what is autoimmune arthritis?

Simply put, autoimmune disease occurs when the body's immune system becomes confused. Instead of attacking things like bacteria and viruses, it attacks the body's tissues. Autoimmune diseases can affect a variety of tissues from joint linings (rheumatoid arthritis) to tear ducts (Sjogren's syndrome). Lupus, ulcerative colitis, diabetes (type 1), Graves disease, psoriasis, and many types of arthritis are autoimmune diseases.

Autoimmune diseases tend to cluster in individuals and in families. For example, I have Hashimoto's disease (an autoimmune thyroid disorder) and autoimmune arthritis. My rheumatologist is still trying to determine whether I have rheumatoid arthritis, psoriatic arthritis (related to psoriasis) or both. My father has rheumatoid arthritis and Sjogren's syndrome and has just been diagnosed with Hashimoto's. His mother likely had rheumatoid arthritis. My maternal grandmother had psoriasis and probably had psoriatic arthritis. Once a person has one autoimmune disease, they are more likely to get another.

Autoimmune arthritis differs from osteoarthritis in a number of ways. Osteoarthritis is primarily due to "wear and tear" on the joints and is associated with aging. It is neither systemic nor due to an immune response. Autoimmune arthritis affects a wide variety of joints irrespective of use and the joints affected vary with the type of arthritis. Left untreated, autoimmune arthritis will likely get worse over time and may result in deformity. Because the tissues affected by the various types of autoimmune arthritis occur throughout the body, not just in the joints, other organs like the heart and eyes--even the salivary glands--can be affected. The inflammation caused by autoimmune arthritis increases the risk of heart disease.

While osteoarthritis can be treated with anti-inflammatories and surgery, autoimmune arthritis typically requires the use of immune suppressing drugs called "disease modifying anti-rheumatic drugs" (DMARDS). Because they suppress the immune system, they make one susceptible to infection. They also can be hard on the body, especially the liver. Regular blood tests are often required to ensure that liiver damage is not occurring.

The course of autoimmune arthritis is impossible to predict. Different people respond to different combinations of drugs. Drugs that have worked well can stop working and require a change in medication. Some patients experience remission. Some experience a sudden worsening of previously stable disease. Autoimmune arthritis doesn't just affect the body; it can rob one of favorite activities, relationships, and even the ability to make a living.

This class of diseases demands consistency in self-care and a commitment to be one's own advocate. Because it is usually invisible--especially in it's early stages--autoimmune arthritis can be lonely, and sufferers can find themselves struggling in an unsympathetic world. Its unpredictability--day to day, hour to hour--can be both frustrating and demoralizing. However, there is one gift that I'm discovering in my disease: it requires me to live in the moment, in increasing nonattachment. All of my best intentions to cultivate a rich spiritual life have been puny compared to the way my arthritis has forced me to engage difficult questions. It's a bittersweet consolation, but a consolation none the less.