Fear of fatigue

The immune system is the body’s defense against infectious invaders like bacteria and viruses. However, in autoimmune diseases, the immune system dysfunctions and attacks the body itself. Dr. Joan Wither, a Senior Scientist at Krembil Research Institute, has devoted her scientific career to finding answers to complex autoimmune diseases such as lupus, Sjögren’s syndrome and scleroderma. This complex group of diseases are debilitating, chronic and can lead to kidney failure and heart disease.

Her most recent research findings show that an increase in fatigue does not mean a worsening of the disease. She has recently published the results of a study in Arthritis Research and Therapy, examining whether tiredness is a harbinger of disease progression these diseases.

Dr. Wither focuses on the genetic origins of these complex autoimmune diseases, known as systemic autoimmune rheumatic disease (SARD), in collaboration with arthritis researchers, including Dr. Arthur Bookman who was a co-author of the study.

The first sign of a SARD is the presence of a specific type of antibody, which is a protein produced by the immune system. Doctors have worried that people with these antibodies who are also experiencing profound tiredness are at an increased risk of progressing to a more severe stage of disease.

As part of the study, Dr. Wither and her team analyzed a combination of questionnaires administered to SARD patients, as well as their blood test results and medical records. The researchers found that individuals with the antibodies and tiredness did not have a greater likelihood of progressing to a SARD.

Instead, they found that approximately one third of patients who participated in the study might be affected by a different disease with similar symptoms: fibromyalgia. Fibromyalgia is a condition with heightened sensitivities to pain and tiredness and is thought to stem from a disorder in the nervous system.

“Based on our findings, clinicians can now reassure their patients that fatigue is not necessarily a sign that their condition is progressing,” says Dr. Wither.

These findings will also improve the diagnosis and treatment of people with elevated tiredness.

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