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- 1 Lyme disease; yes or no?
- 2 Discussion of Autoimmune/inflammation
- 3 Histiocytosis
- 4 Merger
- 5 Old text
- 6 Proposal: Redirecting content to Autoimmunity
- 7 I sure from an autoimmune disease called Polymyositis
- 8 Adding a bit more information?
- 9 Optic neuritis
- 10 mistake
- 11 Disease causation
- 12 Multiple Sclerosis
- 13 Autoimmune disease
- 14 This is for anyone who has any questions or doubts...
- 15 What about Pyoderma Gangrenosum?
- 16 Systemic lupus
- 17 Please add Celiac Disease
- 18 Please fix table where Cattleman's and Celiac Disease are stuck on right side
- 19 Ulcerative colitis
- 20 Merge
- 21 Sources
- 22 Signs & Symptoms
- 23 Narcolepsy
- 24 Harold Ramis & autoimmune inflammatory vasculitis
- 25 Autoimmune Disease Updated Listing and Categorization
- 26 Level of Acceptance
- 27 MeSH as a criteria for Acceptance
- 28 "Penetrance" for autoimmune disease
- 29 Clarification on evidence
- 30 Confusion over the term Autoimmunity
- 31 Categories versus Alpha Listing
- 32 ICD-9 Codes
- 33 JCI review series
- 34 Glycans
Lyme disease; yes or no?
Lymie66 had proposed adding Lyme disease, but someone deleted it citing insufficient evidence; I don't feel strongly about it's inclusion or exclusion, but think it's a good idea to try to keep this list as broad as possible. An entire recent edition of Current Opinions Rheumatology was devoted to the way certain pathogens seem to initiate autoimmune phenomena (see http://www.ncbi.nlm.nih.gov/pubmed/22647621); perhaps if someone could dig up something more specific to how Lyme disease causes the immune system to cause "collateral damage" in certain individuals, it may be more convincing? doctorwolfie (talk) 14:53, 29 August 2012 (UTC) Aaron Abend (talk) 13:12, 1 June 2015 (UTC)There are a number of diseases that seem to follow this pattern, usually some kind of infection followed, in some (but not all) cases, by a chronic condition that shares many attributes of autoimmune diseases. Chagas and Guillame-Barre follow this pattern. If I can find sources to support this pattern, I will add a subsection and a qualifier for these conditions.
Discussion of Autoimmune/inflammation
I undid a revision this morning regarding the exclusion of Crohn's disease. My understanding of this page is that it's meant to be somewhat broad and inclusive (and alphabetical) to give the reader an index of autoimmune conditions. The more I read, the more blurred the distinction seems to become between "autoimmunity" and inflammation and myeloproliferation and even immunodeficiency. I'm working on an article that groups diseases by clinical symptoms (which might be more useful for diagnosticians and primary care people like me) but I wanted to keep this page intentionally broad as a meeting place for clinicians and basic scientists. As the dialog continues, the definition of "autoimmune disease" at the top of the article is likely to evolve. Please feel free to discuss....this page needs help! doctorwolfie (talk) 10:55, 25 July 2012 (UTC)
Aaron Abend (talk) 13:17, 1 June 2015 (UTC)In the latest version of "The Autoimmune Diseases" there is a discussion of the continuum between autoimmune and autoinflammatory diseases. At this time, the list of diseases with the "I" qualifier is incomplete. I am working on this.
I noticed that there was a little activity with regards to Histiocytosis; on further reading I'm assuming that the objection is that histiocytosis is more of a neoplastic process, so that it isn't any more "autoimmune" than leukemia. I've also noticed that we've got some immunodeficiency states listed; perhaps we should clarify in the opening paragraph (ie: what "autoimmune disease" ISN'T with appropriate link outs? Maybe something like:
==="Autoimmune disease should not be confused with either immunodeficiency(in which part of the immune system is simply absent) or myeloproliferative disorders (in which a neoplastic process occurs and the immune system primarily proliferates with admittedly some autoimmune-appearing collateral damage)" (Or am I overthinking this?)=== doctorwolfie (talk) 10:05, 27 April 2012 (UTC)
Although I'm not real happy with this section from Harrison's textbook of Internal Medicine, it seems that current thinking draws a distinction between Autoimmunity (there are frequently non-pathogenic auto-antibodies detectable in healthy individuals...not to mention ordinary the apoptosic process itself...which is "healthy self destruction") and Autoimmune disease (when the system gets out of balance. The presence of auto-antibodies can be misleading because they may occur primarily causing tissue self destruction (Diabetes Mellitus I), self stimulation (Graves disease), receptor blockade (myesthenia gravis), or may have been formed secondary to a cytotoxic reaction (anti-mitochondrial antibodies in primary biliary sclerosis). Furthermore by this model, type I hypersensitivity can be considered "autoimmune disease" because although the triggering antibody (IgE) is not self-directed, the over-enthusiastic response of the innate immune system definitely results in disease. Is there an online medicine Textbook that's widely used in Great Brittain? I would love to compare doctorwolfie (talk) 15:22, 9 November 2011 (UTC)
Alright. The merger tag directs here, so let's discuss it here.
I don't support a merger, for the important reason I mention on the Talk:Autoimmunity page, that not all autoimmunity is pathologic.
I would support relocating discussion of more disease-relevant topics to the Autoimmune Disease page from Autoimmunity, including the sections discussing Genetic Factors, Pathogenesis, Classification, Diagnosis, and Treatments. However, I would propose leaving general theoretical understanding of autoimmunity for the Autoimmunity page - leaving this page more clinical, and that page closer to theoretical.
At the same time, I would have to propose going back to the old separate list page for Autoimmune Diseases, since the comprehensive list itself is enormous, and includes many speculative associations in the current literature. The current proposals on this Talk page will probably continue indefinitely, leaving such a listing enormous - which is what it looked like before being merged into this page.
Alright, I've put a basic draft format of these proposed changes on my Userpages: User:Jbarin/Autoimmune_Disease_draft, User:Jbarin/Autoimmunity draft, and User:Jbarin/List of Autoimmune Diseases draft
Autoimmune should not be combined with Autoimmune Disease, but they should be linked to each other.
Autoimmune disease is a specific list of diseases, each of which has a specific definition, each of which has a specific diagnostic criteria, and which can only exist after the research is complete. This is more closely aligned with the legal definition of recognized diseases, which involves medical competency. That means this article needs to have input from a licensed physician.
Autoimmune is mysterious diseases process not understood by licensed physicians. This concept is more closely aligned with work that must be done before diagnostic criteria and legal definition exist. This has nothing to do with medical competencies, and involves university research or alternative medicine that fall outside the legal scope of a license to practice medicine. The body can have autoimmune reactions outside the scope of an autoimmune disease, such as Gluten Sensitivity that should be discussed with a dietitian and not a doctor (i.e.: someone with a medical license will add negative value to this kind of discussion).
This is an important distinction that will disappear if the articles are combined because these two articles must be edited by totally independent communities that have very different skill sets.Nanoatzin (talk) 02:15, 13 August 2011 (UTC)
- some people view them as instances of diseases of affluence.
- Who specifically an on what grounds ? Any references ?
____ Here are some references:
These are from a range of sources. Obesity is seen as contributing to diabetes and arthritis. Also the mechanisms of autoimune diseaeses is not well understood, whereas communicable diseases are.
For all of these reasons, I think it is reasonable to say that there are some who view auto immune diseases as examples of diseases of affluence. However, neither type is well understood. Maybe we need a new division of development medicine?
I would appreciate further views on this.
TonyClarke 01:28, 2 Jan 2005 (UTC)
Two points: 1. autoimmune diseases are on the rise. (Maybe because people are being cured of other stuff, and maybe just better diagnostics AMONG THE AFFLUENT) 2. Autoimmune diseases are more common under more "hygenic" conditions, ie too clean. Somehow, not being exposed to some agent in nature leads the immune system to react to self. (Sorry that's not coherent.) This was told to me by an autoimmune specialist; I'm sure I;ll find a reference if I get around to looking for it. 184.108.40.206 04:16, 9 May 2005 (UTC)
- Well, that sorta ties in with allergy and the hygiene thingie. See Allergy#The hygiene hypothesis. Alex.tan 10:49, 9 May 2005 (UTC)
- Just in case anyone ever reads this Talk page: Obesity contributes to Type 2 (non-immune-mediated) diabetes and osteoarthritis. "Worn-out pancreas from eating more than you need" and "worn-out joints from carrying all that weight" are not generally considered autoimmune diseases. 220.127.116.11 23:33, 19 October 2007 (UTC)
Like ... Duhh.
Autoimmune is a disease that only affects affluent people when you consider that the average diagnosis for Celiac disease takes 10 years and the test costs about $10,000 after a dozen physicians give you $pricey$ ulcer medicine that doesn't work. Only wealthy people can afford a diagnosis. Poor people have the same problems but they just don't know the name. About 10% of us are walking around with gluten antibodies and don't know it. About 1% of us have active intestinal disease that will cause osteoporosis and cancer if it is not diagnosed.
Proposal: Redirecting content to Autoimmunity
I'm going to bring this up for discussion here, and in the Talk:Autoimmunity page before setting to it. It's occurred to me that there's no discussion of the epidemiology of autoimmunity on that page, and that the discussion of it here actually works much better over there. So barring substantive objection, and rather than duplicate content, I'm going to relocate pretty much the entire introductory text from this article to the main Autoimmunity article. All in favor? Opposed? Jbarin 08:00, 8 May 2007 (UTC)
I sure from an autoimmune disease called Polymyositis
I sure frokm an autoimmune disease called polymyositis. I do not see it here in thw autoimmune disease listings.
The Muscular Dsytrphy Assosication has it listed on there webite with a very good explanation of it as well.
Adding a bit more information?
Does anyone mind if we expand the table of accepted autoimmune conditions to include the type of immune reaction, where known? I envision something that looks like this:
|Ankylosing spondylitis||yes||M08.1, M45.||B cell||is a chronic, painful, progressive inflammatory arthritis primarily affecting spine and sacroiliac joints, causing eventual fusion of the spine.|
|Aplastic anemia||no||D60||T8 cell||is often caused by an autoimmune attack on the bone marrow.|
|Celiac disease||no||K90.0||T8 cell, with antibody component||is a disease characterized by chronic inflammation of the proximal portion of the small intestine caused by exposure to certain dietary gluten proteins.|
|Crohn's disease||no||K50||T cell||is a form of inflammatory bowel disease characterized by chronic inflammation of the intestinal tract. Major symptoms include abdominal pain and diarrhea. There is also a theory that Crohn's Disease is an infectious disease caused by Mycobacterium avium paratuberculosis.|
|Goodpasture's syndrome||yes||M31.0||B cell||is a disease characterised by rapid destruction of the kidneys and haemorrhaging of the lungs through autoimmune reaction against an antigen found in both organs.|
|Graves' disease||yes||E05.0||B cell||is the most common form of hyperthyroidism, and is caused by anti-thyroid antibodies that have the effect of stimulating (agonist) the thyroid into overproduction of thyroid hormone.|
and so forth. Knowing something about the part of the immune system involved has implications for treatment. (For example, B cell diseases should be treatable with anti-B-cell rituximab.)
- I think your suggestion to add a new column is a good one, though I'd encourage you to include references for the type wherever possible. It appears that you're knowledgeable about the subject, but new to Wikipedia, so if you need help, an overview on citation is available at Wikipedia:Manual_of_Style_(medicine-related_articles)#Citing_medical_sources. And if you need any assistance, feel free to ask at my talk page. --Arcadian 00:34, 20 October 2007 (UTC)
While Myositis is a rare autoimmune disease, I think it should be included on the list. There are several forms of this disease - polyomyositis, dermatomyositis, IBM and juvenile dermatomyositis. The main symptoms are muscle weakness and extreme fatigue. In the dermatomyositis form the immune system attacks both the skin and the muscles (in some cases, this includes the lung and the heart). Because the disease is so rare, many doctors are unfamiliar with the disease and diagnosis can take a significant amount of time. In my case, I was lucky, I was able to go the National Institute of Health and Johns Hopkins. —Preceding unsigned comment added by 18.104.22.168 (talk) 23:11, 24 October 2007 (UTC)
I think we should include what body part is attacked and if known what pathogen or toxin is responsible for the immune response. I dont know if we need a complete description or any of that other scientific information you suggested, this is for memeber of the public npot doctors or scienitsts, they can look on the specific pages for that informaiton. Name of diease, part of body attacke, antigen and pathogen/ toxin responsible e, maybe sensityivy if this has some clinical bearing but this would have to be explained i,e. severity of disease. Maybe prevalnce information would be good. 1 in a million etc and if location specific then this too. --22.214.171.124 (talk) 19:42, 28 January 2009 (UTC)
That seems like it would be more appropriate for individual pages for each disease. This article is already threatening (again) to devolve into just another list, with little to no prosaic treatment of useful information. Jbarin (talk) 09:28, 27 October 2010 (UTC)
- I agree. Those conditions without sources should be removed, or at least bumped down. --Arcadian (talk) 20:08, 2 April 2008 (UTC)
Warm autoimmune hemolytic anemia as it is said on page for this disease is IgG conducted sometimes IgA, IgM antibody is used in cold autoimmune hemolytic anemia.Rakamijan (talk) 00:12, 23 April 2008 (UTC)
"Autoimmune diseases are a major cause of immune-mediated diseases." If you follow the link to immune-mediated diseases, it says that autoimmune disease are a subset of immune-mediated diseases. So the statement is like saying "green widgets are a major cause of widgets." That's hard to fathom. Unfree (talk) 22:30, 28 April 2008 (UTC)
My understanding is that autoimmune diseases are certainly a subset of immune mediated diseases. Type 1 hypersensitivity is hardly an autoimmune disease but is certainly an immune mediated disease.
Don't see how it MS meets the Milgrom/Witebsky criteria for being classified an autoimmune disease.
- I agree. The text (Hormone levels have been shown to affect the severity of some autoimmune diseases such as multiple sclerosis) is not relevant. In nearly one year no defense has been made. I have removed it.--Juansempere (talk) 12:08, 2 October 2009 (UTC)
- It was written that MAG is identified as MS molecular target, which is false. I have moved MS from "Confirmed" to "Suspected", adding a reference to an article that explains the molecular complexity of the immune response. --Juansempere (talk) 11:47, 2 October 2009 (UTC)
- There's no link from the MS listing. We can debate ad nauseum about the validity of labelling individual diseases as autoimmune, MS is probably one of the more popular examples. It's probably going to be more efficient if we agree on a single (or very limited) secondary sources -- there's plenty of non-consensus throughout the field, which is clearly impacting this article. Jbarin (talk) 21:00, 1 November 2010 (UTC)
It is innapropiate from my point of view to restrict autoimmune diseases to the hard core criteria like those used here. The article seems to have been based on this list and later other stuff were added with difference sources. The source is clear as to what it considers as autoimmune, which is: Disorders that are characterized by the production of antibodies that react with host tissues or immune effector cells that are autoreactive to endogenous peptides. The second part of this definition seems to give place to inflammatory diseases without a known autoantibody, but the list fall short. From the same line, the Milgrom-Witebsky criteria is too problematic in the context of this article intended for the general public.
For those reasons, I believe the list should include 'disease which is generally believed to be caused by an autoimmune reaction.' It is much less restrictive and is in the same line, which will include inflammatory diseases without directly known autoantibodies or 'proof' of direct result from cell injuries caused by immune attack. Besides, sometimes the association found between an anti-body and a disease does not mean the antibody is responsable of the disease. Hashimoto encephalopathy is not caused by anti-thyroid antibodies, neither is Crohn caused by anti-Saccharomyces cerevisiae. Those may be findings confirming diagnosis but this shows the difficulty in classifying autoimmune only the conditions which are associated with certain antibodies. Even in the cases of Lupus, high titer for antinuclear antibody does not mean that those antibodies cause the disease. They are simply lab findings.
I took the task to rewrite and expend the article, I'll be working on it here, it would help to have some input from editors on the appopriare definition and if they are in agreement.
Also, mixing suspected autoimmunity like in the case of schizophrenia with conditions which are generally agreed to be autoimmune is not a good idea. Both suspected and generaly recognized should have their independent list. Any comment? Inductionheating (talk) 06:59, 26 November 2008 (UTC)
I'm curious I did not see Chrohns on the list. In my reading at the CCFA website they seem to saying the disease is auto-immune with a strong link to some of the same genetic markers noted in the article. I'd like to see it added I'm not a doctor just a 40 year chronie survivor. WarLord (talk) 08:56, 3 January 2009 (UTC)
- Hi, I notice that you tie autoimmunity to hypersensitivity. Not all diseases frequently listed as autoimmune show hypersensitivity. There is another major cause for the immune system to attack healthy cells: poor targeting. How do you see this? Guido den Broeder (talk, visit) 18:20, 23 May 2009 (UTC)
This is for anyone who has any questions or doubts...
Anyone who has any questions or doubts about the validity of the diseases listed as accepted autoimmune disorders should check with The American Autoimmune Related Diseases Association at the following link: .
They are one of the official authorities on the matter, their research is posted from the researchers and doctors as it is being done, and have they have a complete list of accepted diseases, which is updated as their understanding of them changes.
You can get information from them, regular updates, participate in surveys - which I strongly encourage you to do, especially if you have more than one member in your family with an autoimmune disorder, because every piece of information gathered helps lead to a greater understanding of how these diseases work.
It's not just environmental, it's not just genetic, it's not just anything; it's a combination of all that's going on, and as our world is accelerating and everything is becoming so much more accessible so much faster and things are in contact in ways they never have been before, it is going to take time and contribution on everyone's part to piece the puzzle together.
What about Pyoderma Gangrenosum?
After reading the included list of autoimmune diseases, I noted the omission of Pyoderma gangrenosum. As a person and physician who has had this condition in addition to Crohn's and Psoriasis, I can attest to it's membership within this group. I don't want to edit the page personally but simply suggest its inclusion in the list of disorders since it typically only responds to those treatments like TNF inhibitors and immune system suppressors prescribed for other major autoimmune disorders. I can't currently quote it's prevalence among the population. Reb3csc (talk) 02:41, 19 September 2009 (UTC)
What about lupus? Surely this is the worst form of autoimmune disease, since the immune system can affect the body in general? I am not a qualified medical doctor so I would not like to alter the article, but if any one more medically informed than me can help here, that would be appreciated. ACEOREVIVED (talk) 21:34, 11 January 2010 (UTC)
There are many systemic autoimmune diseases, many of which have near identical or overlapping sets of symptoms to Lupus, so it makes no sense to suggest that some are worse than others.Anonymous watcher (talk) 12:29, 3 November 2011 (UTC)
- I think many of us share your frustration: the field itself needs a bit of cleanup; in the meantime clinicians are stuck trying to answer patients' questions without having answers that are very satisfying. However it is comforting for some people (ie: discoid lupus or mixed connective tissue disease) to hear that they're not as likely to develop kidney failure. The classification system with all its faults just helps us give a general idea to patients so that they can have some idea about what to expect. Wish I could do more doctorwolfie (talk) 10:25, 5 November 2011 (UTC)
Please add Celiac Disease
Please add Celiac Disease to the list of autoimmune diseases. Apparently it is the only autoimmune disease for which the trigger is known, i.e. gluten. —Preceding unsigned comment added by 126.96.36.199 (talk) 13:15, 17 June 2010 (UTC)
Please fix table where Cattleman's and Celiac Disease are stuck on right side
Cattleman's and Celiac seem to be in a row of another disease instead of having their own rows.
Ulcerative coliti is listed as "Accepted", yet the article on UC states: "Although ulcerative colitis is treated as though it were an autoimmune disease, there is no consensus that it is such." —Preceding unsigned comment added by 188.8.131.52 (talk) 18:02, 2 March 2011 (UTC)
I agree with the proposed merge, as I believe it is better to deal with the concepts in context. I have already merged systematic autoimmune disease and Witebsky's postulates here, because that made more sense. Autoimmunity will be harder, because it has quite a lot of technical content that needs to be made accessible.
This is a beautifully organized article that really spells out the sequence of discoveries. I think it's probably a bit more relevant for basic research people; so maybe it should stay intact. I've been working with the Autoimmune disease page and have been trying to steer it more toward clinical information. Cross-linking the pages might be an interesting solution (basic scientists strive to understand what's going on, and need access to details; clinicians frequently just need to know what test to order, and may only be marginally interested in the underlying mechanisms....sad to say) :( doctorwolfie (talk) 11:39, 22 October 2011 (UTC)
Scouring through some recent literature:
Signs & Symptoms
The signs and symptoms category is usually found on a disease page. Look at the wikipedia page for cancer. Although the signs and symptoms for autoimmune disease can be very different depending on the type I believe there are some symptoms that could be considered to be frequently associated with autoimmune disease, fatigue being one.
Here's a link to a website that covers what I am talking about. http://women.webmd.com/features/life-with-autoimmune-disease
"As the disease develops vague symptoms start to appear, such as joint and muscle pain (very common), general muscle weakness, possible rashes or low-grade fever, trouble concentrating, or weight loss. More specific signs can point toward something being wrong: numbness and tingling in hands and feet (also common), dry eyes (common), hair loss, shortness of breath, heart palpitations, or repeated miscarriages can also be caused by an autoimmune response." — Preceding unsigned comment added by 184.108.40.206 (talk) 20:20, 8 May 2013 (UTC)
- Trouble is, most of those symptoms are very non-specific. It would be a big mistake to suggest that someone with these symptoms is definitely suffering from an autoimmune disease. JFW | T@lk 21:56, 30 October 2013 (UTC)
This paper was retracted in July 2014. The authors were unable to reproduce the phenomenon. Narcolepsy will be classified as "possible" but not "probable" autoimmune disease. Aaronabend (talk) 00:02, 28 January 2015 (UTC)
Harold Ramis & autoimmune inflammatory vasculitis
According to this Chicago Tribune article, Mr. Ramis died of complications of "autoimmune inflammatory vasculitis": http://www.chicagotribune.com/entertainment/chi-harold-ramis-dead-20140224,0,2259309.story . With more people becoming aware of his death, there will surely be WP queries, but I don't find the term here in this article. Is it a case of "also known as..."? If so, maybe a such a mention will help lay persons to answer their questions. Thank you, Wordreader (talk) 19:03, 24 February 2014 (UTC)
Autoimmune Disease Updated Listing and Categorization
I am preparing a revised list of autoimmune diseases. The revised listing will retain all disorders currently listed with all sources. I will be adding the following:
1. I am going to categorize the diseases to organize by Organ/Tissue type/system. I will include either a special category for "systemic" diseases that affect multiple organs, or, possibly, list diseases that affect more than one organ multiple times with an indicator. Note that some diseases that affect tissue types, rather than specific organs, will be listed under that tissue type. 2. I will include synonyms and subtypes, and try to make clear the relationship between these terms. 3. I will be filling out the Level of Acceptance field for each disease (see the talk section on Level of Acceptance).
Below is the categorization I am planning to use:
- Major Organs
- Adrenal Gland
- Thyroid Gland
- Reproductive Organs
- Salivary Glands
- Digestive System
- Tissues & Systems
- Connective Tissue, Systemic, and multi-organ
- Nervous System
- Vascular system
- Autoimmune Comorbidities (e.g., Reynauds)
- Bacteria Triggered Autoimmune Syndromes (e.g., Lyme)
- Not Autoimmune (e.g., Contact Dermatitis - I cannot find anything to support this disorder being autoimmune)
I am new to editing Wikipedia - suggestions and comments welcome. Thanks.
- Aaronabend The classification will hopefully make the list easier to handle for readers, but is it based on a recognised system (e.g. mono- vs polyglandular autoimmunity)? This will strengthen the system.
I have explored a number of classification options. I am considering copying the SEER system used in the US for cancer stats. Any thoughts on this approach?Aaron Abend (talk) 15:27, 4 February 2015 (UTC)
- I am happy to include "not autoimmune" but we will need a very strong WP:MEDRS-compatible source each time that states clearly that a condition is really really not an autoimmune condition. JFW | T@lk 23:22, 28 January 2015 (UTC)
Level of Acceptance
I plan to indicate the Level of Acceptance for each disease using the following levels:
- Strong: Published papers (primary sources) and textbooks (secondary sources) regard the disease as autoimmune
- Moderate: Published papers point consistently to the disease being autoimmune and there is consensus
- Limited: Some published papers show disease is autoimmune but research has not been be consistently reproduced, there is no clear consensus, or is otherwise controversial
- Comorbidity: A condition common among people with autoimmune disease, but with no evidence of being itself caused by autoimmunity
- Non-autoimmune: The disease is not autoimmune but due to naming issues, misunderstanding of autoimmunity, or other reason, the disease is thought by some people as autoimmune (e.g., many people think AIDS is an autoimmune disease)
In applying these criteria, with reference to the concept of penetrance cited elsewhere on the talk page, I plan to add an asterisk next to any disease that is generally believed to be caused by autoimmune disease some of the time. That is, the evidence is strong or moderate, but not all cases of the disease are caused by autoimmunity. Aaron Abend (talk) 17:24, 6 February 2015 (UTC)
Diseases currently listed as "Accepted" will be, by default, labeled "Moderate". I will then check each disease page for secondary sources and, if they are on the disease page, I will move the disease to "Strong". Conversely, if I cannot find good primary sources indicating the disease is autoimmune, I will relegate it to Limited or, if there is no mention of autoimmunity in the disease page, Non-autoimmune.
I believe all supporting reference to each disease being autoimmune must be included in the disease page. I do not think diseases should be categorized as Autoimmune in this list (even with supporting references) if a person clicks on the link to the disease name and finds no mention of autoimmunity. Aaronabend (talk) 13:16, 30 January 2015 (UTC)
MeSH as a criteria for Acceptance
I have noticed that appearance in the hierarchy of MeSH terms that is headed with Autoimmune Diseases ([C20.111]) is a qualification for assignment as 'Accepted'. Do people believe this is, by itself, a sufficient qualification for regarding a disease as autoimmune? Do people think that should be regarded as "strong" or "moderate" evidence of a disease being autoimmune? Aaron Abend (talk) 20:58, 1 February 2015 (UTC)
- Aaronabend Not an unreasonable thing to say. Unfortunately there is no authoritative or consensus body for this (compare primary immunodeficiency, where an acceptance process exists). JFW | T@lk 10:02, 4 June 2015 (UTC)
"Penetrance" for autoimmune disease
In genetics, Penetrance is the percentage of individuals with genes that are known to cause a specific disease who actually suffer from that disease. In autoimmune disease, there are diseases, such as Addisons, that can be caused by autoimmunity or a virus or something else. Does anyone think we could figure out the values for this concept of penetrance in autoimmunity, or or is it something that should be stated upfront as relevant to all diseases? Aaron Abend (talk) 21:03, 1 February 2015 (UTC)
Clarification on evidence
I just discovered a book, "Epigenetic Contributions in Autoimmune Disease", by Esteban Ballestar, which lists "Autoimmune immunodeficiency" as an autoimmune disease. It references a list of diseases on the website for my organization, AARDA. There is no substantiation for this disease anywhere. I have been discovering other "circular references" and will be making my best effort to remove such diseases from this list completely, or at least moving them to the list of diseases determined to be "Not Autoimmune".
I want to distinguish this class of evidence from that for a disease like Coxsackie myocarditis. This also has few solid references. In these cases, I am using the following criteria: 1) the disease has no other known cause, and 2a) it follows a pattern similar to other autoimmune diseases, such as episodic flare-ups, prevalence in women, or 2b) it is comorbid with other autoimmune diseases that themselves have Moderate or Strong evidence of autoimmunity. Where there is weak "circumstantial" evidence, the disease will be classified as Limited, L - meaning that the evidence is not just limited, but "very limited".Aaron Abend (talk) 14:30, 14 February 2015 (UTC)
Confusion over the term Autoimmunity
I have found a number of diseases in this list that have no evidence of autoimmunity, but where autosomal dominance or the autonomic nervous system are featured prominently. In such cases, I have to assume that somewhere along the way, someone has conflated autoimmunity with these other biological terms. I will classify these diseases as Not Autoimmune and mention that that this is a possible source of the historical miscategorization.
Blau Syndrome, an autosomal dominant condition, falls into this category, though it could, be categorized as "Limited, L" due to comorbidity with known autoimmune diseases. However, in the case of Blau, the only article that connects Blau to autoimmune disease was this list - and a study that looked for a connection between Blau and autoimmunity concluded "There is minimal evidence for autoimmunity and systemic inflammation." Aaron Abend (talk) 14:55, 14 February 2015 (UTC)
Categories versus Alpha Listing
I have reorganized this list to categorize, to the extent possible, by biological system. This is problematic for 2 reasons. Many autoimmune diseases affect more than one system, and in some cases, there are multi-system diseases (the polyendocrine diseases, for example). The alphabetic listing, however, made it hard for someone to see if their disease was included. So many of these diseases have multiple names (and in some cases, it is still not clear if some of these eponymous disease names are real or just random variations of more common diseases.
I would like feedback on this categorization. It would be great if wikipedia could allow sorting by alpha and by category but I could not figure out how to do it. It would not be hard for me to recast this alphabetically, along with the new references and ICD9 codes, etc. but I am not going to do that unless there is a compelling reason to do that. Another option would be to set up an alphabetic list in a section on this page with intra-page links into the categorized list (we could also reverse that approach - using alpha as the primary organization and providing a categorized list with links into the alpha list).
I have added ICD-9 codes to this list. It is challenging, of course, because not all of these conditions have an ICD-9 code. In cases where there is no specific ICD-9 code, the disease may, in practice, be coded with the "Not Elsewhere Classified" or "Unspecified" for the biological system (e.g., 377.30: "Optical Neuritis, Unspecified") along with 279.4: "Autoimmune Disease, Not Elsewhere Classified".
I am planning to add the ICD-10 codes next. Suggestions welcome as to whether we need both. I believe we do, since the mapping from ICD-9 to ICD-10 is not always possible from what I have seen. Aaron Abend (talk) 13:39, 1 June 2015 (UTC)
JCI review series
The "pathophysiology" section was started. There's lots more that needs discussing (e.g. HLA) but I am particularly puzzled by the fact that we have an entire section on glycation based on a single recent review from a single centre proposing a new paradigm (doi:10.1016/j.jaut.2014.12.002). Does it deserve that level of emphasis? JFW | T@lk 14:20, 24 June 2015 (UTC)
- Diamond B, Lipsky PE. Chapter 318. Autoimmunity and Autoimmune Diseases. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J, eds. Harrison's Principles of Internal Medicine. 18th ed. New York: McGraw-Hill; 2011. http://www.accessmedicine.com/content.aspx?aID=9136333. Accessed November 8, 2011