Systemic Autoimmune Diseases
Systemic autoimmune diseases are conditions that can affect many organs, cells or tissues simultaneously instead of only one. These conditions can be challenging to diagnose since they may present with nonspecific symptoms that could mimic other conditions. Among one of the leading causes of death and disability among rheumatological patients, improved knowledge, care and treatments have vastly improved the care of those with such diseases. Common systemic autoimmune diseases include:
Systemic Lupus Erythematosus
Systemic Lupus Erythematosus (SLE, Lupus) is probably the most famous of all the systemic autoimmune diseases. It is an autoimmune disease that can range from very mild or episodic symptoms, to a serious chronic illness affecting internal organs. Lupus can cause inflammation in the joints, skin, kidneys, blood cells, brain, heart and lungs. Symptoms often vary from person to person but can include fatigue, joint pain, rash and fever which can periodically get worse, or flare, then improve. There is no cure for lupus, but current treatments focus on improving quality of life for those affected by controlling symptoms and minimizing flare ups through lifestyle modifications and medication management.
Identified most often by its two most common symptoms, dry eyes and mouth, Sjogren’s causes the body’s immune system to attack the cells which produce saliva and tears. Sjogren’s can occur at any age but older women (over the age of forty) are the most common individuals with this disease, and it can coexist with other autoimmune diseases such as rheumatoid arthritis and lupus. Treatments focus on relieving symptoms and can differ for each person and may include artificial tears for dye eyes and using sugar-free candy or drinking water often for a dry mouth. Currently there is no known proven medication that can stop or reverse the progression of dry eyes and mouth.
Dermatomyositis and Polymyositis
Dermatomyositis and Polymyositis are two of the most common types of inflammatory myositis. Inflammation of the muscles and weakness occur in both conditions while patients with dermatomyositis also have a rash. The loss of muscle strength occurs in the large muscles around the neck, shoulders and hips. In rare serious cases some patients can develop dysphagia (weakness of the esophagus) or respiratory failure (weakness of the diaphragm). Treatment is geared toward reducing inflammation of the muscles so that they can gain back their strength and function. Most individuals are encouraged to limit physical activities until signs of inflammation have been reduced or gone away.
Scleroderma and CREST Syndrome
Scleroderma is a rare autoimmune disease that causes thickening, tightening, and scarring of the collagen-containing organs in the patient’s body. Collagen is found in the skin, blood vessels, lungs, kidneys, heart, gastrointestinal tract. Scleroderma can vary from person to person ranging from mild to very serious internal organ involvement. CREST syndrome is a limited scleroderma variant characterized by “calcinosis, Raynaud’s, esophageal dysmotility, telangiectasias.” While there is no cure for scleroderma, it is important to recognize and treat organ involvement early so as to prevent irreversible damage, protect function, and maintain or improve quality of life.
Mixed Connective Tissue Disease
Mixed Connective Tissue Disease (MCTD) is a rare autoimmune disease associated with characteristic high levels of RNP autoantibody and can have features of SLE, scleroderma, polymyositis and sometimes RA. Typically symptoms of these various conditions do not appear at a single time and instead occur over a number of years and this often makes an accurate diagnosis more complicated. Early signs can include a general feeling of unwellness, cold or numb fingers and/or toes, swollen fingers or hands, muscle weakness or joint pain, and sometimes a rash.Treatment is aimed at the specific manifestation that is affecting the patient’s quality of life and prevention of serious organ damage.
Undifferentiated Connective Tissue Disease
Undifferentiated Connective Tissue Disease (UCTD) is an umbrella term that refers to patients who may have an abnormal blood test called a positive ANA and autoimmune disease-like symptoms such as fatigue, joint pain, nonspecific rash, hair loss, dry eye and mouth, sores in the nose or mouth, but do not meet full criteria for any well-defined autoimmune disease. This could be considered as a mild “pre-autoimmune disease.” You can think of this analogous to prediabetes and full diabetes. Some patients are monitored on no treatment, and others start with treatment, depending on their manifestations and quality of life. Patients with UCTD are closely monitored if there could be any signs or red flags heralding progression into a well-defined autoimmune disease.
Polymyalgia Rheumatica (PMR) causes aching muscle pain and stiffness, most commonly in the shoulders, upper back and hips. This condition classically occurs in Caucasian adults over age fifty, women more than men, and can sometimes develop suddenly, even overnight. It can sometimes co-exist with giant cell arteritis (GCA). PMR is very treatment responsive to moderate and low doses of corticosteroids and can go into remission after a 6-12 months steroid taper.
How does Lomibao Rheumatology & Wellness Care treat Systemic Autoimmune Diseases?
Systemic autoimmune diseases are treated based on current evidence-based guidelines. Treatment is customized based on what body part is currently affected and symptomatic to the patient, prevention of serious organ involvement, and patient preference. Initial fast-acting treatments are typically oral or injection corticosteroids such as prednisone or NSAIDs. DMARDs and Biologics are used as ‘steroid sparing agents’ and are more specific and targeted treatment for the disease. Depending on the patient’s needs, sometimes DMARDs and Biologics may be combined. Common DMARDs used for systemic autoimmune diseases include hydroxychloroquine, methotrexate, and Cellcept. Infusion biologics offered by Lomibao Rheumatology & Wellness Care for treatment of systemic autoimmune disease are Benlysta and Rituxan. Wellness services for systemic autoimmune diseases – 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.
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!
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.
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.
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!
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