Autoimmunity
is a devastating contradiction of human biology in which the very system that
exists to protect an individual from illness launches an attack against that
person’s own body. While some autoimmune diseases can be accurately diagnosed
by identifying particular biological markers in a patient’s blood or tissues,
many patients who suffer from autoimmunity gradually present an array of
symptoms and test negatively for specific disease-markers, making their illness
very difficult to diagnose.
In
the last decade, physicians and researchers have shed light upon a tragic and
deceptive manifestation of autoimmunity—anti-NMDA Receptor Encephalitis—in
which self-reactive (auto-) antibodies cause inflammation of the brain. This
syndrome provides an example of the immense challenge of diagnosing an
autoimmune disease in that it presents clinically in stages as a psychiatric
disorder. Patients who suffer from anti-NMDAR encephalitis develop symptoms of
acute psychosis, including anxiety, fear, delusions, mania, and paranoia. As a
result, the first care-providers that these patients see are often psychiatrists
rather than neurologists, which unfortunately can allow the syndrome to worsen
before a diagnosis is made.
The
elusive nature of autoimmune diseases that anti-NMDAR encephalitis exemplifies raises an important
topic of discussion regarding the common approach to treating and diagnosing
cases of autoimmunity. Having witnessed a great deal of suffering from
undiagnosed autoimmunity in my own family, I have become a strong proponent for
an interdisciplinary approach to patient care in medicine. While it is
undoubtedly an immense feat, I believe it would be of great value for
care-providers in different specialties to collaborate more extensively through
direct communication, rather than indirectly via their patient. In doing so, physicians
might be able to establish a more comprehensive patient profile that leads to
more efficiency in patient diagnosis.
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