Thread by @genderlogindia

Speaking of conditions that affect women disproportionately, most autoimmune diseases are very under diagnosed and under reported in India. AD is an umbrella term that includes many different diseases that can present with myriad symptoms.

https://twitter.com/genderlogindia/status/1026918831304921088

Globally the incidence of autoimmune diseases is increasing steadily, for a variety of reasons. Some theories include significant changes in western dietary habits, environmental surroundings and pollution exposure, infectious habitat and stress load.

pubs.sciepub.com/ijcd/3/4/8/

In India until recently, autoimmune diseases were thought of as a 'western problem' attributed to hereditary aspects and Vit D3 deficiency. Many ADs are idiopathic (i.e. unknown cause) but studies now point to a combination of genetic, environmental, and infectious factors.

Because of higher awareness, and better diagnostic and screening tools, the incidence of ADs in India are increasing too. The most commonly seen are rheumatoid arthritis (in women) and ankylosing disorders (in men). The third most common is lupus (SLE).

telegraphindia.com/1160131/jsp/7d…

Because the symptoms of autoimmune diseases can be so vague and fleeting (and widespread, depending on the disease) getting a diagnosis takes years! Patients are often referred from one doctor to another or sometimes dismissed as psychosocial disorders.

https://twitter.com/pubhealthind/status/1027371057043238914

Most ADs have no cure, per se, but treatment and medication can make symptoms manageable. Unfortunately many people end up with severe complications and sometimes permanent disabilities that could have been prevented with early detection and treatment.

rcshea.com/blog/2018/01/a…

The sex differences in ADs range from modest to strong across different countries and is attributed to many reasons including hormones, and child bearing capacity. It's hypothesized that the potential for immune changes in pregnancy could make some people more susceptible to ADs.

ADs include such a wide variety of different diseases, like Type 1 diabetes, Multiple Sclerosis, Crohn's disease, Guillan-Barre Syndrome, that their individual symptoms are very different, but they share some common early signs that occur as recurrent episodes.

Research on ADs in India is scarce but globally the disease burden of living with ADs is very high. As most of them are incurable chronic diseases, they involve a lifetime of medication, testing, doctors visits, all of which can add up financially.

managedcaremag.com/archives/2016/…

Additionally there is very little social support in India for people with 'hidden disabilities'. They're often dismissed as hypochondriacs or attention seekers. Chronic pain or fatigue is often passed off as normal and not a big deal, especially in women.

I was diagnosed with an autoimmune disease earlier this year and the first thing I felt was relief. That I was crazy, or imagining things. Finally I had a reason for feeling the way I felt. The second feeling, of course, was panic about how much all of it was going to cost 😖

I am really lucky though because being a neuromuscular physiotherapist I've seen lots of patients with autoimmune diseases and I recognised all the signs in myself. It still took me a whole two years to stop gaslighting myself and go to a doctor 🙃

Erm anyway. Nearly 30-40 lakh Indians apparently have ankylosing spondylitis. It usually affects younger men in the spine, but it can spread to other joints, leading to severe back pain, stiffness, hunched posture due to fused vertebrae ('bamboo spine').

business-standard.com/article/news-a…

From the limited studies done on Rheumatoid arthritis in India, it appears to be more common in rural than urban populations. More common in women, it causes stiffness, swelling, pain in small joints especially hands. Long term it can lead to deformities.

onlinelibrary.wiley.com/doi/full/10.11…

SLE is the 3rd most common autoimmune in India but very rarely talked about except by fans of House M.D. >90% are women between 15 and 45y, and can affect multiple organ systems, and episodes could be triggered by many everyday activities.

timesofindia.indiatimes.com/life-style/hea…

India accounts for most of the children with T1DM in South-East Asia. T1DM unlike the better known Type 2 has sudden onset usually in childhood or early adolescence. Some studies show higher prevalence in children of lower socioeconomic background.

ncbi.nlm.nih.gov/pmc/articles/P…

The incidence of Multiple Sclerosis in India keeps increasing significantly with increased access to MRIs and awareness. It was almost unknown until the 60s. MS commonly shows loss of vision, fatigue, pain, impaired coordination, heat intolerance.

ncbi.nlm.nih.gov/pmc/articles/P…

Guillan-Barre Syndrome was found to be more common during winter and often with a predisposing or associated infection (most commonly gastrointestinal and upper respiratory tract). GBS usually starts as tingling in the feet and legs that spreads upwards.

ncbi.nlm.nih.gov/pmc/articles/P…

Thyroid disorders affect 42m Indians! Even post iodization 23% of children were found to have goitre which could possibly be explained by autoimmune thyroiditis (Hashimoto's thyroiditis and Grave's disease).

ncbi.nlm.nih.gov/pmc/articles/P…

India has the highest prevalence of IBD in South Asia. Ulcerative colitis is more common in North India and Crohn's is more common in South. The form seen in India is generally less severe than in the west.

ncbi.nlm.nih.gov/pmc/articles/P…

Autoimmune diseases show a strong tendency to cluster in families. What's less commonly known is that familial autoimmunity *doesn't necessarily have to manifest as the same condition*. One family could have a diverse bunch of ADs that seem totally unrelated.

People with autoimmune diseases are also prone to polyautoimmunity or multiple autoimmune syndrome (defined as 3 or more ADs). Some conditions are more likely to occur together, like MS and ankylosing spondylitis in men.

ncbi.nlm.nih.gov/pmc/articles/P…

Finally here's some really cool art by a really cool person with myasthenia gravis ✨

https://twitter.com/perfecthannah/status/1005686305479712768