Autoimmune Arthritis
Autoimmune arthritis refers to a group of several different types of arthritis whereby your immune system mistakenly attacks your normal healthy joints. Your immune system normally should be defending you against infections and foreign invaders, but it can become dysfunctional and overactive and mistakenly attack your own body. In the case of autoimmune arthritis, the joints are targeted leading to pain, swelling, decreased range of motion, and if left untreated, permanent joint damage and destruction. The most common types of autoimmune arthritis are:
Rheumatoid Arthritis
Rheumatoid arthritis (RA) is the most common type of autoimmune arthritis. RA most commonly causes pain and swelling in symmetrical small joints of the hands, fingers, wrists, feet and ankles. Patients commonly have stiff joints in the morning and can have generalized fatigue. Uncommonly, RA can cause lung fibrosis and rarely, vasculitis. The goal of treatment in RA is to get patients in remission without pain and swelling, improved range of motion and quality of life and reduce or prevent permanent joint damage.
Psoriatic Arthritis
Psoriatic arthritis (PsA) typically occurs in patients who have skin psoriasis, but it can also occur in patients who don’t have any former presentation of psoriasis. PsA can be mild with just occasional flare ups in a few joints, or it can be a chronic arthritis affecting multiple joints. PsA can affect any joint but more commonly affect larger joints in lower extremities but can also show up in the distal fingers, toes, back or sacroiliac joints of the pelvis. Treatment in PsA is tailored to how mild or severe the condition is affecting the patients’ quality of life and prevention of permanent joint damage.
Spondyloarthritis
Spondyloarthritis (SpA) is an umbrella term for autoimmune arthritis that is associated with the HLA-B27 gene, and a unique feature called enthesitis which refers to inflammation of the sites where ligaments and tendons attach to bones. In addition to peripheral involvement (joints of the hands and feet), there can also be axial involvement (spine and sacroiliac joint of the pelvis). SpA can also involve extra-articular manifestations such as iritis or uveitis (inflammation of the eye), psoriasis and pyoderma gangrenosum (skin involvement), and Crohn’s disease and ulcerative colitis (inflammatory bowel disease). Psoriatic arthritis, ankylosing spondylitis, reactive arthritis, IBD-associated arthritis are classified in this family. When a patient has some features of SpA, clearly does not have RA, but cannot be obviously classified in one of those distinct diagnoses, we describe them as undifferentiated SpA.
Ankylosing Spondylitis
Ankylosing spondylitis (AS) causes the spine and sacroiliac joints of the pelvis to fuse and become less flexible which leads to pain and reduced range of motion. It most commonly starts in the teens and early 20s, classically in a young white man but has been found to be under-recognized in women. The major gene associated with AS is called HLA-B27. There is a higher frequency of this gene in the Northern European population. However, having this gene does not automatically make you have this condition. In addition to medications, physical therapy exercises are important in managing symptoms and preventing progression of AS.
Reactive Arthritis
Usually the result of an infection in a different part of the body, reactive arthritis causes joint pain and swelling, most commonly in the knees, ankles and feet. The symptoms of reactive arthritis typically occur days to weeks after the initial infection itself. Classically these bacteria are in the genitals (Chlamydia trachomatis) or the bowel (Campylobacter, Salmonella, Shigella and Yersinia). Reactive arthritis can have a variable course, in some it resolves within six months of the infection, or it can be a relapsing-remitting arthritis, and in others it can evolve into a chronic arthritis requiring long-term treatment to prevent permanent joint damage.
SAPHO Syndrome
SAPHO syndrome (acronym for Synovitis, Acne, Pustulosis, Hyperostosis and Osteitis) is considered to be a rare disorder, though its actual occurrence is probably underreported. The age of onset of symptoms ranges from adolescence to late adulthood, though is most typical among individuals thirty to forty years old. SAPHO syndrome encompasses a wide spectrum manifestations, though often causes bone and skin issues of varying degrees of severity. The onset of bone and joint pain, stiffness and swelling tends to develop slowly over time and may not be recognized at first.
How does Lomibao Rheumatology & Wellness Care treat Autoimmune Arthritis?
Treatment is based on current evidence-based guidelines and is customized to the severity of disease as well as patient preference. Initial fast-acting treatments are typically oral or injection corticosteroids such as prednisone or NSAIDs (non-steroidal anti-inflammatory drugs). DMARDs (disease modifying anti-rheumatic drugs) and Biologics are used as ‘steroid sparing agents’ and are more specific and targeted treatment for the disease. The goal is to reduce pain and swelling, improve range of motion and quality of life, and prevent disease progression observed by joint space narrowing and erosions. Depending on the patient’s needs, sometimes DMARDs and Biologics may be combined. Common DMARDs used for treating autoimmune arthritis include hydroxychloroquine, sulfasalazine, and methotrexate. Infusion biologics offered by Lomibao Rheumatology & Wellness Care for treatment of autoimmune arthritis are Remicade, Simponi Aria, Actemra, Orencia, Rituxan. An injectable treatment offered is Stelara. Wellness services for autoimmune arthritis – coming soon!
What Our Patients Are Saying
Most Personable Rheumatologist
Dr. Lomibao has been my Rheumatologist for over 4 years. I have had RA for 25 years, and Dr. Lomibao by far is the best doctor I have seen. She is an excellent and experienced physician who truly listens and cares. She has developed a treatment plan that has given me my life back.
Phenomenal Physician
I am so thankful to be under the care of Dr Lomibao! I could honestly write an essay about her and how wonderful she is. From my first visit to the present she is always thorough and has a incredible bedside manner. I don't think I've ever waited more than 10-15 minutes in the office either. They are so efficient. I have recommended her to many people and will continue to do so. I love Dr Lomibao!
Exceptional Physician
I am so thankful to have found Dr Lomibao. She's been my rheumatologist since the very beginning of my autoimmune illness journey and I can't say enough good things about her. She spent so much time at my initial getting to know me and my symptoms and now I've been a patient of hers for over two years and she still spends all the time with me I need to get my questions and concerns addressed. She is so thorough and has the best bedside manner. I have recommended her to many friends. Dr lomibao is a fantastic physician.
The Best Rheumatologist
I could write a whole story. I won't because you may stop reading. Dr. Lomibao is the best I've came across during my search for a rheumatologist. She isn't like most doctors. She listens to you. She doesn't force meds on you and actually cares about your well being. I'm a lupus and arthritis patients. She has assisted me in getting my condition under control. If you want a caring doctor come see her and I promise you will not be disappointed.
Great Rheumatologist
I was diagnosed with lupus almost 4 years ago and after searching. I finally found a rheumatologist who listened. She was compassionate and caring. She has never tried to force a treatment or force meds. Dr. Lomibao has the best bedside manner and communicates with all my other doctors so we are all on the same page. She's such a great doctor I pay out of my pocket to see her because she isn't in my insurance network. That should tell you my true thoughts about Dr. Lomibao. If you are looking for a doctor who will listen and help you find a solution. Go see her.
She helped me knock my arthritis to the curb!
I had some difficulty with my arthritis and I wasn't particularly thrilled with my previous doctor's treatment plan. I decided to see Dr. Lomibao because there had to be another option. I was soooo glad I did!! Dr. Lomibao sat, listened and took notes like crazy. She really listened to my concerns and why I didn't want to be on steroids. When I finished, she put her pen down, looked me in the eyes and told me, "We will find something to help you." She reviewed all my options and provided the pros/cons on everything I could do. She provided me her most recommended options and then I was able to choose the best fit for me. It took a little bit of time, but I am now on a regimen that has my arthritis at the curb! You will not find a more personable, knowledgeable and caring physician around.
One of the Best to ever do it!!!
I have been seeing Dr. Lomibao for almost 2 years. Follow-up hospital visit. She was new to me on our first visit she sat and asked so many questions in regard to the new diagnosis of my auto-immune disease. At first glance, some told me she looks young and she may not be as knowledgeable as others. I say to them she is freaking awesome and amazing. I never feel rushed or feel like I'm being pushed out quickly. Not that I take a lot of time but, as a patient you want to feel like your Dr. truly cares about what you're going through and find a way to solve the problem. During this recent pandemic, I've been teaching from home. I had to move my daughter home from college and I had to work the very next day. I was exhausted and had an appointment with Dr. Lomibao the very next day. My body was not cooperating and I left a message with her nurse and my Dr. did a virtual appointment to address my issues. Video or by phone was optional. They always return calls and are accommodating. God Bless you guys stay safe!
I love Dr. Lomibao
Dr. Lomibao was the first Rheumatologist I saw after I started exhibiting symptoms of inflammatory arthritis in 2018. I have been appreciative of her analytical and compassionate nature since my first appointment! Dr. Lomibao doesn't just check boxes off her chart and move on to her next patient. During my appointments, she takes the time to relate to me and allows me space to communicate the various areas of my life that are affected by my illness. This has greatly affected the amount of trust I have for her. I am an over-thinker who loves knowing why and how aspects of my illness are affecting me, and Dr. Lomibao has never dismissed my questions or made me feel like I am wasting her time by asking a question. Dr. Lomibao and her staff have gone above and beyond to make me feel the best I possibly can! I am very grateful for their care.
Caring and Open Expert Physician
I highly recommend Dr. Frances Lomibao if you are looking for a knowledgeable, kind, and proactive rheumatologist. Dr. Lomibao diagnosed me with RA this year, and has been so compassionate, caring, and informative every step of the way. She takes time to answer my questions in depth, and I always have a lot of them. She is open to my desire to find a way to treat this disease as holistically and naturally as possible, and I truly feel that we are a team united in the fight. Visiting with Dr. Lomibao feels like meeting up with a friend. I’m always nervous before doctor visits but her presence is so comforting, and she’s hilarious! She helps take the edge off of potentially receiving tough news. When we found that I would need to take medication (which wasn’t my plan originally), she spent so much time with me discussing treatments and helping me find what’s best for me. She made me feel comfortable with my treatment plan, and I appreciated her boldness to tell a crunchy hippie like me that while diet and lifestyle changes and supplements would help, it wouldn’t be enough for how my disease is progressing. I have a long history of poor medical care, so being able to partner with Dr. Lomibao is a true blessing.
Five Stars
I have been under Dr. Lomibao's care for 2 1/2 years. She is an amazing rheumatologist that has a genuine care for her patients. I have had RA for 15 years and seen many doctors but she is by far the very best! If you need a physician who not only cares but gets to the bottom of your condition, look no further. I HIGHLY recommend Dr. Frances Lomibao! God bless her!