Disease Description (Causes and Symptoms)
- Definition: A group of diseases that occur when the immune system attacks the body's normal tissues due to an autoimmune response (e.g., systemic lupus erythematosus, rheumatoid arthritis, and autoimmune thyroid diseases).
- Causes/Pathophysiology: Genetic predisposition (family history), hormonal influences (more common in women), and environmental factors (infection, medications, stress, ultraviolet light, etc.) act together to disrupt immune tolerance, leading to the formation of autoantibodies or autoreactive T cells that damage target tissues.
- Main symptoms (vary depending on the affected area): chronic fatigue, fever (low-grade), weight changes (gain/loss), appetite changes, hair loss, skin rashes, joint pain·arthritis, muscle pain, sensory disturbances, decreased memory, depression and sleep disorders, digestive problems, etc. When specific organs (thyroid, pancreas, liver, kidneys, etc.) are affected, symptoms related to those organs may occur.
Treatment Methods
- General principles: Relieve symptoms, suppress inflammation and immune responses, prevent organ damage, and preserve function. Treatment is tailored according to the type and severity of the disease.
- Medication treatment
- Short-term or long-term corticosteroids (to suppress inflammation).
- Nonsteroidal anti-inflammatory drugs (NSAIDs) — to control pain and inflammation.
- Systemic immunosuppressants (e.g., methotrexate, azathioprine, mycophenolate mofetil, cyclophosphamide, etc.).
- Biologics (e.g., TNF inhibitors and B-cell-targeted treatments [rituximab], etc.) — used as targeted treatments for certain diseases.
- Targeted hormone treatment (organ-specific medications, such as for autoimmune thyroid disease).
- Non-medication treatment and supportive therapy
- Physical therapy and rehabilitation (to preserve joint and muscle function).
- Nutritional management and regular exercise (to improve fatigue and depression).
- Mental health care (management of depression and stress).
- Procedures/surgery
- Surgical treatment due to organ damage (such as joint replacement for severe joint damage) or plasmapheresis (in acute situations caused by specific autoantibodies).
- Precautions during treatment
- Increased risk of infection due to immunosuppressive treatment — vaccination (inactivated vaccines are recommended), avoidance of exposure to infections, and prompt visits to a medical institution are necessary.
- Monitoring is necessary for side effects of long-term medications (osteoporosis, hyperglycemia, liver or kidney toxicity, etc.).
- Treatment adjustment is necessary when planning pregnancy (some immunosuppressants carry a risk of birth defects).
- Ultraviolet light (especially in lupus): Strong sun protection is recommended (SPF≥30, regular reapplication, hat and long sleeves).
Checklist Before an Outpatient Visit (Including Preparation Materials and Sample Questions)
- Materials/information to bring
- A list of all medications currently being taken (including prescription and nonprescription medications and supplements), including doses and administration times.
- Copies or summaries of previous test results (blood tests, autoantibody tests, imaging tests [X-ray, ultrasound, MRI, etc.]).
- A symptom diary recording the onset and changes in symptoms and situations that worsen them (pain, fever, fatigue, weight changes, etc.).
- Family history (whether autoimmune diseases are present) and medical history (infections, surgeries, pregnancy history, etc.).
- Lifestyle information (smoking, alcohol consumption, occupational exposure, sleep and exercise patterns).
- Priority information to show the doctor during the outpatient visit
- Recent test results with abnormal findings, medication list, and symptom diary.
Examples of General Questions to Ask the Doctor
- What are the major expected side effects of this medication, and how should I respond if side effects occur?
- What is the prognosis of my disease? What should I focus on managing to preserve function in the future?
- Which vaccinations should I receive while undergoing immunosuppressive treatment?
- I am planning a pregnancy. Do I need medication adjustments or additional tests?
Examples of Disease-Specific Questions
- Which items in my blood test results (autoantibodies and inflammatory markers) require particular attention, and how will those results affect changes in treatment?
- I am planning a pregnancy. Should I stop or switch the medications I am currently taking (e.g., methotrexate, biologics, etc.)?