize the impact of such a disease, it is necessary to carefully follow the rules of oral hygiene and to undergo frequent dental examinations.

Diseases affecting the oral cavity

Crohn’s disease affects all parts of the gastrointestinal tract. The disease usually develops in patients between the ages of 20 and 40, but it can occur later, between the ages of 60 and 80, according to the Medscape website.In 8–29 percent of patients with Crohn’s disease, the disease affects the mouth. Crohn’s disease symptoms that occur in the mouth include swollen gums, mouth ulcers, and swollen lips. These symptoms can cause difficulty in eating and are often among the first symptoms of the disease.

Systemic lupus erythematosus, according to the US Women’s Health Service, affects parts of the body such as the skin, joints and kidneys. It most often develops in young women, but it can affect people of any gender and age.This disease is accompanied by fever, weight loss, and a butterfly rash on the nose and cheeks. The most significant intraoral sign is mouth ulcers, which may not cause pain in the patient.

Psoriasis is an autoimmune skin disease. About 2 percent of the US population suffers, according to the Medscape website. It usually develops in patients between the ages of 20 and 40 and appears as scaly white patches on the scalp, elbows, and knees.Although psoriasis is usually not accompanied by intraoral symptoms, it can affect the lips, tongue, palate, and gums.

Diseases that make it difficult to swallow

Hashimoto’s disease, or inflammation of the thyroid gland, is the most common thyroid depressant disorder, according to the United States Women’s Health Service. Women are more prone to this disease than men, and it develops more often in middle age.The disease can be accompanied by facial swelling, weakness, fatigue, and increased sensitivity to cold. The throat may swell to the point where the patient has difficulty swallowing.

Scleroderma – excessive growth of the connective tissue of the skin and blood vessels, which can lead to disruption of the organ. The disease can cause thickening of the skin or excessive thickening of the facial skin. People with this condition may have difficulty swallowing.

More than 80 different types of autoimmune diseases are known. The number of people with these conditions is growing, and many of them are difficult to diagnose. If you develop any of the symptoms described above, see a doctor who is experienced in treating such conditions. In addition, in order to eliminate and neutralize the negative impact of the disease on oral health, it is necessary to undergo frequent dental examinations and carefully observe the rules of oral hygiene.

90,000 What are autoimmune diseases?

The main task of the immune system is to protect the body from harmful viruses and bacteria, as well as prevent the development of diseases. However, sometimes the immune system perceives the cells of its own body as foreign substances, attacking and destroying them. As a result of this disorder, autoimmune diseases develop. In this article, we will look at their types, symptoms and diagnostic methods.

When a foreign substance, for example, a flu virus, tries to enter our body, the immune system tries to defend itself with all its might.She identifies the virus, then attacks it and removes it from the body. But sometimes the immune system malfunctions, due to which it mistakenly attacks the healthy cells of its own body. It is in this case that autoimmune diseases develop (“autoimmune” means immunity to oneself).

This disorder can affect almost any part of the body. It affects the heart, brain, nerves, muscles, skin, eyes, joints, lungs, kidneys, glands, gastrointestinal tract and blood vessels.

The classic symptom of autoimmune disease is inflammation. It causes redness, a feeling of warmth in the affected area, pain and swelling. How exactly this disease affects the patient depends on the part of the body that has been affected by the immune cells.

If the joints are damaged, as in the case of rheumatoid arthritis, the person develops pain in the joints and loses their mobility. If immune cells attack the thyroid gland, as in the case of Graves’ disease and thyroiditis, the patient will feel tired and muscle pain; he is also gaining weight.In the case of skin lesions, as is the case with scleroderma, vitiligo disease or systemic lupus erythematosus, the skin color changes, and a rash appears and blisters form.

Many autoimmune diseases affect several organs or parts of the body at once. For example, systemic lupus erythematosus affects not only the skin, but also joints, kidneys, nerves, blood vessels, heart. Type 1 diabetes mellitus disables the endocrine glands, as well as the eyes, kidneys, muscles and other organs and systems.

The most common types of autoimmune diseases

In total, there are about 80 disorders. Many of them have similar symptoms, making it very difficult for doctors to make an accurate diagnosis. Typically, a person suffering from an autoimmune disease goes from periods of remission (complete or partial absence of symptoms) to periods of exacerbation, when symptoms worsen.

Below is a list of the most common autoimmune diseases:

• Rheumatoid arthritis – inflammation of the joints and surrounding tissues.
• Systemic lupus erythematosus is a chronic inflammation that simultaneously affects several organs, including the skin, joints, kidneys, brain, and other organs.
• Celiac disease is a reaction to gluten (gluten), which is found in wheat, rye and barley. In celiac disease, the villi of the small intestine are damaged and function is impaired.
• Pernicious anemia (B-12 deficiency anemia) is a decrease in red blood cells caused by the body’s inability to absorb vitamin B-12.
• Vitiligo – loss of skin pigment that appears as white spots on the skin.
• Scleroderma is an autoimmune disease of the connective tissue, which manifests itself as thickening of the skin. Sometimes scleroderma affects the blood vessels as well as muscles and internal organs.
• Psoriasis is a disease characterized by redness and irritation of the skin. People with this disease develop thick, scaly, silvery-white patches.
• Inflammatory bowel disease is a group of inflammatory disorders that affect the small and large intestines.These include Crohn’s disease and ulcerative colitis.
• Hashimoto’s disease – inflammation of the thyroid gland.
• Addison’s disease – a deficiency of hormones that are produced by the adrenal glands.
• Graves’ disease (hyperthyroidism) is an autoimmune disease in which the thyroid gland produces too many hormones.
• Reactive arthritis – inflammation of the joints, urethra and eyes. Sometimes, reactive arthritis causes wounds to form on the skin and mucous membranes.
• Sjogren’s Syndrome (Dryness Syndrome) – This disease destroys the glands that produce tears and saliva, which causes dry eyes and mouth.
• Type 1 diabetes mellitus – the destruction of pancreatic cells that produce the hormone insulin.

Why does the immune system attack healthy cells?

The causes of autoimmune diseases are unknown. There are many theories that try to explain the mechanism of their development. Scientists believe that the culprits of autoimmune diseases are:

• Bacteria or viruses,
• Medicines,
• Chemical irritants,
• Environmental irritants,
• Genes (heredity).

What are the Symptoms Autoimmune Diseases ?

Due to the large number of different disorders, the symptoms of each of them can be very different. However, experts still note several common features. These include fatigue, fever, inflammation, and a feeling of general malaise. During periods of exacerbation, the symptoms of autoimmune diseases intensify, and during periods of remission, they weaken.

What is the diagnosis of autoimmune diseases?

Usually, when harmful substances try to enter our body, the immune system produces antibodies. These are proteins that recognize and destroy specific harmful substances. The latter include:

• Viruses,
• Bacteria,
• Parasites
• Fungi.

In a person with an autoimmune disease, the body produces antibodies against its own organs and tissues. Diagnostics is precisely aimed at detecting and recognizing these antibodies.

Several tests are used to diagnose autoimmune diseases:

Autoantibody Test

This test detects specific antibodies that are produced in response to tissue attack.

Antinuclear (Antinuclear) Antibody Test

This test examines the antinuclear antibodies that attack the cell nuclei of the body.

General (detailed) blood test

This test is prescribed to count the number of red and white blood cells in the blood.If the immune system is actively fighting, their indicators will go beyond the normal range.

C-reactive protein

Markers of autoimmune diseases must include C-reactive protein analysis. An increase in this indicator indicates the presence of an inflammatory process in the body.

Erythrocyte sedimentation rate

This analysis helps to understand how severe inflammation has formed in the patient’s body.

Treatment autoimmune diseases

Unfortunately, today scientists cannot develop effective methods of treatment. This is due to the fact that the mechanism of development of these diseases has not yet been fully understood. Treatment for autoimmune diseases is aimed only at eliminating symptoms and preventing complications. For this, patients are prescribed:

• Immunosuppressants,
• Hormone replacement therapy (if necessary),
• Blood transfusion in case of its damage,
• Anti-inflammatory drugs, if the joints are affected,
• Painkillers,
• Physiotherapy.

If you suspect you have an autoimmune disease, you need to see a physician. It is this specialist who will conduct an examination and prescribe the necessary tests for markers of autoimmune diseases. At the Persomed clinic, all the necessary tests are performed that help to detect the inflammatory process and even identify individual autoimmune diseases.

Sources:

1. Understanding Autoimmune Diseases, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS),
2. Autoimmune disorders, Department of Health & Human Services, State Government of Victoria, Australia,
3. Autoimmune Disease. HealthLine,
4. Lupus, American College of Rheumatology,
5. Scleroderma, MayoClinic.

Autoimmune diseases (discoid lupus erythematosus, scleroderma, vasculitis)

Autoimmune diseases is a collective term used to denote a number of pathological conditions that develop due to the abnormal production of autoimmune antibodies or autoaggressive clones of NK cells against healthy tissues, causing their destruction and the development of inflammatory processes. According to medical statistics, most often they affect female patients. The exact reasons for their development have not yet been established, but researchers have proven that they can be inherited.

The Department of Dermatovenerology CELT invites you to undergo diagnostics and treatment of autoimmune diseases in Moscow. Our clinic has been operating in the metropolitan market of paid medical services for almost three decades and enjoys a positive reputation among patients. The arsenal of our specialists has everything you need for accurate diagnosis and successful treatment in accordance with international standards.

At CELT you can get a consultation with a specialist dermatologist.

• Initial consultation – 3 500
• Repeated consultation – 2 300

Make an appointment

Types of autoimmune diseases

Experts identify several types of autoimmune diseases that affect various organs and systems of the human body. They are represented by almost eighty diseases with different clinical manifestations. The most famous and common ones are presented in our table below:

Autoimmune diseases: increased risk factors

Despite the fact that diseases of this type can affect almost anyone, numerous studies have established increased risk factors:

• Genetic – diseases can be inherited;
• Sexual – female patients are more susceptible to diseases of the immune system;
• Age – pathologies affect young and middle-aged patients;
• Infectious – infections caused by viruses or bacteria increase the risk of getting sick in patients at risk of genetics;
• Ethnic – Native Americans, Negroes, and Hispanics are more likely to get sick than Asians and Europeans.

Diagnostics and treatment of autoimmune diseases in CELT

The diagnostic feature of autoimmune diseases is the difficulty of making an accurate diagnosis due to the similarity of the clinical manifestations of various pathological conditions. CELT specialists have ample opportunities to conduct specific tests that allow a correct diagnosis. Depending on the situation, various techniques are used to identify the cause of certain symptoms quite accurately.

Treatment of autoimmune diseases can be carried out by different specialists – a nephrologist, dermatologist, rheumatologist, gastroenterologist – depending on which organs and systems are affected. The treatment tactics are selected individually, based on the results of diagnostic studies and the patient’s indications. Drug treatment allows you to solve several important tasks at once:

• minimization of clinical manifestations;
• Ensuring the intake of substances into the body that it cannot produce on its own – replenishment of hormones;
• suppression of the activity of the immune system for the normal functioning of the internal organs and control of the disease process.

In addition, physiotherapy exercises can be used to ensure good mobility of the articular joints. If indicated, it is advisable to use surgical techniques. They are used if the patient has intestinal obstruction or damaged joints need to be replaced.

Modern techniques include the use of modulators of the immune system, as well as treatment at the cell level. In the process, stem cell transplantation is used to restore the correct functioning of the patient’s immune system.

At CELT, doctors of the highest category and candidates of sciences with practical experience of twenty years or more are receiving appointments. You can make an appointment with them online through our website or by contacting our operators: +7 (495) 788 33 88.

Diagnosis of autoimmune kidney damage

Laboratory examination to determine the main markers of autoimmune kidney damage, which includes the detection of antiglomerular antibodies, antibodies to the cytoplasm of neutrophils and antinuclear factor in the patient’s blood.

Synonyms Russian

Anti-BMK, antiglomerular antibodies, antinuclear factor (ANF), antinuclear antibodies, antinuclear antibodies (ANA), antibodies to the cytoplasm of neutrophils, ANCA.

Synonyms English

Antibody to human glomerular basement membrane; Anti-GBM antibodies, anti-GBM, ANCA, antinuclear antibodies (ANA), Hep-2 Substrate, ANA-Hep2, and anti-neutrophilic / cytoplasm antibodies.

Research method

Indirect immunofluorescence reaction.

What kind of biomaterial can be used for research?

Venous blood.

How to properly prepare for the study?

• Do not smoke for 30 minutes prior to examination.

General information about the study

In medical practice, the determination in the patient’s blood of antiglomerular antibodies, antibodies to the cytoplasm of neutrophils and antinuclear factor is used to diagnose autoimmune kidney damage, clarify the cause of glomerulonephritis, examine patients with suspected autoimmune vasculitis, monitor the effectiveness of therapy for autoimmune diseases

The study is recommended for patients with a combination of two or more symptoms, such as arterial hypertension, oliguria, peripheral edema and pastiness, increased levels of urea, creatinine in the blood, pain in the joints, hearing loss, abdominal pain, hematuria, shortness of breath, dry cough with blood.

A huge number of systemic diseases can affect kidney function. Kidney disease is an insidious thing; symptoms of the disease may be absent for a long time. Unfortunately, many people only become aware of kidney problems when the disease manifests itself as pain in the lumbar region or blood in the urine.

Systemic vasculitis often leads to kidney damage in the form of focal necrotizing glomerulonephritis, these include Wegener’s granulomatosis, microscopic polyangiitis, sickle necrotizing glomerulonephritis, Churg-Strauss syndrome (eosinophilic granulomatous vasculiteritis), periarteritis nodosa.

The above diseases are autoimmune and are associated with the appearance in the patient’s body of antibodies to the cytoplasm of neutrophils, which cause damage to the vessels of the kidneys.

Wegener’s granulomatosis is a rare form of vasculitis. It is believed that with this pathology, autoimmune damage to endothelial cells occurs. This is a systemic disease, in which almost all body systems are involved. It can manifest itself with the following symptoms: fatigue, general weakness, fever, night sweats, loss of appetite, sinusitis, facial pain, cough, shortness of breath, chest pain, joint pain, hearing loss, abdominal pain, hematuria.

The kidneys are often affected in systemic lupus erythematosus (lupus nephritis). A kidney biopsy is required to confirm the diagnosis. Treatment consists in effective treatment of the underlying disease and elimination of “renal” symptoms.

Systemic scleroderma causes microangiopathy, which causes kidney damage. Renal crisis (arterial hypertension, oliguria, headaches, peripheral edema and pastiness, increased levels of urea, creatinine in the patient’s blood) is detected in 10% of patients with systemic scleroderma.With this pathological condition, hemodialysis is indicated.

Sjogren’s syndrome is an autoimmune disease characterized by a predominant lesion of the exocrine (salivary, lacrimal) glands, resulting in keratoconjunctivitis, dry mouth, stomatitis. This pathology is often combined with diseases such as systemic scleroderma, antiphospholipid syndrome and kidney disease.

Goodpasture Syndrome is an autoimmune disease in which autoantibodies (antiglomerular antibodies) destroy collagen, causing rapidly progressive renal failure and lung damage.

Clinical manifestations of the disease are loss of appetite, general weakness, shortness of breath, dry cough of blood, nausea, vomiting, edema, pallor of the skin, burning sensation when urinating.

What is the research used for?

• For the diagnosis of autoimmune kidney damage;
• to clarify the cause of glomerulonephritis;
• for examining patients with suspected autoimmune vasculitis;
• to monitor the effectiveness of therapy for autoimmune diseases.

When is the study scheduled?

• When the patient detects signs characteristic of autoimmune kidney damage;
• , if necessary, to monitor the effectiveness of the treatment.

What do the results mean?

Reference values ​​

1. Antinuclear factor

Title:

Result: negative.

2. Antibodies to the basement membrane of the glomerulus: 0 – 7 U / ml.

3. Antibodies to the cytoplasm of neutrophils

Title:

Result: not found.

If the level of the tested antibodies in the blood is within the reference values, it means that he does not have autoimmune kidney damage.

If the test antibodies are detected in the blood, then the autoimmune nature of kidney damage should be suspected and an in-depth examination should be carried out.

What can influence the result?

The likelihood of a false positive test result is increased in older people with malignant neoplasms, chronic diseases or infections.

The endocrinologist named the signs of complications for the thyroid gland after COVID

The most common symptoms faced by postcoid patients are decreased performance, asthenia, mood swings, sleep problems, and cognitive impairment. Such patients should consult an endocrinologist in order to exclude thyroid diseases that could have been provoked by a coronavirus infection, says Elena Kiseleva, endocrinologist at the Invitro-Voronezh network of medical laboratories.

“COVID-19, like any viral infection, can trigger autoimmune processes in the body. The immune system fails and begins to perceive its own cells as foreign. The body produces antibodies that infect its own organs. In the case of the thyroid gland, coronavirus infection can become the cause of autoimmune thyroiditis, subacute de Quervain’s thyroiditis, “explained Elena Kiseleva.

The expert explained that autoimmune diseases of the thyroid gland can proceed in different ways: with increased, normal and decreased function, respectively, symptoms and complaints may differ.

The main symptoms of subacute thyroiditis:

• – pain in the thyroid region, sometimes quite severe;
• – temperature rise;
• – trembling, sweating, irritability (these are signs of increased thyroid function).

“If these symptoms appear some time after any viral infection, including COVID-19, you should immediately contact an endocrinologist,” Elena Kiseleva emphasized.

General weakness, which is noted after suffering COVID-19, in her opinion, this is one hundred percent reason to check thyroid hormones, even in the absence of other symptoms.

“There may be weakness, drowsiness, sweating, palpitations, irritability, swelling, shortness of breath, weight changes in both directions, menstrual irregularities in women, erectile dysfunction in men, changes in libido in both sexes. grow nodules “, – the doctor listed the possible manifestations of the disease.

She recommended 4-8 weeks after the infection to check the hormonal status of the thyroid gland by performing the following tests:

• -TTG,
• -T3 free,
• -T4 free,
• – AT-TPO).

“In 3-6 months after suffering COVID-19, it is advisable to do an ultrasound of the thyroid gland.