By David H. Freedman: For More Info, Go Here…
Even specialists often struggle to make sense of the puzzling symptoms that come with these slow-moving disorders.
The patient came to her doctor with a low-grade fever, some achiness and fatigue, and a touch of diarrhea. The doctor told her it was probably a mild case of the flu. But weeks later the symptoms hadn’t gone away. The doctor ran some lab tests, but the results didn’t clearly indicate any problems, and he insisted there didn’t seem to be anything physically wrong with her. Still feeling off, she eventually saw other doctors. Yet over years of continuing and even slowly worsening symptoms, none of these doctors were able to tell her what was wrong. Finally, 15 years after she first felt ill, a specialist gave her the diagnosis: She had lupus erythematosus, the most common form of lupus — an autoimmune disease, where the immune system drives the disease instead of protecting against it.
If only that story were unusual. While 1.5 million Americans have been diagnosed with lupus erythematosus, experts believe the number of undiagnosed cases is higher. And lupus is just one of more than 100 autoimmune diseases affecting nearly 25 million Americans, diseases that together present a challenging and often frustrating path to diagnosis for doctors and patients alike. “These patients often get sent on a long journey before they get an answer,” says Robert Lahita, M.D., the chairman of medicine at St. Joseph’s Healthcare in Wayne, N.J., and the autoimmune specialist who finally diagnosed that lupus patient. “Some physicians will tell them it’s all in their head. It’s not, and they can be miserable for years until they get diagnosed.”
Among the typical symptoms in these earlier, less-acute stages are fatigue, aches, rashes, swelling, difficulty concentrating, and slight fevers. That’s not much help to doctors in narrowing things down, because any autoimmune disease — and indeed, a wide range of other common conditions — can cause any or all of these symptoms. But there are exacerbating factors that should cause doctors to want to consider an autoimmune disorder as a possible culprit. “If the symptoms persist for many weeks, if the appetite goes, if rather than just feeling tired you feel sick, and if there are no apparent other reasons for all this, then it’s time to wonder if something is going on,” says David Pisetsky, M.D., an immunologist at Duke University.