Autoimmune Disorders That Affect the Blood – Autoimmune Center -Everyday Health

Autoimmune disorders can affect virtually every part of the body, and blood and blood vessels are no exception.

“These are relatively uncommon disorders,” says Alex Limanni, MD, a rheumatologist with Baylor University Medical Center in Dallas. “However, in their most severe forms, they can be life-threatening.”

Common Blood-Related Autoimmune Disorders

Here are some of the most common autoimmune disorders affecting the blood and circulatory system:

Lupus. Also known as systemic lupus erythematosus, lupus is a condition in which immune system attacks healthy tissue. “It can affect a number of different organs from top to bottom, including the brain, heart, lungs, joints, and kidneys,” Dr. Limanni says. Estimates put the number of Americans with lupus at 1.5 million.

Lupus can cause inflammation of the blood vessels, a condition known as vasculitis, which can damage the vessels. “That’s why we think many patients with lupus have a higher risk of coronary artery disease,” Limanni says.

Lupus can also affect the blood by lowering white blood cell and platelet counts. Some lupus patients develop anemia, a condition in which red blood cells are too low in number to adequately carry oxygen to the body’s tissues. Lupus patients may also have hemolytic anemia, which happens when the immune system attacks and destroys healthy red blood cells.

Medications are available for the treatment of lupus. For patients who develop vasculitis with their lupus, doctors will often prescribe Azasan or Imuran (azathioprine), which work by suppressing the immune system.

Lupus patients who develop hemolytic anemia can be treated with high doses of steroids to prevent red blood cell destruction, Limanni says. Some people with low platelet counts can also be treated with a splenectomy, a surgical procedure that removes the spleen.

Symptoms of lupus include extreme tiredness, anemia, and swollen joints. If you have these symptoms and suspect you have lupus, consult a physician.

Antiphospholipid antibody syndrome. Known as APS, this condition occurs when the body’s immune system mistakenly attacks phospholipid, a type of fat that is present in all living cells. In some cases, the attacks can cause clotting in the blood vessels and may lead to serious conditions such as stroke or heart attack. Women who have APS may also find that they have trouble carrying a pregnancy to term. About 1 to 5 percent of the general population is thought to have APS.

In many cases, the disease doesn’t cause any unwanted effects, and it’s only through routine blood tests that the APS antibodies are discovered. “Often, it’s a problem that doesn’t require therapy,” Limanni says.

People who do find that their APS is creating health problems can be treated with anticoagulants, or medicines that thin the blood. One of the most common blood thinners prescribed is Coumadin (warfarin). Women whose APS interferes with pregnancy are usually prescribed an injectable blood thinner like Lovenox (enoxaparin).

Symptoms of APS relate to blood clots and can include chest pain, shortness of breath, and pain or swelling in the limbs. If your doctor suspects that you have APS, a blood test can confirm the diagnosis.

Vasculitis. Vasculitis occurs when the immune system attacks healthy blood vessels and the inflamed vessels can then narrow or even burst. Vasculitis is considered a rare disease, affecting less than 200,000 people in the United States.

Vasculitis is most commonly categorized by the sizes of the blood vessels affected by the inflammation. Small-vessel vasculitis, for example, damages the smallest vessels in the body, like the capillaries. Symptoms of small-vessel vasculitis range from mild to severe. “It can be anything from a fairly limited disease that causes purpura, or purple lesions in the skin, to a condition that causes abdominal bleeding and pulmonary hemorrhage,” Limanni says.

Medium- and large-vessel vasculitis are less common, but more dangerous. “They will frequently involve blood vessels that supply the heart, lungs, kidneys, brain, and liver, so they can lead to stroke, heart attack, and renal failure.” says Limanni.

Mild forms of vasculitis can be treated with antimalarials like Plaquenil (hydroxychloroquine), immunosuppresssants like Azasan or Imuran, or steroids like prednisone. Medium- and large-blood-vessel vasculitis may call for more aggressive therapy. According to Limanni, “Treatment is going to consist of steroids and a chemotherapy-type immunosuppressant, like cyclophosphamide (Cytoxan, Neosar).”

Symptoms of vasculitis include fever, weight loss, and aches and pains. If vasculitis is affecting your skin, you may notice purple or red spots. If it affects your lungs, you may feel shortness of breath. To make a definitive diagnosis of vasculitis, your doctor can perform a biopsy to check for damage to the blood vessels, or a blood test to check for certain substances in the blood. Levels of antineutrophil cytoplasmic antibodies, or ANCA, are often elevated in people with vasculitis, for example.

Autoimmune hemolytic anemia. Known as AIHA, this condition occurs when the immune system creates antibodies that destroy red blood cells. Because red blood cells carry oxygen to the body’s tissues, AIHA can result in a reduced amount of oxygen in the body. It can also make the heart work harder to move blood through the body, potentially causing heart problems. At least 1 in 80,000 people are thought to develop AIHA each year.

Very mild forms of AIHA often don’t require treatment. But if medications are requuire, people are often treated with steroids like prednisone or drugs like Myfortic or CellCept (mycophenolate), which work by suppressing the immune system.

Signs of AIHA are often the same as the symptoms of other types of anemia, and may include fatigue, dizziness, and jaundice (a yellowing of the skin or whites of the eyes). One way to diagnose AIHA is by examining a small amount of your blood under a microscope — a procedure known as a peripheral smear. “They’ll look at the red blood cells and see whether there is evidence of destruction,” Limanni says.

If you notice the symptoms of any of these blood and blood vessel autoimmune disorders, contact your doctor. All of these conditions are treatable — and the sooner you know what is causing your symptoms, the sooner that treatment can begin.

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