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Understanding Autoimmune Diseases

May 20, 2021
by Jane E. Dee

The prevalence of autoimmunity is on the rise in the United States. Researchers have found a 44% increase in ANA, the autoantibody (antibodies that target self) in lupus, in the last 25 years, with 41 million people affected. These autoantibodies presage autoimmune diseases such as rheumatoid arthritis, which is the most common type of autoimmune arthritis, and systemic lupus erythematosus (SLE) in about 30% of individuals over a 5-10 year period, said Richard Bucala, MD, PhD, Waldemar Von Zedtwitz Professor of Medicine (Rheumatology) and Professor of Pathology and of Epidemiology (Microbial Diseases) and the chief of the Section of Rheumatology, Allergy & Immunology at Yale School of Medicine (YSM).

“The good news is that high-risk individuals can be identified, and treatment may prevent disease progression,” Bucala said.

Degenerative joint disease, known as osteoarthritis, is the most common joint disorder, affecting 20-44% of adults over age 70. It is the single greatest cause of disability globally, with a more than 1% GDP cost to the U.S, Bucala said.

The other common autoimmune diseases are rheumatoid arthritis and lupus. Rheumatoid arthritis occurs when the body’s immune system attacks the lining of its joints, causing pain, inflammation, and eventually, cartilage and bone damage. Rheumatoid arthritis can also harm the body’s internal organs such as the heart, lungs, and nervous system.

Lupus is an autoimmune disorder that causes inflammation in the skin, joints, and kidneys. Symptoms include fatigue, joint pain, skin rashes, leg swelling, and chest discomfort.

A less frequent autoimmune disease, scleroderma, has the highest case-fatality rate for any rheumatic disease.

Scleroderma is a rare autoimmune disease in which normal tissue is replaced with scar tissue with extra collagen. Although it most often affects the skin, scleroderma also can affect many other parts of the body. It is four times more common in women than in men. Scleroderma usually develops between the ages of 25 and 55, although it can occur in adults at any age.

The Yale Medicine Scleroderma Program has been designated as a Scleroderma Center of Excellence by the Scleroderma Foundation. “This means that we have successfully developed a program that is specifically geared to the special needs of scleroderma patients,” says Monique Hinchcliff, MD, MS, associate professor in the Section of Rheumatology, Allergy & Immunology at YSM and the director of the Yale Scleroderma Program. “We have specialists not only from rheumatology, but also from allergy & immunology, cardiology, dermatology, gastroenterology, nephrology, and pulmonary critical care that are experienced and dedicated to providing top-notch care to scleroderma patients.”

The Section of Rheumatology, Allergy & Immunology is one of the eleven academic sections within YSM’s Department of Internal Medicine. To learn more about its work, visit Rheumatology, Allergy & Immunology.

Submitted by Jane E. Dee on May 05, 2021