ARTICLE dominance ( 80-99 %) with age of onset ranging from 32-44 years . 1 The prevalence of SADs ranges from 5-9 % in the general population , with UCTD incidence ranging from 14 to 140 per 100,000 people annually . 5 Autoimmune diseases present significant clinical issues due to their chronic nature and impact on healthcare costs . 3
No treatment guidelines are currently available for UCTD . 6 Treatment aims to avoid progression to a defined connective tissue disease ( CTD ) with severe organ involvement , which occurs in 30 % of cases within 3-5 years . 7 Conventional management includes NSAIDs , antimalarial drugs ( hydroxychloroquine ), corticosteroids and immunosuppressants , which can produce undesirable side effects such as osteoporosis , muscle weakness and increased susceptibility to infection . 8 Naturopathically , autoimmune treatment involves removing disturbing factors and implementing strategies targeting anti-inflammatory , antioxidant and immunomodulatory mechanisms . 9
Case Report
In this case report , the patient has been de-identified for confidentiality . The patient has given consent for the deidentified report to be published .
Presenting Complaint ( PC ) The patient , a 54-year-old semi-retired Caucasian woman , presented with UCTD diagnosed two years previously by an immunologist . Onset was described as dull body aches / pains and extreme fatigue , with rashes on her extremities and swollen , painful joints . Symptoms commenced after a period of high stress which involved losing both parents , a heavy workload and family health issues . Symptom flares occurred weekly and presented as body aches / pains , headaches and fatigue , rendering her bedridden for three days , with subjective flare severity graded 10 / 10 . Flare onset signs included sore throat , fatigue and diarrhoea . Times of high stress , exertion and assaults on the immune system , such as enteric or respiratory infection , triggered significant flares .
Conventional treatment to manage her symptoms included 300mg hydroxychloroquine ‘ Plaquenil ’ daily , controlling the rashes and swelling but not preventing flares , with several side effects including dry eyes . Corticosteroids were used to manage acute severe flares .
Concomitant recurrent tinnitus was present , with episodes daily . Digestive symptoms of bloating , flatulence , loose stools and nausea were present , with gluten a noted trigger . Osteopenia was present , treated with vitamin D3 / K2 supplementation ( 1000IU vitamin D daily ).
Exercise was limited as ‘ crashes ’ often occurred afterwards . The patient felt well supported by her husband but had substantial emotional stress with her children and siblings . She had recently started a business which caused significant stress and triggered several flares , but she felt it necessary for her sense of purpose .
Medical History Her medical history included chronic sinusitis , resolved through sinus surgery two years previously , and frequent colds and flu that subsided following surgery . A substantial history of emotional trauma and anxiety was managed with 20mg Cipramil , an SSRI , daily . Breast cancer diagnosis eight years before her first naturopathic consultation resulted in double mastectomy and breast reconstruction , with silicone implants triggering autoimmune / inflammatory syndrome induced by adjuvants ( ASIA ). The implants were removed 12 months before her first naturopathic consultation in an attempt to relieve her symptoms , with flares decreasing seven weeks after removal . Tamoxifen treatment following breast cancer induced early menopause six years ago with only mild symptoms . Her family history included anxiety , stroke and Alzheimer ’ s disease paternally , and lung , liver and bladder cancer maternally . Both children , now adults , had mental health issues , aggravating her stress .
Diet The patient ’ s diet was poor , largely due to poor appetite , often skipping meals and relying on coffee with cow ’ s milk and sugar . She had 1-2 meals a day consisting of animal-based protein and vegetables , often microwave-steamed , or salad . Gluten was generally avoided as it had been identified as a symptom trigger , but dairy , refined sugar and caffeine featured frequently . Water intake was minimal , 1-2 glasses daily , and alcohol , in the form of wine or champagne , was consumed regularly , despite being a noted trigger for flares .
Relevant Physical Examination and Pathology Results Physical examination revealed poor turgor , indicating dehydration , but good capillary return and strong pink conjunctiva , suggesting adequate iron levels . Nails were flaking with white spots present , indicating several nutrient deficiencies . Her tongue was cracked with a thick rear coating , suggestive of poor connective tissue integrity , food sensitivities and nutrient deficiencies . Iridology showed signs of lymphatic congestion , inflammation , digestive insufficiency , food sensitivities and weakness in the adrenal glands , thyroid , liver , pancreas , kidneys and colon . Relevant pathology results are outlined in Table 2 .
Table 2 . Relevant pathology results . 10
Pathology Result Low protein levels
High cholesterol and triglycerides
High ferritin
Low vitamin D
Elevated vitamin B12
Elevated C-Reactive Protein ( CRP ) and Erythrocyte Sedimentation Rate ( ESR )
Negative ANA ( Antinuclear Antibody )
Positive SCL-70
Positive EBV IgG
Clinical Significance Indicating malnutrition
Common in postmenopausal women and with steroid-use
Indicating inflammation
Deficiency common in autoimmunity
Indicating potential methylation issues
Indicating both acutephase and chronic inflammation
Generalised serological autoimmune marker
Biomarker for scleroderma
History of Epstein-Barr virus ( EBV )
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