Concerned about autoimmune disorders and how it affects your body? Dr Yeo Siaw Ing, Senior Consultant from the Department of Rheumatology & Immunology at Singapore General Hospital, gives detailed answers to your questions.
Autoimmune disorders refer to conditions where the body is attacked by its own immune system. These disorders can affect any part of the body. In Singapore, common autoimmune disorders include rheumatoid arthritis, spondyloarthritis and lupus. The sooner these conditions are diagnosed, the better any long-lasting damage can be prevented.
Dr Yeo Siaw Ing, Senior Consultant from the Department of Rheumatology & Immunology at Singapore General Hospital, gives detailed answers to your questions.
Question by rsim
Dear Dr Yeo, what causes this disorder? Is this due to genes inheritance from our parents?
Answered by Dr Yeo Siaw Ing, Senior Consultant, Department of Rheumatology and Immunology, Singapore General Hospital
Our immune system serves to protect us from foreign invaders (eg. bacteria, viruses) and also to prevent our own cells from growing uncontrollably (eg. some cancers). Sometimes the immune system becomes confused and damages our body instead. This can lead to the development of autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus or vasculitis. Genetic background and environmental stimuli such as smoking and infection can increase the risk for developing an autoimmune disorder.
Autoimmune rheumatic diseases can be difficult to diagnose. Systemic lupus erythematosus, for example, may take years to evolve. Because of this, Rheumatologists sometimes follow-up patients who have positive autoantibodies (eg. ANA – antinuclear antibody) and features (joint pain, oral ulcers, rash) of underlying autoimmune rheumatic disease.
Question by chai
Hi Dr Yeo, what are the early symptoms that will show up for autoimmune disorder? Is frequent unwell/catch sick virus one of it?
Answered by Dr Yeo Siaw Ing, Senior Consultant, Department of Rheumatology and Immunology, Singapore General Hospital
Our immune system serves to protect us from foreign invaders (eg. bacteria, viruses) and also to prevent our own cells from growing uncontrollably (eg. some cancers). Sometimes the immune system becomes confused and damages our body instead. This can lead to the development of autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus or vasculitis. Genetic background and environmental stimuli such as smoking and infection can increase the risk for developing an autoimmune disorder.
Autoimmune rheumatic diseases can be difficult to diagnose. Systemic lupus erythematosus, for example, may take years to evolve. Because of this, Rheumatologists sometimes follow-up patients who have positive autoantibodies (eg. ANA – antinuclear antibody) and features (joint pain, oral ulcers, rash) of underlying autoimmune rheumatic disease.
There is no specific diagnostic test for each kind of autoimmune rheumatic disease. Each diagnosis requires a thorough history, physical examination and laboratory tests. Sometimes it is necessary to take a biopsy of the organ involved eg. skin or kidney.
A Rheumatologist is specifically trained to diagnose and treat these diseases. As the treatment is usually targeted at the immune system, patients require close monitoring for side effects and to ensure a positive outcome. Even if it is not possible to predict or prevent the development of an autoimmune disease, one should still strive to maintain a healthy lifestyle.
Question by simly6
Dear Dr Yeo,
Are there any preventive measures to take against this disorder?
Answered by Dr Yeo Siaw Ing, Senior Consultant, Department of Rheumatology and Immunology, Singapore General Hospital
Our immune system serves to protect us from foreign invaders (eg. bacteria, viruses) and also to prevent our own cells from growing uncontrollably (eg. some cancers). Sometimes the immune system becomes confused and damages our body instead. This can lead to the development of autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus or vasculitis. Genetic background and environmental stimuli such as smoking and infection can increase the risk for developing an autoimmune disorder.
Autoimmune rheumatic diseases can be difficult to diagnose. Systemic lupus erythematosus, for example, may take years to evolve. Because of this, Rheumatologists sometimes follow-up patients who have positive autoantibodies (eg. ANA – antinuclear antibody) and features (joint pain, oral ulcers, rash) of underlying autoimmune rheumatic disease.
There is no specific diagnostic test for each kind of autoimmune rheumatic disease. Each diagnosis requires a thorough history, physical examination and laboratory tests. Sometimes it is necessary to take a biopsy of the organ involved eg. skin or kidney.
A Rheumatologist is specifically trained to diagnose and treat these diseases. As the treatment is usually targeted at the immune system, patients require close monitoring for side effects and to ensure a positive outcome. Even if it is not possible to predict or prevent the development of an autoimmune disease, one should still strive to maintain a healthy lifestyle.
Question by pocoyosky
Hi Dr Yeo,
Are there any screening available to check if one has this disorder? Will a blood test able to detect this condition?
Answered by Dr Yeo Siaw Ing, Senior Consultant, Department of Rheumatology and Immunology, Singapore General Hospital
There is no specific diagnostic test for each kind of autoimmune rheumatic disease. Each diagnosis requires a thorough history, physical examination and laboratory tests. Sometimes it is necessary to take a biopsy of the organ involved eg. skin or kidney.
A Rheumatologist is specifically trained to diagnose and treat these diseases. As the treatment is usually targeted at the immune system, patients require close monitoring for side effects and to ensure a positive outcome. Even if it is not possible to predict or prevent the development of an autoimmune disease, one should still strive to maintain a healthy lifestyle.
Question by dsim
Dear Dr Yeo,
Is there a cure to autoimmune disorder? Can we stop the disorder by medication?
Answered by Dr Yeo Siaw Ing, Senior Consultant, Department of Rheumatology and Immunology, Singapore General Hospital
There are many types of autoimmune rheumatic diseases. As yet, there is no known cure for any of these conditions. However, there have been significant developments in treatment options for control of these, often, complex diseases.
Degenerative disease of the joints, on the other hand, is termed osteoarthritis. This is the most common form of arthritis and is associated with older age (>50 years old) and “wear and tear” of the joints. Additionally, osteoarthritis is aggravated by conditions which put abnormal stress on joints such as obesity, malformed hips and knees, previous joint trauma or repeated stress as is seen in some sports people. Osteoarthritis can also develop in joints which have been damaged by inflammatory arthritis eg. rheumatoid arthritis. Although one is not able to prevent aging, it is possible to reduce the risk of developing osteoarthritis by maintaining a healthy weight through moderate exercise and appropriate nutrition. Early diagnosis of predisposing risk factors may also prevent further joint damage and deformity.
There is no conclusive evidence for glucosamine and chrondoitin supplements in the prevention and treatment of osteoarthritis.
Question by mrina
Hi Dr Yeo,
Are there any preventive measures within our control; such as healthy nutritional diet. lifestyle etc to avoid this disorder?
Answered by Dr Yeo Siaw Ing, Senior Consultant, Department of Rheumatology and Immunology, Singapore General Hospital
Our immune system serves to protect us from foreign invaders (eg. bacteria, viruses) and also to prevent our own cells from growing uncontrollably (eg. some cancers). Sometimes the immune system becomes confused and damages our body instead. This can lead to the development of autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus or vasculitis. Genetic background and environmental stimuli such as smoking and infection can increase the risk for developing an autoimmune disorder.
Autoimmune rheumatic diseases can be difficult to diagnose. Systemic lupus erythematosus, for example, may take years to evolve. Because of this, Rheumatologists sometimes follow-up patients who have positive autoantibodies (eg. ANA – antinuclear antibody) and features (joint pain, oral ulcers, rash) of underlying autoimmune rheumatic disease.
There is no specific diagnostic test for each kind of autoimmune rheumatic disease. Each diagnosis requires a thorough history, physical examination and laboratory tests. Sometimes it is necessary to take a biopsy of the organ involved eg. skin or kidney.
A Rheumatologist is specifically trained to diagnose and treat these diseases. As the treatment is usually targeted at the immune system, patients require close monitoring for side effects and to ensure a positive outcome. Even if it is not possible to predict or prevent the development of an autoimmune disease, one should still strive to maintain a healthy lifestyle.
Question by sch
Hi Dr Yeo,
Is this disorder curable, any treatment available? If there is, what are the chances of recovery after treatment?
Answered by Dr Yeo Siaw Ing, Senior Consultant, Department of Rheumatology and Immunology, Singapore General Hospital
There are many types of autoimmune rheumatic diseases. As yet, there is no known cure for any of these conditions. However, there have been significant developments in treatment options for control of these, often, complex diseases.
Degenerative disease of the joints, on the other hand, is termed osteoarthritis. This is the most common form of arthritis and is associated with older age (>50 years old) and “wear and tear” of the joints.
Additionally, osteoarthritis is aggravated by conditions which put abnormal stress on joints such as obesity, malformed hips and knees, previous joint trauma or repeated stress as is seen in some sports people. Osteoarthritis can also develop in joints which have been damaged by inflammatory arthritis eg. rheumatoid arthritis.
Although one is not able to prevent aging, it is possible to reduce the risk of developing osteoarthritis by maintaining a healthy weight through moderate exercise and appropriate nutrition. Early diagnosis of predisposing risk factors may also prevent further joint damage and deformity.
There is no conclusive evidence for glucosamine and chrondoitin supplements in the prevention and treatment of osteoarthritis.
Question by 53yokechan
Dr Yeo,
Does those annual basic health screening able to detect autoimmune disorders? How do we detect visually if a family member have autoimmune disorders in the early stage?
Answered by Dr Yeo Siaw Ing, Senior Consultant, Department of Rheumatology and Immunology, Singapore General Hospital
Our immune system serves to protect us from foreign invaders (eg. bacteria, viruses) and also to prevent our own cells from growing uncontrollably (eg. some cancers). Sometimes the immune system becomes confused and damages our body instead. This can lead to the development of autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus or vasculitis. Genetic background and environmental stimuli such as smoking and infection can increase the risk for developing an autoimmune disorder.
Autoimmune rheumatic diseases can be difficult to diagnose. Systemic lupus erythematosus, for example, may take years to evolve. Because of this, Rheumatologists sometimes follow-up patients who have positive autoantibodies (eg. ANA – antinuclear antibody) and features (joint pain, oral ulcers, rash) of underlying autoimmune rheumatic disease.
There is no specific diagnostic test for each kind of autoimmune rheumatic disease. Each diagnosis requires a thorough history, physical examination and laboratory tests. Sometimes it is necessary to take a biopsy of the organ involved eg. skin or kidney.
A Rheumatologist is specifically trained to diagnose and treat these diseases. As the treatment is usually targeted at the immune system, patients require close monitoring for side effects and to ensure a positive outcome. Even if it is not possible to predict or prevent the development of an autoimmune disease, one should still strive to maintain a healthy lifestyle.
Question by yenahhoe
Dear Dr Yeo,
Does rheumatoid arthritis usually occurs only to people of older age or woman after menopause? Is there any prevention in younger years for rheumatoid arthritis?
Answered by Dr Yeo Siaw Ing, Senior Consultant, Department of Rheumatology and Immunology, Singapore General Hospital
Rheumatoid arthritis is an inflammatory arthritis which has higher predilection for females. The peak age of onset is between 35-50 years. This condition may present with pain and stiffness in the fingers and toes. Other joints may also be affected. The stiffness in the joints is normally worse first thing in the morning and improves with use, a warm bath or anti-inflammatory pain killers.
It is not clear why certain individuals develop rheumatoid arthritis. However, there appears to be an interplay between environmental (eg. viruses, smoking) and genetic factors which increase an individual’s susceptibility to developing this condition.
Thus far, glucosamine and chondroitin, and other supplements have not been shown to prevent or treat autoimmune conditions such as rheumatoid arthritis. Although rheumatoid factor is found on blood testing in a large proportion of people with rheumatoid arthritis, there are patients who have the condition but do not have this antibody in their blood. If the pain, stiffness and swelling in your joints persist, do visit your family doctor or Rheumatologist.
Question by elares
Dear Dr Yeo,
Are there treatments for Ankylosing Spondylitis beyond physiotherapy? Many thanks.
Answered by Dr Yeo Siaw Ing, Senior Consultant, Department of Rheumatology and Immunology, Singapore General Hospital
Ankylosing spondylitis is an inflammatory condition which affects the spine but may also involve the peripheral joints. Physiotherapy and regular stretching exercises remain the cornerstones of treatment in this condition.
There has been growing interest in earlier diagnosis, treatment and prognosis of this disease.
Hence, there is increasing evidence that supports the use of drugs such as non-steroidal anti-inflammatory drugs, immunosuppressants eg. sulfasalazine and biologic therapy. All of these treatments have to be initiated by a Rheumatologist who has made a careful assessment of the patient’s disease.
Question by elgasg
Dear Dr. Yeo,
My right fingers tend to be stiff early in the morning. After a brief massage, they are fine. It only happens 1st time in the morning. Wondering if this is one of the symptoms of autoimmune? Please advise
Answered by Dr Yeo Siaw Ing, Senior Consultant, Department of Rheumatology and Immunology, Singapore General Hospital
Rheumatoid arthritis is an inflammatory arthritis which has higher predilection for females. The peak age of onset is between 35-50 years. This condition may present with pain and stiffness in the fingers and toes. Other joints may also be affected. The stiffness in the joints is normally worse first thing in the morning and improves with use, a warm bath or anti-inflammatory pain killers.
It is not clear why certain individuals develop rheumatoid arthritis. However, there appears to be an interplay between environmental (eg. viruses, smoking) and genetic factors which increase an individual’s susceptibility to developing this condition.
Thus far, glucosamine and chondroitin, and other supplements have not been shown to prevent or treat autoimmune conditions such as rheumatoid arthritis. Although rheumatoid factor is found on blood testing in a large proportion of people with rheumatoid arthritis, there are patients who have the condition but do not have this antibody in their blood.
If the pain, stiffness and swelling in your joints persist, do visit your family doctor or Rheumatologist.
Reposted by administrator
Hi Dr Yeo,
Is there any complete cure for autoimmune disorder otherwise what type of exercises should we do to prevent from degeneration. Thank you!
Answered by Dr Yeo Siaw Ing, Senior Consultant, Department of Rheumatology and Immunology, Singapore General Hospital
There are many types of autoimmune rheumatic diseases. As yet, there is no known cure for any of these conditions. However, there have been significant developments in treatment options for control of these, often, complex diseases.
Degenerative disease of the joints, on the other hand, is termed osteoarthritis. This is the most common form of arthritis and is associated with older age (>50 years old) and “wear and tear” of the joints. Additionally, osteoarthritis is aggravated by conditions which put abnormal stress on joints such as obesity, malformed hips and knees, previous joint trauma or repeated stress as is seen in some sports people.
Osteoarthritis can also develop in joints which have been damaged by inflammatory arthritis eg. rheumatoid arthritis. Although one is not able to prevent aging, it is possible to reduce the risk of developing osteoarthritis by maintaining a healthy weight through moderate exercise and appropriate nutrition. Early diagnosis of predisposing risk factors may also prevent further joint damage and deformity.
There is no conclusive evidence for glucosamine and chrondoitin supplements in the prevention and treatment of osteoarthritis.
Question by oct20100
Dear Dr Yeo,
If a woman in forties is having joints pain for many years over the fingers joints of both hands, occasionally with low grade fever, fatigue, oral ulcers, easy bruising. If the ANA results is negative currently, even though 4 years ago, it was positive and the highest was only >= 640 Titre, and the pattern most of the time is homogenous and once homogenous + speckled, However dsDNA and Rheumatoid factor tested negative. Thus,can doctor confirm this is not autoimmune disease? If the ESR is normal. can the doctor conclude that there is no inflammatory and no treatment can be provided? Is there a diagnostic test that doctor can tell what type of autoimmune disease and is there a cure? If the person with autoimmune disease is in remission for 5 years, is this considered cure? Can you advise? Thank you.
Answered by Dr Yeo Siaw Ing, Senior Consultant, Department of Rheumatology and Immunology, Singapore General Hospital
Our immune system serves to protect us from foreign invaders (eg. bacteria, viruses) and also to prevent our own cells from growing uncontrollably (eg. some cancers). Sometimes the immune system becomes confused and damages our body instead. This can lead to the development of autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus or vasculitis. Genetic background and environmental stimuli such as smoking and infection can increase the risk for developing an autoimmune disorder.
Autoimmune rheumatic diseases can be difficult to diagnose. Systemic lupus erythematosus, for example, may take years to evolve. Because of this, Rheumatologists sometimes follow-up patients who have positive autoantibodies (eg. ANA – antinuclear antibody) and features (joint pain, oral ulcers, rash) of underlying autoimmune rheumatic disease.
There is no specific diagnostic test for each kind of autoimmune rheumatic disease. Each diagnosis requires a thorough history, physical examination and laboratory tests. Sometimes it is necessary to take a biopsy of the organ involved eg. skin or kidney.
A Rheumatologist is specifically trained to diagnose and treat these diseases. As the treatment is usually targeted at the immune system, patients require close monitoring for side effects and to ensure a positive outcome. Even if it is not possible to predict or prevent the development of an autoimmune disease, one should still strive to maintain a healthy lifestyle.
Question by angeliac
I'm a 50 yr old female whose blood test was negative for RA taken 3 months ago. My symptoms are aches in my finger & toe joints as well as in both ball of the feet throughout the day & stiffness in the night/morning. I do not have any meds but am currently taking health supplements 1500mg glucosamine 1200mg chondroitin & olivita forte olive oil capsules. I'm also experiencing peri-menopausal symptoms.Should I see an orthopaedic surgeon or rheumatologist? Please help.
Answered by Dr Yeo Siaw Ing, Senior Consultant, Department of Rheumatology and Immunology, Singapore General Hospital
Rheumatoid arthritis is an inflammatory arthritis which has higher predilection for females. The peak age of onset is between 35-50 years. This condition may present with pain and stiffness in the fingers and toes. Other joints may also be affected. The stiffness in the joints is normally worse first thing in the morning and improves with use, a warm bath or anti-inflammatory pain killers.
It is not clear why certain individuals develop rheumatoid arthritis. However, there appears to be an interplay between environmental (eg. viruses, smoking) and genetic factors which increase an individual’s susceptibility to developing this condition.
Thus far, glucosamine and chondroitin, and other supplements have not been shown to prevent or treat autoimmune conditions such as rheumatoid arthritis. Although rheumatoid factor is found on blood testing in a large proportion of people with rheumatoid arthritis, there are patients who have the condition but do not have this antibody in their blood.
If the pain, stiffness and swelling in your joints persist, do visit your family doctor or Rheumatologist.
Ref: S13
