Diagnosis of autoimmune urticaria

The autologous serum skin test is used as a screening test for chronic autoimmune urticaria and has a sensitivity and specificity of about 70 and 80%, respectively. The current gold standard diagnostic test is the basophil histamine release assay. NCBI
Autoimmune urticaria (AIU) cannot be diagnosed by this test alone. A study has been done showing "A simple, combined test can improve the diagnosis of autoimmune urticaria."

Researchers from Hungary’s University of Debrecen have shown a more effective testing procedure for diagnosing AIU. The combination of tests have increased the sensitivity and specificity to 98% and 86%. 

The researchers found that ASST positivity, the occurrence of symptoms at night, angioedema, incidence of more than five symptomatic days per week, and anti-thyroid antibody positivity were more frequent in the AIU group versus patients with chronic spontaneous non-AIU. These parameters were defined as specific to AIU. MD Magazine

urticaria on back
Urticaria is another name for hives which are raised red marks on the skin that can occur anywhere on the body. Chronic urticaria is when the hives have been there for 6 weeks or more. This is called chronic idiopathic urticaria, which means there is no known cause. Many people with chronic idiopathic urticaria are thought to have autoimmune urticaria (AIU) where antibodies exist. 

A strong connection has been found between AIU and the existence of other autoimmune diseases, such as rheumatoid arthritis, Sjögren's syndrome, Lupus (SLE) and celiac disease. 


Fatigue in Sjogren's Syndrome

Fatigue and Sjogren's Syndrome

A U.K. study found that factors that associated with high levels of fatigue among patients with Sjogren's syndrome included pain, depression, and - unexpectedly - low levels of two proinflammatory cytokines. Proinflammatory cytokines are cytokines that promote systemic inflammation.

"This suggests that measures of disease activity in primary Sjogren's syndrome appear to be less important than cytokines, depression, and pain in accurately predicting fatigue levels," the researchers observed.

Conclusions: Cytokines, pain and depression appear to be the most powerful predictors of fatigue in Sjogren's Syndrome.  The research data challenged the idea that proinflammatory cytokines directly cause fatigue in chronic immune conditions. "Instead, we hypothesise that mechanisms regulating inflammatory responses may be important."  

Fatigue in primary Sjogren's syndrome is associated with lower levels of proinflammatory cytokines. Published in BMJ Journals in 19 July 2016


What to eat when your body attacks itself: immune diet

immune diet

Many people have found improvement in their autoimmune symptoms when changing their diet. If you are interested in diet and it's role in helping improve a damaged immune system, i.e. one with an autoimmune condition, you may be interested in these ideas: 
Get off gluten grains: wheat, barley, rye. And don’t go for so-called “gluten-free” breads, as they generally contain soy or corn products or members of the nightshade family, especially potatoes, that can also damage the lining of your intestinal tract.
Get off all cow dairy products.
If you stop insulting your gut tract, it will probably recover to some extent.
In addition to the things you should avoid, there are foods to improve the health of your intestinal wall. While not a complete list, these include:
A probiotic supplement.
Fresh fruits and vegetables, especially green and leafy ones.
Healing supplements like L-glutamine; omega-3 fatty acids; vitamins A, C and E; and turmeric.
From an article by Bob Keller, a holistic practitioner, Making Sense of Medicine

READ A BOOK ABOUT AUTOIMMUNE DIET: The Autoimmune Diet: Feel the freedom and energy of using whole food to manage autoimmune disease symptoms

Gigi Hadid talks about her autoimmune condition

Supermodel Gigi Hadid has just revealed she has an autoimmune disease that causes her weight to fluctuate - Hashimoto's Thyroiditis.
"My metabolism actually changed like crazy this year. I have Hashimoto's disease. It's a thyroid disease, and it's now been two years since taking the medication for it, so for the VS show I didn't want to lose any more weight, I just want to have muscles in the right place, and if my butt can get a little perkier, then that's good." she told Elle magazine.
Gigi Hadid, age 21, is one of the most famous supermodels in the world right now participating in the Victoria Secret runway for a second time this year. But despite millions of headlines and her Instagram account there is still a lot we don't know about the Reebok #PerfectNever campaign spokesperson. Today we learned a little about her autoimmune condition.
Her sister, model Bella Hadid, her brother Anwar and her mother Yolande all suffer from Lyme disease. 

FIND OUT MORE: Hypothyroidism and Hashimoto's




Morphine paradoxically prolongs neuropathic pain in rats

morphine and pain

Pain after disease/damage of the nervous system is predominantly treated with opioids, but without exploration of the long-term consequences. We demonstrate that a short course of morphine after nerve injury doubles the duration of neuropathic pain.

A University of Colorado Boulder study led by Professor Peter Grace showed that just a few days of morphine treatment caused chronic pain. This pain continued for several months doe to the release of pain signals from specific immune cells in the spinal cord. The results suggest that the recent escalation of opioid prescriptions in humans may be a contributor to chronic pain.

Read more PNAS
Proceedings of the National Academy of Sciences of the United States of America


Allergies and Multiple Sclerosis

Food allergies associated with MS

Allergies Are Associated with Increased Disease Activity in Multiple Sclerosis 

This study found that patients with Multiple Sclerosis (MS) who have food allergies have a more active disease than those without allergies. There suggestions were for exploration of the allergy-associated immune mechanisms that modulates the MS disease course. 

Patients enrolled in the Comprehensive Longitudinal Investigation of Multiple Sclerosis at the Brigham and Women’s Hospital (CLIMB) study completed a self-administered questionnaire on environmental, drug and food allergies.

  • Tanuja Chitnis. 

  • Published: Neurologyvol. 86 no. 16 Supplement P2.187

    FirstWord Pharma

    Related articles: Hayfever Hope


    Autoimmune colors

    Autoimmune ribbon colors

    The use of different colors and different colored ribbons, was created to bring awareness to different issues including health and disease conditions.  The colors bring awareness, education, understanding and support for people affected by these disorders and wearing your colors helps bring awareness to that specific condition. Keep in mind though that some colors are used by more than one advocacy group for example purple is for Migraine awareness, Crohn's Disease and Colitis awareness, Cancer survivors, Sarcoidosis awareness, Fibromyalgia, Lupus and Peripheral Neuropathy to name just a few.

    The history of the coloured ribbons seem to stem back to the early 1980's when yellow became the color for safe return from war.  Because of the then popular song titled, “Tie a Yellow Ribbon ‘Round the Ole Oak Tree” Penny Laingen tied yellow ribbons around trees near her home to show her support for her husband and his safe return from Iran. In 1986 rainbow colored ribbons were used at the London AIDS Faith Alliance conference.  In 1991 the pink ribbon became the official symbol for National Breast Cancer Awareness Month. The popularity of these ribbons inspired many other organizations to use a colored ribbon to symbolize and represent their cause.

    Here I have tried to list the Autoimmune conditions in alphabetical order and their colors,  If you would like to make any corrections or additions please leave a comment here on this post. Go to the list of colors.

    Autoimmune colors for awaeness


    Acute Disseminated Encephalomyelitis (ADEM)

     Disease in focus: 

    Acute Disseminated Encephalomyelitis (ADEM) or acute demyelinating encephalomyelitis is thought to be an autoimmune disorder in which the body’s immune system attacks its own brain tissue. It damages the myelin – the protective covering of nerve fibers - of the brain and the spinal cord and sometimes the optic nerve.

    An illustration of a myelin map in the human brain
    from a paper by HCP researchers Matt Glasser and David Van Essen,
    published by the Journal of Neuroscience

    ADEM is more common in children than it is in adults. More than 80 percent of childhood cases occur in patients younger than 10 years old. Most of the remaining cases occur between the ages of 10 and 20. In more than 50% percent of ADEM cases, the inflammatory attack is preceded by a viral or bacterial infection.  Most cases begin about 7 to 14 days after an infection or following a vaccination. In some cases of ADEM, no preceding event is identified. 

    Symptoms of ADEM include fever, headache, confusion, altered level of consciousness ranging from lethargy to coma, acute cognitive dysfunction, behavioral changes, vomiting and seizures in about a third of those diagnosed. Neurologic signs of ADEM include decreased voluntary movement, muscle weakness on one side of the body, decreased muscle coordination and damage of cranial nerves.

    The diagnosis of ADEM is considered when there is an infection and the development of more than one neurological symptom, accompanied by headache, fever, and an altered mental state.
    Magnetic resonance imaging (MRI) is an important part of the diagnosis. In ADEM, there are usually widespread, multiple changes in the white matter of the brain which contains the nerve fibers. Over months these brain changes gradually improve and even completely disappear.
    A lumbar puncture may be needed in patients with ADEM to rule out direct infections or other processes that look similar to ADEM such as Multiple Sclerosis. The spinal fluid often shows an increase in white cells, usually lymphocytes. These cells are an active part of the immune system. 
    Transverse Myelitis Association 

    Cleveland Clinic Acute disseminated encephalomyelitis (ADEM)
    Medscape Acute Disseminated Encephalomyelitis Author: J Nicholas Brenton, MD; Chief Editor: Tarakad S Ramachandran, MBBS, FRCP, FRCPC 

    NINDS Acute Disseminated Encephalomyelitis Information Page. 2010 

    PubMed Article: Acute disseminated encephalomyelitis (ADEM)

    National MS Society: Acute Disseminated Encephalomyelitis (ADEM)


    Disease in focus: Juvenile Arthritis

    Juvenile Arthritis

    This article will explain the different types of Juvenile Arthritis and give some practical tips to Help a Child Live Well With Juvenile Arthritis. If you scroll down to the end you will find links to forums and other links relating to Juvenile Arthritis.

    What Is Juvenile Idiopathic Arthritis?

    Juvenile idiopathic arthritis is currently the most widely accepted term to describe various types of chronic arthritis in children.
    In general, the symptoms of juvenile idiopathic arthritis include joint pain, swelling, tenderness, warmth, and stiffness that last for more than 6 continuous weeks. It is divided into seven separate subtypes, each with characteristic symptoms:
    1. Systemic arthritis (formerly known as systemic juvenile rheumatoid arthritis). A patient has arthritis with, or that was preceded by, a fever that has lasted for at least 2 weeks. It must be documented as an intermittent fever, spiking for at least 3 days, and it must be accompanied by at least one or more of the following:
      • Generalized enlargement of the lymph nodes.
      • Enlargement of the liver or spleen.
      • Inflammation of the lining of the heart or the lungs (pericarditis or pleuritis).
      • The characteristic rheumatoid rash, which is flat, pale, pink, and generally not itchy. The individual spots of the rash are usually the size of a quarter or smaller. They are present for a few minutes to a few hours, and then disappear without any changes in the skin. The rash may move from one part of the body to another.
    2. Oligoarthritis (formerly known as pauciarticular juvenile rheumatoid arthritis). A patient has arthritis affecting one to four joints during the first 6 months of disease. Two subcategories are recognized:
      • Persistent oligoarthritis, which means the child never has more than four joints involved throughout the disease course.
      • Extended oligoarthritis, which means that more than four joints are involved after the first 6 months of the disease.
    3. Polyarthritis—rheumatoid factor negative (formerly known as polyarticular juvenile rheumatoid arthritis—rheumatoid factor negative). A patient has arthritis in five or more joints during the first 6 months of disease, and all tests for rheumatoid factor (proteins produced by the immune system that can attack healthy tissue, which are commonly found in rheumatoid arthritis and juvenile arthritis) are negative.
    4. Polyarthritis—rheumatoid factor positive (formerly known as polyarticular rheumatoid arthritis—rheumatoid factor positive). A patient has arthritis in five or more joints during the first 6 months of the disease. Also, at least two tests for rheumatoid factor, at least 3 months apart, are positive.
    5. Psoriatic arthritis. Patients have both arthritis and psoriasis (a skin disease), or they have arthritis and at least two of the following:
      • inflammation and swelling of an entire finger or toe (this is called dactylitis)
      • nail pitting or splitting
      • a first-degree relative with psoriasis.
    6. Enthesitis-related arthritis. The enthesis is the point at which a ligament, tendon, or joint capsule attaches to the bone. If this point becomes inflamed, it can be tender, swollen, and painful with use. The most common locations are around the knee and at the Achilles tendon on the back of the ankle. Patients are diagnosed with this juvenile idiopathic arthritis subtype if they have both arthritis and inflammation of an enthesitis site, or if they have either arthritis or enthesitis with at least two of the following:
      • inflammation of the sacroiliac joints (at the bottom of the back) or pain and stiffness in the lumbosacral area (in the lower back)
      • a positive blood test for the human leukocyte antigen (HLA) B27 gene
      • onset of arthritis in males after age 6 years
      • a first-degree relative diagnosed with ankylosing spondylitis, enthesitis-related arthritis, or inflammation of the sacroiliac joint in association with inflammatory bowel disease or acute inflammation of the eye.
    7. Undifferentiated arthritis. A child is said to have this subtype of juvenile idiopathic arthritis if the arthritis manifestations do not fulfill the criteria for one of the other six categories or if they fulfill the criteria for more than one category.

    How Can the Family Help a Child Live Well With Juvenile Arthritis?

    Juvenile arthritis affects the entire family, all of whom must cope with the special challenges of this disease. Juvenile arthritis can strain a child’s participation in social and after-school activities and make schoolwork more difficult. Family members can do several things to help the child physically and emotionally.
    • Get the best care possible. Ensure that the child receives appropriate medical care and follows the doctor’s instructions. If possible, have a pediatric rheumatologist manage your child’s care. If such a specialist is not close by, consider having your child see one yearly or twice a year. A pediatric rheumatologist can devise a treatment plan and consult with your child’s doctor, who will help you carry it out and monitor your child’s progress.
    • Learn as much as you can about your child’s disease and its treatment. (The resources listed at the end of this publication can help.) Many treatment options are available, and because juvenile arthritis is different in each child, what works for one may not work for another. If the medications that the doctor prescribes do not relieve symptoms or if they cause unpleasant side effects, you and your child should discuss other choices with the doctor. A person with juvenile arthritis can be more active when symptoms are controlled.
    • Consider joining a support group. Try to find other parents and kids who face similar experiences. It can help you—and your child—to know you’re not alone. Some organizations have support groups for people with juvenile arthritis and their families.
    • Treat the child as normally as possible. Try not to cut your child too much slack just because he or she has arthritis. Too much coddling can keep your child from being responsible and independent and can cause resentment in siblings.
    • Encourage exercise and physical therapy for the child. For many young people, exercise and physical therapy play important roles in managing juvenile arthritis. Parents can arrange for children to participate in activities that the doctor recommends. During symptom-free periods, many doctors suggest playing team sports or doing other activities. The goal is to help keep the joints strong and flexible, to provide play time with other children, and to encourage appropriate social development.
    • Work closely with your child’s school. Help your child’s school to develop a suitable lesson plan, and educate your child’s teacher and classmates about juvenile arthritis. Some children with juvenile arthritis may be absent from school for prolonged periods and need to have the teacher send assignments home. Some minor changes—such as having an extra set of books or leaving class a few minutes early to get to the next class on time—can be a great help. With proper attention, most children progress normally through school.
    • Talk with your child. Explain that getting juvenile arthritis is nobody’s fault. Some children believe that juvenile arthritis is a punishment for something they did. Let your child know you are always available to listen, and help him or her in any way you can.
    • Work with therapists or social workers. They can help you and your child adapt more easily to the lifestyle changes juvenile arthritis may bring.

    Do These Children Have to Limit Activities?

    Although pain sometimes limits physical activity, exercise is important for reducing the symptoms of juvenile arthritis and maintaining function and range of motion of the joints. Most children with juvenile arthritis can take part fully in physical activities and selected sports when their symptoms are under control. During a disease flare, however, the doctor may advise limiting certain activities, depending on the joints involved. Once the flare is over, the child can start regular activities again.
    Swimming is particularly useful because it uses many joints and muscles without putting weight on the joints. A doctor or physical therapist can recommend exercises and activities.

    See the full publication from National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) 
    Hospitals known for treating childhood autoimmune conditions

    Arthritis Ireland: videos for different ages
    Kids Get Arthritis Too site by ARTHRITIS FOUNDATION USA 
    Juvenile Arthritis Association
    Juvenile Arthritis: Arthritis Foundation USA

    Children with Arthritis by Arthritis Foundation of Western Australia


    TREATMENTS other than medications:
    Can Manual Therapy Help Kids with Arthritis 


    Book written by a teenager with Juvenile Arthritis:Juvenile Arthritis: The Ultimate Teen Guide (It Happened to Me) 

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