World AUTOimmune & AUTOinflammatory Arthritis Day

May 20th, 2018

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  • Rheumatoid Arthritis (RA) - autoimmune
  • Psoriatic Arthritis (PsA) - autoimmune
  • Ankylosing Spondylitis (AS) - considered cross between autoimmune & autoinflammatory
  • Axial Spondyloarthropathy (axSpA) - considered cross between autoimmune & autoinflammatory
  • Adult Onset Still's Disease (AOSD) - autoinflammatory, some still consider partly autoimmune
  • Sjögren’s Syndrome (SS) - autoimmune
  • Systemic Lupus Erythematosus (SLE) - autoimmune

Patients who are suspected of having early disease, but the specific type is not yet apparent, are often initially diagnosed with Undifferentiated Connective Tissue Disease (UCTD), Undifferentiated Spondylitis (USpA), inflammatory polyarthritis, or simply "inflammatory arthritis - nonspecific".  

Juvenile Arthritis versions of the diseases listed above are also included in this group.  Formerly called Juvenile Rheumatoid Arthritis, this is now commonly referred to as either Juvenile Idiopathic Arthritis (autoimmune) or systemic Juvenile Idiopathic Arthritis/Still's  (autoinflammatory).

  • This type of arthritis is a result of degeneration of the cartilage between the joints and the bones. This wear and tear can occur due to aging, injury, or excessive pressure on the joints over a long period of time.
  • There is scientific proof that some people may be genetically predisposed to degeneration in the joints; however, often this type of arthritis is not due to genetics.
  • Joints affected are typically localized to one or more large, weight-bearing locations. Often a person will have this type of arthritis "in their knee".  It is highly unlikely a person living with autoimmune arthritis or autoinflammatory arthritis can have their arthritis only in their knee (or one location), because of its' full body disease.
  • The pain starts after the damage has occurred.

Overlapping symptoms, regardless of diagnosis, ofteninclude:  debilitating fatigue, fevers (various levels), severe and prolonged stiffness after rest, brain fog ("mental cloudiness"), and joint pain. 

Autoinflammatory diseases usually also present with a rash (type varies).

degenerative Arthritis
  • Stems from parts of the immune system, therefore, the disease produces inflammation that spreads throughout the whole body.  In some of these autoimmune and autoinflammatory diseases, the joints are clinically affected as a major component of the condition.
  • There is a genetic component involved with developing these diseases; this is why onset is most often young (20-40 in adults).
  • While the initial onset may start in one joint, usually many joints are affected because the inflammation travels through the bloodstream; additionally any joint in the body can be affected.
  • The pain in the joints, because it is a result of inflammation, feels a lot like an injury or bone bruise.  The pain starts at initial onset, well before any damage occurs.  Therefore, this type of arthritis is often considered "invisible" until it progresses and causes visible - and permanent - damage.

Early detection: symptoms

Autoimmune and Autoinflammatory Arthritis

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Autoimmune versus autoinflammatory - what's the difference?

Also, the "Autoimmune" and "Autoinflammatory" disease itself affects much more than joints; the inflammation also targets tissues and organs.  While there are over 100 diseases that can include arthritis, only just over a couple dozen are also autoimmune or autoinflammatory in origin. 

Furthermore, even a smaller subset of those diseases are so alike in symptoms, presentation, and treatment that they are sometimes difficult to differentiate early in disease onset, resulting in a delay in diagnosis and, sometimes, misdiagnosis.  These diseases include:

The immune system is comprised of two parts - the innate and the acquired immune system.  The innate means essentially inborn, while the acquired reacts to learned responses.  Autoimmune diseases stem from the acquired immune system; onset occurs due to a genetic predisposition in addition to an environmental trigger (something acquired).  Autoinflammatory diseases also have a genetic predisposition, but they trigger for no known reason.

Learn more about the differences between Autoimmune & Autoinflammatory.

"Autoimmune Arthritis" and "Autoinflammatory Arthritis" refers to type of arthritis caused by inflammation in association with autoimmune or autoinflammatory diseases. It is not the same type of arthritis associated with aging, wear and tear, injury, or extreme pressure/weight on the joints; this common form is called Osteoarthriits (OA).  While common, however, it can be quite severe, causing complete destruction of the cartilage and resulting in bone on bone pain.  The arthritis associated with autoimmune and autoinflammatory diseases is very different.

other autoimmune and autoinflammatory diseases

The following diseases may or may not present with joint pain as a major component.  These also have other specific clinical features that may differentiate them from the diseases listed above.  They include:

Behcet's Disease
Crohn's Disease
Mixed Connective Tissue Disease ("overlap" of three connective tissue diseases, including systemic lupus erythematosus, scleroderma, and polymyositis).
Relapsing Polychondritis

Ehlers-Danlos Syndrome
Enteropathic Arthritis
Felty's Syndrome
Jaccoud's Arthritis 
Palindromic Rheumatism
Polymyalgia Rheumatica
Reactive Arthritis
TRAPS (Tumor Necrosis Factor Receptor-Associated Periodic Syndrome)
Wegener's Granulomatosis

Diseases or conditions that often occur as a comorbidity with Autoimmune-Autoinflammatory Arthritis diseases:

Fibromyalgia (nerve condition)

Raynaud's Phenomenon

AI arthritis (Autoimmune & Autoinflammatory Arthritis)