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Thursday, May 23, 2013
Relationship of Autoimmune diseases
What is the likelihood of someone having Hashimotos thyroiditis, Sjogrens syndrome and Antiphospholipid syndrome and not having Lupus? Can all three of these occur as primary diseases together in the same individual?
Many patients diagnosed with autoimmune rheumatic diseases cannot be categorized into one of the established clinical entities such as systemic lupus erythematosus. In some patients several connective tissue or autoimmune disorders may overlap. For example: Clinical evidence of Hashimoto’s thyroiditis has been detected in approximately 10-15% of patients with Sjögren's disease.
Sjögren's syndrome is classified as either primary or secondary disease. Primary Sjögren's occurs by itself, and secondary Sjögren's occurs with another disease (lupus, rheumatoid arthritis). In primary Sjögren's syndrome, the doctor can trace the symptoms to problems with the tear and saliva glands. People with primary disease are more likely to have certain antibodies circulating in their blood than people with secondary disease. These antibodies are called SS-A and SS-B. People with primary Sjögren's are more likely to have antinuclear antibodies (ANAs) in their blood. In secondary Sjögren's syndrome, the person had an autoimmune disease like rheumatoid arthritis or lupus before Sjögren's developed
Antiphospholipid antibodies were first discovered in people who have lupus, but it is not necessary to have lupus to have these antibodies. In fact, in most studies, over 50% of people with these antibodies do not have lupus.
To answer your question: You may have an overlap of several autoimmune problems without having Lupus.
Yolanda Farhey, MD
College of Medicine
University of Cincinnati