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The immune system is a defense and adaptation system of our body in relation to the external environment. It allows us to distinguish what we accept and what we do not from everything around us—foods, germs, chemical substances, our own aged or damaged cells, etc.—in order to preserve good health. All disorders caused by either an excess or a deficiency of this function are included within these diseases.
It has two fundamental components: innate immunity, which depends on the genes of our species and does not need to be trained to function, and acquired immunity, which depends on the learning process of our body through contact with infections, foods, or chemical substances. Both work together in close collaboration and in a delicate balance.
Immune System Diseases
There are immune system disorders caused by:
a) Loss of function: Primary immunodeficiencies, acquired immunodeficiencies.
b) Excess of function: Autoimmune diseases, in which the body, through an excessive exercise of its defenses, attacks itself due to the loss of a fundamental function: self-tolerance. This means that under normal conditions, a body’s own cell will never attack another of its own cells.
In the first case, immunodeficiencies are indicated by the repeated occurrence of infections, which is the key sign for detection. These can appear early in life due to a genetic alteration, in adulthood as a result of treatments for other diseases such as cancer, or can be acquired through viral infections, with HIV (human immunodeficiency virus) being one of the most significant.
In the second case, autoimmune diseases are suggested by the appearance of inflammation without apparent cause in joints, lungs, kidneys, liver, or other organs.
Symptoms primarily depend on whether they are due to a loss of function (recurrent infections) or an excess of function (inflammatory disease affecting one or more organs).
Immune diseases can affect anyone throughout their life. In general, immunodeficiencies are more common in early childhood, while autoimmune diseases usually affect young adults, more frequently women.
The body’s defense capacity is assessed in two ways:
Basal state: in the patient’s ordinary condition.
After stimulation: the immune cells are stimulated in the laboratory to evaluate their function.
For autoimmune diseases, factors present in the blood are analyzed; elevated levels may indicate abnormal activity against the body itself.
Diagnostic evaluations include:a) Study of innate immunityb) Study of acquired immunityc) Study of the functional capacity of the immune systemd) Study of factors characterizing autoimmune disease
Assessing immune competence can be done in several ways:
Detection and counting of immune cells, specifically lymphocytes.
Laboratory stimulation of lymphocytes to test their functionality.
Analysis of blood or biopsy samples for factors causing self-attack, such as autoantibodies (defense proteins with abnormal self-aggressive function).
Study of elevated cellular messengers indicating the activity of these cells against the body.
Immunodeficiency: restoration of the immune system’s functional capacity.
Autoimmunity: modulation or inhibition of the immune system’s self-aggressive capacity.
Laboratory tests to assess immune system functionality are standard. Genetic tests are also used to assist in diagnosis.
In addition to general recommendations for a healthy diet, regular exercise, and abstaining from smoking, adherence to the childhood vaccination schedule is essential. Vaccinations not only protect against specific infections but also help improve overall immune defense.
Fibromyalgia is a condition that is part of the so-called central sensitization syndromes. There is a hyperexcitation of the central nervous system with a lowered pain threshold, which causes pain to appear earlier and become more intense, longer-lasting, and more widespread.
Generalized pain is often accompanied by other symptoms, such as fatigue or sleep disturbances. It is diagnosed based on criteria that rely on symptoms and physical examination. There is no specific medical test.
Fibromyalgia is a common condition, affecting 2.4 % of the general population, and is part of the so-called central sensitization syndromes. It is mainly characterized by widespread pain. There is hyperexcitation of the central nervous system with a lowered pain threshold, causing pain to appear earlier and be more intense, longer-lasting, and more diffuse. There is an exaggerated response to painful stimuli (hyperalgesia) and pain in response to normally non-painful stimuli (allodynia). Its cause is unknown, but sometimes there are clear triggers such as physical or emotional trauma or infections.
It is a chronic condition with a fluctuating course, with periods of improvement and others of clinical worsening.
The main symptom is widespread pain, but it is often accompanied by other symptoms such as fatigue, insomnia, tingling in the limbs, headache, dizziness, memory and concentration problems, anxiety, or depression.
It usually affects middle-aged women, with a peak between 40 and 49 years, but it can affect people of all sexes and ages.
Diagnosis is based on criteria that rely on the patient’s clinical presentation, according to the presence of characteristic symptoms and signs.
There is no specific medical test.
Laboratory tests and sometimes imaging studies help rule out other conditions that are often concomitant (present at the same time).
Treatment of fibromyalgia should be based on four pillars: patient education (general information about the disease and attitude toward it), physical exercise according to tolerance, cognitive-behavioral therapy if appropriate, and pharmacological treatment.
1. Patient education and attitude toward the disease
The disease should be explained, providing general advice to improve well-being.
2. Physical exercise according to tolerance
There is evidence of its effectiveness on pain, well-being, and physical function.
It is recommended to start with low-impact aerobic exercise: walking, swimming, stationary cycling, aquagym, tai chi, or pilates.
Exercise should be performed regularly and progressively.
It is recommended to do 20–50 minutes per session, at least three days per week.
In cases of lower tolerance, start with ten minutes per session, four to six days per week, and gradually increase duration, frequency, and intensity, if possible, each month.
3. Cognitive-behavioral therapy
Provided by clinical psychologists in cases of accompanying anxiety or depression.
Although fibromyalgia is not a psychological condition, anxiety and depression can trigger and perpetuate symptoms.
4. Pharmacological treatment
Can help manage some symptoms such as pain, fatigue, or sleep disturbances, although its effectiveness is limited in a large percentage of patients.
Currently, analgesics, muscle relaxants, anticonvulsants, and some groups of antidepressants are used.
The risk/benefit and potential side effects of any medications should be carefully evaluated.
A healthy lifestyle is recommended, maintaining weight with aerobic exercise according to tolerance and a balanced diet, organizing and prioritizing daily tasks with short breaks, and avoiding physically and emotionally stressful activities.
Health advice for people with fibromyalgia is provided.
Rheumatology, Traumatology, Rehabilitation and Burns Hospital
Sjögren's Syndrome is a chronic, systemic autoimmune disease, the cause of which is unknown. Its main symptoms are a dry mouth (xerostomia) and dry eyes (xerophthalmia). In this disease, the cells making up our defence system (immune system) attack parts of the body itself, such as the glands that keep the eyes and mouth moist, and glands in other parts of the body, altering their function. Symptoms in other organs, such as the lungs, joints or nervous system, may also occur.
Patients with Sjögren's Syndrome often have other conditions related to anomalous functioning of the immune system, such as systemic lupus erythematosus, scleroderma and rheumatoid arthritis.
Patients with Sjögren's Syndrome mainly have symptoms related to a lack of tear and saliva production, which causes dryness in the mouth and eyes. The main symptoms suffered by patients are a burning, gritty sensation in the eyes, red eyes, blurred vision, the need to drink water frequently, difficulty swallowing dry food and a higher propensity for tooth decay and mouth infections. This dryness may also affect the skin and vaginal area, which causes painful sexual relationships. Other symptoms that Sjögren's Syndrome patients may show are joint or muscle pain and fatigue. Less frequently, other organs, such as the lungs, kidney and nerve endings, may be affected.
Above all, the disease affects women aged between 40 and 60. It is calculated that the incidence is between 0.5% and 3% of the population.
There is no single test enabling diagnosis of Sjögren's Syndrome. Diagnosing Sjögren's Syndrome in a patient referred with dry eyes and mouth is based on tests that confirm the existence of a deficit in tear and saliva production and that prove that the dryness is associated with an imbalance in the immune system.
Treatment of Sjögren's Syndrome is essentially based on measures that alleviate the feeling of dryness shown by the patient. The treatment includes the use of artificial tears, eye gels, eye drops, nebulisers and tablets to stimulate saliva production. Particular patients may be given treatment to stimulate glandular secretion. In serious cases, where there are symptoms in organs other than the glands (lungs and peripheral nerves, etc) it may be necessary to administer medication that acts to decrease immune system activity (immunosuppressant drugs).
Patients with Sjögren's Syndrome must undergo a series of eye tests, blood and urine tests and, on certain occasions, it is necessary to do a small biopsy of lip mucous to confirm the existence of inflammation in the glands producing saliva.
Sindrome-Sjogren
Sociedad Española de Medicina Interna
American College of Rheumatology: Síndrome de Sjögren
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