Summary

Autoimmune diseases -- including chronic fatigue syndrome, vasculitis, juvenile diabetes, alopecia, Graves' disease, Sjogren's syndrome, lupus, rheumatoid arthritis, and multiple sclerosis -- are among the hottest topics in the medical community. Although these diseases express themselves in different ways, in all of them, the body's immune system begins to attack normally functioning, healthy cells. Despite the recent surge in interest and research, these fascinating diseases are highly mysterious, frequently misdiagnosed, and controversial in cause and treatment. They are often interconnected in ways that are both misunderstood and life-threatening. And one of the biggest puzzles is why 80 percent of autoimmune disease sufferers are women.

Author Biography

Robert G. Lahita, M.D., Ph.D., is a professor of medicine at the Mount Sinai Medical School and chairman of medicine and vice president of the Jersey City Medical Center

INTRODUCTION

PART ONE: WHAT IS AN AUTOIMMUNE DISEASE?

ONE THE IMMUNE SYSTEM:

(15)

First Line of Defense

TWO AUTOIMMUNE DISEASES

(19)

PART TWO: THE AUTOIMMUNE DISEASES

THREE THE ANTIPHOSPHOLIPID SYNDROME:

(14)

Sticky Blood

FOUR IDIOPATHIC THROMBOCYTOPENIC PURPURA:

(10)

Murder in the Village: The Case of the Homicidal Antibody

FIVE TYPE 1 JUVENILE DIABETES:

(13)

When Sweetness Falls from Grace

SIX MULTIPLE SCLEROSIS:

(14)

Electricity without Insulation

SEVEN PANDAS:

(9)

The Jekyll and Hyde Syndrome

EIGHT STREPTOCOCCAL INFECTION AND RHEUMATIC FEVER:

(8)

A Bacterial Mime

NINE VASCULITIS:

105

(11)

Destroyed Pipes

TEN SYSTEMIC LUPUS ERYTHEMATOSUS:

116

(16)

The Red Wolf

ELEVEN ALOPECIA UNIVERSALIS:

132

(11)

Bald All Over

TWELVE SJOGREN'S SYNDROME:

143

(12)

Dry as a Desert

THIRTEEN AUTOIMMUNE THYROID DISEASE:

155

(6)

Disabling the Body's Nuclear Reactor

FOURTEEN AUTOIMMUNE DISEASE OF THE LIVER:

161

(7)

Lucky Woman Thrown by a Horse

FIFTEEN SCLERODERMA:

168

(14)

The Woman with Thick Skin

SIXTEEN POLYMYOSITIS AND DERMATOMYOSITIS:

182

(8)

Ragged Fibers

SEVENTEEN RHEUMATOID ARTHRITIS:

190

(13)

Like Swimming through a Bowl of Jell-O

EIGHTEEN FIBROMYALGIA, CHRONIC FATIGUE SYNDROME, AND SILICONE IMPLANT SYNDROME:

203

(12)

The Mystery Diseases

PART THREE: TREATMENTS

NINETEEN DRUGS AND OTHER THERAPIES:

215

(21)

Harnessing the Immune System

TWENTY ALTERNATIVE AND COMPLEMENTARY THERAPIES:

236

(21)

From Acupuncture to Zinc

GLOSSARY

257

(10)

Supplemental Materials

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Excerpts

Women and Autoimmune Disease
The Mysterious Ways Your Body Betrays Itself

Chapter One

Part One: What Is an Autoimmune Disease?

For most of us who go about the everyday tasks of work,shopping, or life in general, the immune system does notseem particularly remarkable. Why would it be? Fewmovies of the week have been made about it. There are no weekendtelethons on its behalf. It does not have a star such as Britney Spearsanxious to attach her name to it, nor does Katie Couric remind us tohave it checked every year, or two, or five.

No, it is just there, doing its job of protecting us from the, oh, say5 or 6 billion molecules of viruses, bacteria, parasites, pollutants, andgerms to which we open our doors—not to mention our mouths—every single day of our lives. When things are going smoothly, we areall a bit guilty of a laissez-faire attitude about the immune system. Ah,but let something go awry and watch out! Now it has our attention.

And well it should.

We cannot live, at least not very well, without our immune systems.The immune system is the body's natural defense mechanism againstthe attackers I have cited above—as well as many as-yet-unknown microbes that would love nothing more than to climb inside and setup shop all over our bodies. To get a good sense of the might of thissilent but hardworking system, consider what happens to somethingliving once it dies: Within minutes, everything shuts down; withinhours the process of decomposition sets in, and long before sunset,the body is completely taken over by all sorts of unwelcome visitors. Ineed not go further. You get the picture.

If you are in any way concerned about autoimmune disease—and Isuspect you are if you're reading this book—it is essential that youunderstand the basic workings of the healthy immune system. Thischapter explains it, but be forewarned; in large part, it will be a vocabularylesson. Many of the terms I use here are repeated throughoutthe book, so it is helpful to understand them from the first. I dopromise this, however: To the extent that it is possible to illustratethings clearly otherwise, I will not burden you with so much as an extraneousmicrobe.

Central to the workings of the immune system is its ability to distinguishbetween what is “us” and what is “not us,” hereafter known asself and nonself. Every cell in the body carries distinctive moleculesthat distinguish it as “self.” When foreign—“nonself”—moleculesenter the body, if they trigger an immune reaction, they are known asantigens (against self).

Antigens can come from outside the body or may actually exist aspart of the body itself. An external antigen could be a bacterium, avirus, or a parasite, for example. Tissues or cells from other humans,such as those introduced during a heart or lung transplant, also arerecognized as antigens, which is why, without strong drugs to suppressthe immune system, the body rejects transplanted organs. Assoon as the immune system recognizes an antigen in the bloodstream,it responds by producing antibodies, which are molecules designed tocounteract the antigen and render it impotent. The process of creatingan antibody upon recognition of an antigen is known as an immuneresponse.

For an example of an internal antigen, there are times when the im-mune system suddenly turns on the hair follicles, mistakenly recognizingthem as foreign and makes antibodies against them. This constitutesan autoimmune response that can result in an autoimmunedisease called alopecia areata universalis, or complete loss of hair.The hair follicle itself has become the antigen and is now called anautoantigen. Why cells in the body that heretofore coexisted in peacesuddenly become the enemy, no one knows.

The organs that comprise the immune system include the bone marrow,the lymph nodes, the thymus, and the spleen. These organs areconnected to each other and to other organs of the body by way ofthe lymphatic vessels, a network that courses throughout the body ina manner similar to the blood vessels.

The bone marrow serves as the factory that produces, amongother things, the white blood cell (also known as leukocytes) a collectionof different kinds of cells, such as polymorphonuclear leukocytes(phagocytes), monocytes, and lymphocytes. They are consideredthe backbone of the immune system, and many of them are describedbelow.

The lymph nodes are small bean-shaped structures that contain filtertissue and work as the clearinghouse for germs and foreign invaders.They are the place where the immune cells face off withantigens. Using a police force as an analogy for the immune system,you might consider the lymph nodes as police precincts that arestrategically placed in various parts of the body where the immunesystem has to be on high alert—for example, the tonsils, the ears, themouth, the genitals, or any area where there might be an invasion ofa foreign substance or a foreign germ. When fighting a bacterial infection,for example, the nodes are the battleground for bacteria andthe immune cells that are fighting them. The result of this influx ofcells and cell activity is a swollen lymph node, which is a good predictorthat an infection exists.

The thymus, which is located in the middle of the chest under thebreastbone and below the thyroid gland, is the master programmer ofthe immune system. Interestingly, the thymus usually disappears byOrgans of the Immune System...Women and Autoimmune Disease
The Mysterious Ways Your Body Betrays Itself. Copyright © by Robert Lahita. Reprinted by permission of HarperCollins Publishers, Inc. All rights reserved. Available now wherever books are sold.

Excerpted from Women and Autoimmune Disease: The Mysterious Ways Your Body Betrays Itself by Robert G. Lahita
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