Autoimmune vs Autoinflammatory: What‘s the Difference? Conversation with Dr. Apostolos Kontzias

Welcome to AiArthritis Voices 360.This episode join your host, Tiffany, and special guest Dr. Apostolos Kontzias from the Center of Autoinflammatory Diseases, as they discuss the distinction between these two sides of the immune system, and the diseases that stem from them. Inconclusive laboratory results, a shortage of experts in the field, and poor understanding of these conditions can cause diagnostic delays, leading to poor outcomes. This confusion also causes patients with adult onset  diseases become a forgotten subgroup within the AiArthritis community.

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AiArthritis Voices 360 is produced by the International Foundation for Autoimmune and Autoinflammatory Arthritis. Visit us on the web at www.aiarthritis.org/talkshow. Find us on Twitter, Instagram, TikTok, or Facebook (@ifAiArthritis) or email us (podcast@aiarthritis.org).

 

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Show Notes: Episode 3 – “Autoimmune vs Autoinflammatory”

 

00:52 – Tiffany welcomes listeners

01:49 – This episode will explain autoimmune vs autoinflammatory arthritis

02:41 - “Auto” in both terms means immune mediated 

03:13 - This will be an ongoing discussion beyond today’s episode

04:29 - Tiffany welcomes special guest, Dr. Apostolos Kontzias

05:24 - Dr. Kontzias’ credentials

07:40 - Dr. Kontzias explains the distinction between autoimmune and autoinflammatory, which both stem from the immune system, just different sides (“innate” vs “acquired”)

09:00 - Autoinflammatory patients usually lack laboratory markers for autoimmune disease - despite inflammatory symptoms - which can cause a diagnostic delay 

09:23 - Both autoimmune patients and autoinflammatory patients can present with arthritis and other common features (fatigue, varying degrees of fevers)

10:16 - Autoinflammatory syndromes are innate (of unknown cause, from the primal part of the immune system) and thus can present early in life, but some do not present until adulthood

11:42 - Either type of immune response may be initially triggered by environmental factors, but also environmental factors can trigger disease activity

12:12 - Viral infections can trigger autoinflammatory syndromes

12:25 - Menstruation can trigger increases in symptoms for female patients for either type of disease

12:55 - Some conditions “bridge” the two types and can have features of both adaptive and innate immunity.  

14:14 - By definition, patients with autoinflammatory conditions have an immune system that does not recognize the patient’s own structural components of their cells

15:17 - Fevers and rashes are often markers for autoinflammatory conditions.  General markers for inflammation without laboratory results that support traditional autoimmune diagnoses are also predictive of autoinflammatory conditions

17:37 - Tiffany thanks Dr. Kontzias for his time

18:37 - IFAA working on designing informational brochure about Stills Disease based on patient input

19:28 - Patients report that there are differences between pediatric and adult Stills Disease even though scientifically they are the same 

20:34 - Adults have extreme difficulty receiving accurate diagnosis for Stills Disease because the medical community only considers it as a plausible diagnosis for children

21:02 - IFAA wants to shine a light on those with adult onset autoinflammatory conditions because they are often a forgotten subgroup within our community

22:36 - Tiffany points out that there are so many patients who are told they do not have a problem because they do not have the positive lab results or biomarkers, including autoimmune (not specific to autoinflammatory, requires further discussion)

23:22 - Dr. Kontzias and IFAA want all medical professionals to listen to patients

24:13 - What else do you need to understand to help with your journey?  Submit responses at www.aiarthritis.org/podcast

24:19 - If you are a medical professional, we want to hear your ideas on how we can help people understand these diseases better and lead to earlier detection or better disease management. Submit responses at www.aiarthritis.org/podcast

25:09 - Tiffany thanks listeners for tuning in to learn more about the difference between autoimmune and autoinflammatory diseases.