Latest news with #autoimmuneDisease
Daily Mail
02-07-2025
- Health
- Daily Mail
I've been diagnosed with an autoimmune disease - here are all the warning signs I missed
A woman with an autoimmune disease has revealed all the symptoms she missed in a bid to warn others. Nicky, from Plymouth, said she has just been diagnosed with rheumatoid arthritis by doctors. This type of arthritis is a long-term condition that causes pain, swelling and stiffness in the joints and usually affects the hands, feet and wrists. She said she had many symptoms that she thought were normal but were actually a result of her medical condition. But she got a shock a couple of months ago when she could not get out of bed one day and said that her 'life has changed'. Nicky spoke about the first sign she ignored and said: 'For the last couple of years I'd wake up in pain and my whole body would hurt, but it would only last for 30 seconds maybe, maximum a minute. 'And then you forget... I thought that was normal.' The beautician also said she felt very achy while sitting down after working for the day, but she just put this down to having a busy job. She added: 'But then it started when I wasn't working and I haven't done anything and when I say aching, I mean [it felt] like I had ran a marathon.' Nicky said that she has also not been able to control her body heat for 'many years', adding that she could not sit in the sun for long periods of time. She said: 'It could be winter but I would be boiling hot and sweating. I can't sit in the sun [as] I'd get rashes and I feel like I'm cooking from the inside out. I thought that was normal.' Nicky said that she has also experienced joint pain in her hands over the years, but she thought that this was because she is a hairdresser. 'I used to put that down to my job and thought that was normal,' she added. She's also had problems sleeping and said that she has not been able to go for a kip for many years. She said: 'I just couldn't function, fatigue, tired constantly, again, I thought that was normal. I work a busy, busy job, I run a salon and I've got my own business so I just put it down to that.' Nicky urged anyone who is experiencing these symptoms to get themselves checked out, as it could be an underlying health issue. The clip racked up more than 560,000 views on TikTok and Nicky got thousands of comments from people sharing their thoughts The clip racked up more than 560,000 views on TikTok and Nicky got thousands of comments from people sharing their thoughts. One wrote: 'I have psoriatic arthritis, I'm on so much medication... it's so hard,' to which Nicky responded: 'I feel you.' Another penned: 'I was diagnosed with RA as well but two years later they changed the diagnosis to Psoriatic arthritis. I only have psoriasis on my nails so it confused them. The pain was as you say, debilitating.' A third said: 'I was first told I had fibymalgia then menopause and then rheumatoid arthritis, I think it's a bit of them all to be honest.' A fourth commented: 'I have the same symptoms as you. But I've been diagnosed with Fibromyalgia. I've got so bad I had to give up my job.'
Medscape
19-06-2025
- Health
- Medscape
Is It Worth Adding Chemo to ICI for NSCLC in Older Adults?
Immune checkpoint inhibitors (ICI) are a cornerstone of non-small cell lung cancer (NSCLC) treatment, but it's not clear whether adding chemotherapy to ICI — a common practice with younger patients with NSCLC — helps older ones. No randomized trial has directly compared stand-alone ICI with chemoimmunotherapy in geriatric patients with NSCLC. Without strong data supporting the combined approach, oncologists may stay away from offering chemoimmunotherapy to older patients, especially to those with multiple comorbidities, given concerns about increased toxicity. To address the evidence gap, investigators linked Medicare and Surveillance, Epidemiology, and End Results data to compare outcomes between 14,249 older patients with NSCLC who received ICI alone (pembrolizumab or nivolumab) and 3432 treated with ICI and platinum doublet chemotherapy. Patients were aged 74 years, on average, and at least 66 years. The median follow-up duration was 211 days. The team weighed the risks and benefits of chemoimmunotherapy vs stand-alone ICI to answer a key question: Is adding chemotherapy to ICI worth it for elderly patients with NSCLC? The findings were recently published in Jama Oncology . Benefits: Prolonged Survival in First Line In the upfront setting, chemotherapy add-on reduced patients' mortality risk by 34% compared with ICI alone. Benefits were slightly more notable in women (hazard ratio [HR], 0.62) than in men (HR, 0.72). Patients with autoimmune disease — who are often excluded from trials and who made up almost 20% of the study population — benefited the most, with a mortality risk reduction of 49%. A similar mortality benefit was observed in patients aged 66-75 years and those aged 76 years or older, 'which is notable given that immune senescence is hypothesized to lessen ICI treatment response in patients older than 75 years,' wrote the investigators, led by James Heyward, PhD, a pharmacoepidemiologist at Johns Hopkins Bloomberg School of Public Health in Baltimore. However, in the second or later lines of treatment, patients did not experience a significant survival benefit with chemoimmunotherapy (HR, 0.94; 95% CI, 0.68-1.03). Risks: Increased Toxicity Adding chemotherapy in the first-line setting increased the risk for severe immune-related adverse events (AEs), which can include pneumonitis, colitis, hepatitis, and myocarditis, by 18%. Severe AEs were more common in men (HR, 1.29) than in women (HR, 1.08). Patients aged 76 years or older had the highest risk (30%) for severe immune-related AEs. However, older patients did not have an increased risk for severe immune-related AEs in second and later lines. The study did not consider chemotherapy toxicities. Is It Worth It? The team extrapolated from their data to calculate the harm-benefit trade-off of adding ICI to chemotherapy in older patients. The researchers found that for each extra year of life gained with first-line chemoimmunotherapy, the risk for severe immune-related AEs would be 0.31. Put differently, 31% of patients predicted to gain 1 extra year of life were likely to experience one severe immune-related AE. Past studies have found that patients are often willing to accept one severe AE for 1 year of added survival, which indicates that chemoimmunotherapy in the first line may be worth it for older patients with NSCLC. 'Given patient prioritization of survival benefits vs prevention of adverse effects, patients may prefer to initiate treatment with ICI + chemotherapy, albeit with careful follow-up for mitigation of severe immune-related AEs,' the investigators wrote. But, the authors noted, 'men experienced more harm and less benefit than women' in the first-line setting, which is consistent with previous research. And patients with an autoimmune disorder who received chemoimmunotherapy had a slightly higher risk for severe immune-related AEs (HR, 1.22) than those without a disorder (HR, 1.16). Still, the authors said, 'the reduction in mortality was also the highest for this group of patients, suggesting that the potential benefits of treatment may outweigh the potential harms.' In the second and later lines, the researchers found no increased risk for immune-related AEs with chemoimmunotherapy. Given the lack of statistically significant mortality benefit, the results suggest that stand-alone ICI are a better approach in this setting. Overall, this study provides 'a valuable contribution to an ongoing and complex discussion,' said medical oncologist Alessio Cortellini, MD, PhD, an immunotherapy and lung cancer specialist at Imperial College London, London, England, who was not involved in the research. However, it will be important to closely monitor patients for severe immune-related AEs. 'While adding chemotherapy to immunotherapy may be appropriate for selected older adults with NSCLC, I remain cautious about its widespread use in frail patients,' Cortellini added. 'Until we have dedicated trials in frail populations, the decision to use [chemotherapy-ICI]combinations in older adults should be highly individualized.'
Medical News Today
29-05-2025
- General
- Medical News Today
Leukemia and lupus: Link and research explained
Link explained Cancer risk Symptoms Seeking medical help Summary Leukemia and lupus are both conditions that affect the immune system. Although they are different, they share certain symptoms. A person with lupus may have increased risk of developing leukemia. Lupus is an autoimmune disease. A person's immune system is responsible for protecting the body from infection and disease. Autoimmune conditions affect the immune system, causing it to attack healthy tissue. Leukemia is cancer of the blood. There are different forms of leukemia. The type a person has is determined by what type of blood cell it affects, as well as its speed of growth. Some forms of leukemia affect the white blood cells. White blood cells help to fight diseases as part of the immune system. If a person has a problem with their white blood cells, they may be prone to sickness or infection. Lupus and leukemia have certain symptoms in common. Additionally, some research suggests that there may be a link between the two conditions. Read on to learn more about the relationship between lupus and leukemia, as well as when to see a doctor. AbrahamCertain research suggests that there may be a link between lupus and leukemia. A review from 2018 found that having lupus may increase a person's overall risk of developing cancer. It may also increase a person's risk of specific cancers, including: leukemia non-Hodgkin's lymphoma Hodgkin's lymphoma multiple myeloma cervical cancer vaginal/vulval cancer renal cancer bladder cancer esophageal cancer gastric cancer hepatobiliary cancer lung cancer oropharynx cancer larynx cancer non-melanoma skin cancer thyroid cancer Additionally, research from 2022 noted that autoimmune hemolytic anemia (AIHA) may increase a person's risk of leukemia. AIHA is a condition that causes the immune system to destroy red blood cells. A further study from 2022 stated that around 10% of people with lupus develop AIHA. A study from 2024 noted that there are rare reports of chronic myeloid leukemia (CML) occurring alongside lupus. CML is a form of leukemia that affects the blood and bone marrow. Researchers believe that lupus may increase a person's risk of certain cancers due to its weakening of the immune system. Further research is required to determine the link between lupus and leukemia. A doctor may use immunosuppressants to treat a person with lupus. Immunosuppressants work by suppressing a person's immune system. This helps to prevent it from damaging healthy tissue. However, immunosuppressants may reduce how well the immune system works. This may weaken a person's immune system, causing them to become vulnerable to infections. Information from the American College of Rheumatology notes that the immunosuppressant cyclophosphamide (Cytoxan) is used for severe complications of lupus. They also note that this medication may increase a person's risk of certain cancers, including: lymphoma skin cancer bladder cancer Research from 2017 found that the increased cancer risk of cyclophosphamide may occur when it is given at higher doses. Additionally, researchers found that hydroxychloroquine, another immunosuppressant used to treat lupus, may reduce a person's cancer risk when given at low doses. If a person has lupus, they should speak with their doctor about the risks and benefits of their treatments. Although lupus and leukemia are different conditions, they do have some overlapping symptoms. These shared symptoms include: fatigue fever weight loss petechiae, which are tiny red dots on the skin joint pain swollen glands dizziness A person should speak with their doctor if they notice any signs of lupus or leukemia. If a person has lupus, they should speak with their doctor if they notice any new or concerning symptoms. shortness of breath during physical activities paleness frequent infections bruising easily prolonged bleeding from cuts frequent or severe nosebleeds bleeding gums heavier or more frequent menstrual bleeding night sweats enlarged spleen or liver feeling of pain or fullness below the ribs wheezing coughing painful breathing Lupus and leukemia are both conditions that affect a person's immune system. If a person has lupus, they may be more likely to develop certain cancers. These may include leukemia. Researchers are not currently sure what the link is between lupus and leukemia. They believe lupus may increase a person's risk of cancer by weakening the immune system. Additionally, certain treatments for lupus may increase cancer risk. Both lupus and leukemia share certain symptoms. If a person notices any symptoms of either condition, they should speak with a doctor. A person with lupus should speak with their doctor if they notice any signs of leukemia, such as prolonged bleeding from cuts. Leukemia Lupus Blood / Hematology Cancer / Oncology Medical News Today has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy. BalajiSubramanian S, et al. A rare case of dual metachronous primary malignancies, chronic myeloid leukemia, and tongue carcinoma in a patient with long-standing systemic lupus erythematosus: A case report and review of literature. Cyclophosphamide (Cytoxan). (2024). Guo J, et al. (2020). The relationship between cancer and medication exposure in patients with systemic lupus erythematosus: A nested case-control study. Hsu C-Y, et al. (2017). Cumulative immunosuppressant exposure is associated with diversified cancer risk among 14 832 patients with systemic lupus erythematosus: A nested case–control study. Leukemia. (n.d.). Leukemia—patient version. (n.d.). Lupus. (2024). Medications used to treat lupus. (2023). Signs and symptoms. (n.d.). Song L, et al. (2018). The risks of cancer development in systemic lupus erythematosus (SLE) patients: A systematic review and meta-analysis. Suzuki E, et al. (2023). Systemic lupus erythematosus and antiphospholipid syndrome accompanied by mixed-type autoimmune hemolytic anemia. Systemic lupus erythematosus. (2022). Systemic lupus erythematosus (Lupus). (2022). Zhang Y, et al. (2022). Hematological malignancies in systemic lupus erythematosus: Clinical characteristics, risk factors, and prognosis—a case-control study.
Free Malaysia Today
13-05-2025
- Health
- Free Malaysia Today
Living with myasthenia gravis, a rare but manageable condition
53-year-old Alina Ali began suffering from symptoms of myasthenia gravis in 2010, but was only diagnosed with the rare condition in 2016. (Bernama pic) KUALA LUMPUR : It began suddenly in 2010, when secondary-school teacher Alina Ali inexplicably began feeling fatigued, her voice growing hoarse. Chalking it up to work-related stress, she visited her doctor but found nothing abnormal. Some of her colleagues asked why she 'seemed lazier lately'. Others attributed her condition to 'black magic' or 'disturbance by a spiritual entity', leaving Alina feeling unsettled. She consulted specialists from various fields, from eye doctors to psychiatrists, and even sought the help of traditional healers – but none of them could give her a clear answer. By the end of 2015, her symptoms had worsened, with severe body weakness. Still, she figured her exhaustion was from caring for her children after her husband passed away suddenly from a heart attack that August. Sometime the following year, she began to experience a drooping of both upper eyelids. Alina was referred to a neurologist at Hospital Serdang in Selangor and, after undergoing several tests, was diagnosed with myasthenia gravis (MG), a rare autoimmune disease. 'I didn't know what to feel – relieved because I finally knew the cause, or afraid because I had never even heard of the disease before,' the now 53-year-old told Bernama. She was prescribed the medication pyridostigmine and steroid prednisolone. Despite numerous side effects – including diarrhoea, watery eyes, increased saliva production, weight gain, spikes in blood sugar, narrow blood vessels that rupture easily, and proneness to skin, blood and lung infections – she was determined to stick with her treatment. Alina, who retired from teaching in 2021, is now active in the MG community, sharing her experiences and offering support to others. While MG patients do not fully recover, the condition is manageable, and Alina is committed to raising public awareness about the disease. According to consultant neurologist Dr Rabani Remli, MG is a chronic autoimmune disease caused by disruptions in the transmission of nerve impulses to the muscles. As a result, the muscles become weak when a person performs repeated physical movements. The disease is neither contagious nor inherited. It is often misunderstood as a psychological issue or mistaken for other conditions such as stroke or eye-muscle disorders. Symptoms of MG include body weakness, especially in the arms and thighs, making it hard for patients to climb stairs or carry out daily activities. (Envato Elements pic) Rabani explained that MG is difficult to diagnose as its symptoms can be confusing and can vary. Patients often present with drooping eyelids or double vision, difficulty speaking clearly, and trouble swallowing. Some may experience muscle weakness in the arms and thighs, making it hard for them to climb stairs or carry out daily activities. Although there is no official data on the prevalence of MG in Malaysia, previous studies have shown that MG among Malaysians displays clinical characteristics similar to those in other countries. Women are more frequently diagnosed at a younger age, usually between 20 and 30, while men are usually diagnosed later, in their 60s. There are two classifications of MG: ocular, which only involves the eye muscles, or generalised, which involves muscle weakness in other parts of the body. 'Identifying the MG category is important for determining the treatment approach,' Rabani said. 'Detecting MG requires a careful approach due to its unclear and inconsistent early symptoms. Taking a detailed patient history is key to record a pattern known as 'fatiguability' – a hallmark of MG: symptoms that worsen with physical activity or repeated muscle use, but improve after rest.' Neurological examinations are necessary, including asking the patient to raise their eyelids and move their arms and legs. Blood tests are conducted to detect antibodies, while further evaluation may include nerve-conduction tests or a chest CT scan to detect any tumour or enlargement of the thymus gland – located behind the breastbone between the lungs – which is often associated with MG. 'If there is swelling in the thymus, we will refer the patient for thymus-gland surgery. Thymus-gland tumours are a major cause of this disease,' Rabani noted. Although MG cannot be completely cured, it can be controlled with proper treatment. Medications such as pyridostigmine work by enhancing the transmission of nerve signals to muscles, temporarily reducing muscle weakness. Effects may vary from person to person. For more serious cases, patients are prescribed immunosuppressive treatments such as steroids, azathioprine or mycophenolate mofetil, which can help reduce antibody production. These treatments, however, require close monitoring as each can have short- and long-term side effects. Neurologist Dr Rabani Remli says one of the main challenges in managing MG in Malaysia is the low level of awareness, not only among the public but also among general medical practitioners. (Rabani Remli pic) In more complicated cases or during an 'MG crisis', emergency treatments such as intravenous immunoglobulin or plasma exchange are used to neutralise and eliminate antibodies more quickly. These treatments have also been found to be very effective during critical phases or before surgery. 'If a patient is found to have a tumour in the thymus gland, they will be advised to undergo a thymectomy, which is the surgical removal of the thymus. Patients who undergo this surgery, especially younger ones, usually show better symptom control in the long term.' Alongside medical treatment, patients need to better control their stress and get sufficient rest. Avoiding certain medications that can trigger MG is also crucial. Furthermore, psychological effects pose a major challenge for MG patients, Rabani said: some of her patients suffer from depression because they are misunderstood by others who brand them as lazy, spoiled, or having psychological issues. 'The loss of control over body functions and the difficulty in planning daily activities are major causes of depression as patients don't know when their body will fail to function. This makes it hard for them to work or live a normal social life,' Rabani explained. The main challenge in managing MG in Malaysia is the low level of awareness, not only among the public but also among general medical practitioners. As such, Rabani hopes support groups like the Malaysian Rare Disorders Society and other NGOs will continue to shed light on MG, while assisting patients and their families.
