Autoimmune Disorders

The immune system normally distinguishes the body's own tissue from anything foreign. In an autoimmune disease that distinction fails, and antibodies and immune cells attack the body's own joints, skin, gut, glands or blood vessels.

These conditions share a pattern instead of a single cause: they flare and settle, they often affect more than one organ, and they are commoner in women and in families where someone else is affected. Which organ is targeted is what gives each its name.

Your doctor takes a long history, because the pattern over months is more informative than any single day. Which joints, in what order, how long the morning stiffness lasts, what the rash does in sunlight, and what else has happened over the years all narrow it down.

Blood tests measure inflammation and look for specific antibodies, and the antibody results are read alongside the picture instead of on their own: a positive result is common in healthy people, and a negative one does not exclude disease. Organ function is checked at the same time, since damage can be silent.

These are conditions that are controlled instead of cured. The aim is remission, meaning no active inflammation, and reaching it usually takes two to three months from starting treatment.

The medicines need regular blood tests, most often for the blood count and the liver, monthly at first and then less often. Live vaccines are avoided while you are on them, and an infection needs reporting early because the usual signs are damped down.