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Medical experts say autoimmune disease is not curable but symptoms can help manage the condition.

A 25-year-old Singaporean preschool teacher named Nurul Jannah Mohd Nasri ended her wedding day in the hospital after a week of experiencing what she thought was a regular migraine behind her left eye.

Jannah initially thought seeing a gray pixelated line in the middle was just her vision going blurry. It only got worse when the vision in her left eye worsened, and her head would not stop pounding. She asked her newly-wed husband, 27-year-old marketing executive Zamani Razali, to excuse herself to rest in their hotel room.

"I was starting to get worried that I would be unable to fly the next day for my honeymoon [in South Korea] if I was still unwell," she told The Straits Times. "My husband urged me to visit the doctor to get medication."

She was taken to National University Hospital (NUH) by her parents to be checked by eye specialists, who told her she was experiencing optic nerve inflammation, which could cause blurred vision. Doctors also told her she needed to be hospitalized immediately to prevent her symptoms from worsening.

Jannah said she felt bad for Zamani as they had saved and planned for their honeymoon but was repeatedly assured by her husband her health came first.

After undergoing multiple procedures to confirm what was causing the inflammation, including CT and MRI scans, lumbar puncture, and blood tests, a neurologist told her she might have myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease.

MOG antibody disease is a recently recognized autoimmune inflammatory disorder targeting the central nervous system. NUH neurology division senior consultant Dr. Amy Quek said the inflammation primarily targets the optic nerve, spinal cord, and/or brain during an attack.

Patients with an autoimmune disease could experience different symptoms depending on which area was being targeted.

What is Autoimmune Disease?

According to Johns Hopkins Medicine, an autoimmune disease happens when the body's natural defense system cannot distinguish between one's and foreign cells, causing the body to attack normal cells mistakenly.

More than 80 types of autoimmune diseases affect a wide range of body parts.

Jannah's autoimmune disorder is classified as optic neuritis, which means she and other patients may experience vision blurring or loss. Spinal cord inflammation, on the other hand, could result in limb weakness, numbness, and disturbances in urinary or bowel function.

As for brain involvement, Quek said it could result in symptoms like confusion, headaches, vomiting, speech problems, weakness, and seizures. She added the occurrence rate of the disease is unknown as it is a relatively uncommon and newly-recognized neurological disorder.

Other common autoimmune diseases in women include rheumatoid arthritis, psoriasis, psoriatic arthritis, lupus, thyroid diseases like Graves' disease, and even type 1 diabetes.

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Main Cause of Autoimmune Disease?

The blood cells in the body's immune system help protect against antigens or harmful substances like bacteria, viruses, toxins, cancer cells, and external blood and tissue. The immune system produces antibodies destroying the antigens entering the human system.

When a person has an autoimmune disorder, the patient's immune system does not distinguish between healthy tissue and potentially harmful antigens, resulting in a bodily reaction destroying normal tissues.

While researchers have no idea what causes autoimmune disease, several theories point to an overactive immune system attacking the body after an infection or injury.

Nevertheless, certain risk factors increase the chances of developing autoimmune disorders, such as genetics, weight and how one manages it, and smoking.

Another theory indicates that some microorganisms or drugs may trigger changes that confuse the immune system. Orbai explained certain medications or antibiotics could also be a factor causing autoimmune disease, especially if they can trigger drug-induced lupus, which is often a more benign form.

Common Symptoms of Autoimmune Disease?

Despite the varying types of autoimmune disease, many share similar symptoms, such as fatigue, joint pain and swelling, skin problems, abdominal pain or digestive issues, recurring fever, and swollen glands. An autoimmune disorder may also result in the abnormal growth of an organ or changes in its function.

"There are different degrees of autoimmune disease," said Dr. Ana-Maria Orbai, a rheumatologist at the Johns Hopkins Arthritis Center. "The symptoms a person gets likely relate to multiple factors that include genetics, environment and personal health."

After her diagnosis, Jannah realized why she felt tired and sleepy almost daily despite having sufficient rest.

"My students caught me falling asleep in class a few times, and I would get tired more easily when I was out," she added.

How Can One Be Diagnosed with Autoimmune Disease?

It can be hard to diagnose an autoimmune disorder, especially in its earlier stages, and if multiple organs or systems are involved. Healthcare providers will need to physically examine those suspected to have autoimmune disease, such as antinuclear antibody (ANA) tests, autoantibody tests, and complete blood count. Other tests include a comprehensive metabolic panel, C-reactive protein, erythrocyte sedimentation rate, and urinalysis.

Orbai added it is also hard to get diagnosed with an autoimmune disease, especially for women, as there is no single test to diagnose autoimmune disease.

"You have to have certain symptoms combined with specific blood markers and in some cases, even a tissue biopsy," she added. "It's not just one factor."

As much as common symptoms for autoimmune disease are difficult, so is diagnosing it because the symptoms could come from other common conditions. Orbai emphasized that women should seek treatment when they notice new symptoms as soon as possible.

Is Autoimmune Curable?

There are no cures or known disease prevention. Still, treatments and medication are available to manage the condition, control the autoimmune process, and maintain the body's ability to fight the disease. Treatments would depend on one's disease and symptoms, which include surgery and blood transfusions if the blood is affected. Physical therapy and supplements are also available to reduce the symptoms of autoimmune disease.

Jannah takes daily medication to manage her symptoms. "I hope that despite living with this condition, it won't hinder me from having children, as having my own family is a dream for me," she added.

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