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Bone Fractures in lupus and other immune diseases

Short post departmemt. I just watched several videos on YouTube (where we all go for health informatIon!!) NOT 😐  The videos I found were more than interesting; both were of interviews with physicians at the meeting of the ACR (American College of Rheumatology) attended by some 15000 members.

One physician spoke of bone fractures and lupus. Were you aware that people with lupus are at an 8 times greater risk for sufferring from bone fractures? That the risk of lupus with kidney disease is more than 10 times? I sure wasn’t; the video:

Then, another physician sampled some 3000 individuals taking plaquenil (hydroxycholorquine). All lupies know of the connection between peripheral field blindness and Plaquenil and the need to have visual field studies every 6 months. Right? Read on! Of 3,000 lupus patients taking plaquenil, 0 suffered from visual field problems which lead to blindness. The blindness resulted was due to other conditions, possibly diabetes or macular degeneration.

 

 

 

 

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Immune-Suppression

Virus in blood – Scanning Electron Microscopy stylised

Finally, the combination of methotrexate, prednisone and Plaquenil™ had been titrated for my Rheumatoid Arthritis and worked ‘like a charm.’ But, after about 8 consecutive months on this ‘cocktail,’ I developed pneumonia. Strange thing; I had also been on these same meds a year ago, when another type of pneumonia was diagnosed.

In both peumonias, the ‘culprit’ was determined to be methotrexate. Methotrexate causes pneumonia? Not directly but when the immune system is suppressed by methotrexate, the body is susceptible to other germs. Not only is this true of methotrexate, but of prednisone, Humira™, Rituxan™ and other medications used in the treatment of autoimmune diseases. This supression of the immune system: immune-suppression.

These meds really stop inflammation, but at an expense. That expense? They can leave your immune system unable to mount a defense against foreign invaders. That’s why you see this admonishment in advertisements for the above meds: “make sure that you tell your doctor about any infections you have and avoid going to large public places.” My solution: have an intimate dinner at home and invite a few friends-who don’t have colds! Continue reading

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Steroids-“when they’re good, they’re very, very good; but when they’re bad, they’re horrid”

 

I used to be skinny, so skinny, that jokes followed me around. Yep, people said, “she’s like a McDonald’s hamburger; so skinny, she only has one side;” that sort of thing. Then I was diagnosed with lupus and all that changed Why?

Meds commonly used for autoimmune symptoms are often non-steroidal anti-inflammatories drugs or NSAIDs. While they don’t pack on the pounds, if symptoms worsen and other meds which include  prednisone, Decadron™ or Solu-Medrol™ are used, watch the scales for weight gain which can increase the problems one has with ‘carting around’ extra weight.

It is known that steroids cause fluid retention and an increased appetite; both of which will increase weight rapidly. All of a sudden eating that second piece of pie is completely normal behavior! Another way is theorized: interference with fat metabolism and a redistribution of body fat.

But, steroid medications do have a good effect, one so good that having the moon face and other side effects of steroids is sometimes worth the side effects. Steroids are so good at relieving the inflammation which causes the discomfort and some of the life-threatening side effects from autoimmune disease (for example, the joint pain from RA) or the inflammation of the lung lining: pleurisy. Without them there would be more pain and aches.

Steroids also play a huge role in the treatment of asthma. The asthmatic would also have to make the choice to suffer the side effects of steroids or to breathe. Kind of an untenable choice, don’t you think? But there is an increased risk of osteoporosis due to their effects on the bones. 

Also, because there is redistributing of fat, you don’t have to take steroids for autoimmunity. Ashley Judd took high dose of steroids for a sinus infection and as beautiful as she is, you can see the impact of steroids on her face.

But there are ‘new kids on the block’ which don’t have the risk/side effects of steroids; Rituxan™, methotrexate™, Benlysta™ and a host of others.

 

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Autoimmunity took my teeth and mouth hostage!

 

How Autoimmune Disease Impacts Oral Health

Did you know that people who suffer from immune diseases have an increased risk of developing oral health conditions and gum diseases? Numbered below are common immune diseases and how oral health is impacted by them:

  1. LUPUS ERYTHEMATOSUS

The inflammation caused by lupus affects the mouth and tongue. This inflammation, can cause sores on the lips, palate and inside the cheeks. In extreme cases patients may also experience burning of the mouth and lack of saliva. Since saliva normally washes away food, sugars and bacteria, a lack of it can result in dry mouth and an increase in dental caries. Dry mouth increases the risk of decay and yeast/fungal infections of the mouth. Tooth decay can incrase the need for fillings, the need to extract teeth, dentures to replace missing teeth or ineffective chewing which can result in stomach and digestive problems

     2 RHEUMATOID ARTHRITIS

Rheumatoid arthritis causes inflammation of the joints, and Rheumatoid Arthritis patients can experience inflammation of the temporomandibular joint (TMJ). TMJ patients experience extreme discomfort while performing any activity using their mouths: chewing and talking, opening their mouth at the dentist, eating. They may also experience facial pain, headaches, earaches, locking of the jaw, worn teeth and ringing in the ears. In a few cases, TMJ is caused by misalignment of joint and often expensive orthodontic treatment is needed to lessen or prevent the symptoms.

People suffering from Rheumatoid Arthritis can also have SjĂśgren’s Syndrome, an autoimmune disease of the salivary and tear glands. Sjogren’s causes severe dryness of the mouth; thus creating problems with chewing and swallowing  and dryness. Because of this dryness there can result in heavy plaque deposits on the teeth. This in turn increases the chances of tooth decay and periodontal gum disease. Because of oral dryness and food not being completely digested when it leaves the mouth and difficulty swallowing,Sjogren’s patients also experience pneumonia because they choked on food. .

     3.SCLEORDERMA (Progressive Systemic Sclerosis)

Scleroderma is known for it’s hardening of the skin; often the lips and tongue are involved. As the effects of this increases, the mouth becomes narrower and the lips and tongue grow more rigid. A tightened mouth makes it difficult to open or move the jaw, thus causing difficulties cleaning the mouth. This increases the risk of developing tooth and gum infections, including periodontal disease or tooth caries.

     4.THYMIC HYPOPLASIA 

Thymic hypoplasia, (DiGeorge’s syndrome) causes abnormal growth of the thymus and parathyroid glands, leading to a white blood cell deficiency. Therefore, people with thymic hypoplasia are prone to viral and fungal infections, especially in the mouth. Oral Candidiasis, thrush, and herpes are some of most common fungal infections that affect those suffering from Thymic hypoplasia. In extreme cases, Thymic Hypoplasia affects the mouth and jaw, resulting in improper development of the palate resulting often in a cleft palate, a split uvula, a receding chin, or a shorter-than-normal distance between the nose and the upper lip.

     5 DERMATOMYOSITIS

Dermatomyositis is an inflammatory muscle disease that causes unusual skin rashes. It affects women more than men and can affect people at any age. Muscle weakness in the head and neck are the more common signs of dermatomyositis. This is especially concerning as it can also lead to difficulty in swallowing and chewing, and those suffering from Dermatomyositis may have hard bumps inside their face and tongue.

As you can see, each of the above mentioned diseases can have adverse impacts on the health of your mouth. Since the condition of your mouth directly impacts the functioning of your mouth and digestive system, the above mentioned diseases can drastically affect your overall health. If you have been diagnosed with any of the diseases mentioned above,  I can’t stress enough the necessity of meeting with your dentist, explain the concerns you have about your mouth and find out what you need to do to avoid the chances of complications due to oral dryness.

 

Author Bio:

Emily found the perfect fit for herself as the Online Marketing Manager at Thurman Orthodontics in Fresno CA. She believes that a great smile does more than just make a person look great – it makes them feel great as well. The power of a smile has always been a mystery to Emily that she solves by researching and writing about. She loves to write about everything to do with a healthy bite and a beautiful smile – whether is it ways to achieve it or the importance of it in the various aspects of life. What brings a big smile on Emily’s face is her family and surfing. She also likes to bake and her children and co-workers call her the cookie fairy!

 

 

 

 

 

 

 

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Lupus Clinical Trial

This study is testing a ‘monoclonal antibody’ that may help to control the symptoms of SLE including the skin manifestations of lupus. A what? A monoclonal antibody! What’s that?

Monoclonal Antibodies (mAb) are heard of more often and have more uses, these days. But what are they? Remember, that antibodies are cells in the immune system which fight off invading organisms. Monoclonal antibodies are antibodies made by combining B lymphocytes with cancer-causing cells to the same end: to fight off invadng organisms. These cells are usually used to produce antibodies against the cancerous cells. Monoclonal antibodies are used instead of chemotherapy in patients with a form of bone cancer.

It was discovered that mAbs had uses in autoimmune diseases, like lupus, plaque psoriasis, rheumtoid arthritis to name a few. These are a few of the more common mAbs: Humira™, is a mAb, used for plaque psoriasis and Rheumatoid Arthritis. Rituxan™ is an mAb often used for lupus. Benlysta™ is an mAb often used for the treatment of SLE also. In fact, Benlysta™ was the first medication approved by the FDA for lupus treatment.

Unlike chemotherapy, which targets-well everthing, mAb’s targets specific structures (bacteria, viruses, cancer cells, etc-therefore there are fewer side effects to therapy with mAbs. Fewer side effects, more targeted medication, FDA-approved; what’s not to like?

Click here to be directed to the questionairre to see if you qualify for the clinical trial!

 

 

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The bleeding won’t stop!

Idiopathic Thrombocytic Purpura. Say what? Forget that it’s difficult to pronounce; what the heck does it mean? You’ve heard of red cells and white cells in the blood. There is another kind of cell; that cell is the platelet.

Technically speaking, platelets aren’t cells because they lack DNA. (To be considered ‘real’ cells, ‘cells’ need a nucleus with DNA). Platelets lack DNA, so technically they are not cells). But they, platelets (thrombocytes) cause the blood to clot.

People who have lupus can have low numbers of platelets for several reasons. In lupus and in all autoimmune diseases, cells of the immune system attack other cells. When platelets are attacked and killed, their numbers are decreased resulting in thrombocytopenia (low platelets in the blood); blood may or may not clot. That is one of the many reasons they check your platelet count before surgery. Can you see the headlines now? ‘The operation was a success, but the patient bled to death!’ It has happened.

Another reason that people with lupus might have low platelets is APS or antiphospholipid syndrome; another clotting disorder, often caused by lupus which increases the likelihood of blood-clotting. How could this be so? An increased likelihood of clotting at the same time there is a decreased likelihood? Platelets are so busy causing blood to clot in in all parts of the body, that in some areas, there are not adequate numbers of them to cause blood to clot. So much for the thrombocyte (thrombocytic) part. So much for the thrombocytic part and on to the idiopathic part!

‘Idiopathic’ simply means docs don’t know what causes something to happen. 

Purpura is a simple reference to what can happen when blood fails to clot. Blood may pool close to the skin surface, eventually clot and there is a resulting purplish discoloration; purpura or in it’s very technical term: bruising!

There you have it, ITP or Idiopathic Thrombocytic Purpura, sometimes not hazardous, but it can be serious and depending upon the severity, ITP may or may not be treated,. If it is treated, Plaquenil,™ steroids, Benlysta,™ CellCept™ or mycophenolate are among many meds of choice Other treatments can be Rituxan™ or in more severe cases, the surgical removal of the spleen (splenectomy). New treatments are in clinical trials, now.

 

 

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Join me in a lupus clinical trial

There is a lupus clinical trial that is recruiting applicants now. We all know that lupus is a chronic inflammatory disease that occurs when your body’s immune system attacks your own tissues and organs. Inflammation caused by lupus can affect many different body systems — including your joints, skin, kidneys, blood cells, brain, heart and lungs.

Many people think of the inconvenient and bothersome side effects of lupus. Like sore joints and dry mouth. No, lupus affects the skin in many ways, too (makes it tighten and sometimes causes the formation of painful sores). Internally, it can wreak havoc on the heart, lungs as said before, causing inflammation; yes, lupus can and does KILL.

Approximately two-thirds of people with lupus will observe some type of effect on their skin. In fact, 40-70 percent of people with lupus will find that their disease is made worse by exposure to ultraviolet (UV) rays from sunlight or artificial light. This study will take place in 30 areas of the US and will involve the use of  monoclonal  antibody to treat lupus.

As always, information here is not intended to take the place of the materials given to you by the clinical trial, but I know of the safety and efficacy of these trials.

 

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