Across outpatient clinics in India, a rising number of patients report rashes, itching, sinus congestion, chronic fatigue or swelling — complaints often dismissed as “allergies.” But internal medicine specialists are now warning that a surprising proportion of these routine symptoms may actually be the earliest signs of autoimmune diseases . The overlap is so convincing that many individuals spend months or even years treating allergies they never had.



Autoimmune disorders occur when the immune system mistakenly attacks the body’s own cells, while allergies are exaggerated reactions to external triggers like pollen or dust. Yet in the earliest stages, the two can look deceptively alike. Skin inflammation, breathlessness, swelling, and persistent tiredness often get mislabelled as seasonal allergies, especially in high-pollution regions where patients assume, “It must be the weather.”



Why the confusion happens

Autoimmune diseases are often referred to as “clinical chameleons” because their symptoms appear, disappear and evolve in unpredictable patterns. Unlike allergies, these symptoms:

• Do not follow seasonal trends


• Do not respond consistently to antihistamines


• Tend to involve multiple organ systems over time

A rash that seems like contact dermatitis may, over months, progress to joint pain, digestive disturbances or unexplained fevers. Patients often believe they are developing “new allergies,” when in fact the immune system is gradually turning against the body — affecting skin, lungs, joints, gut or connective tissues.



Symptoms most often mistaken for allergies

• Recurrent rashes/redness unresponsive to allergy treatment


• Persistent itching without an identifiable trigger


• Facial puffiness or generalised swelling


• Chronic sinus congestion or breathlessness


• Fatigue that lingers despite rest


• Low-grade fevers without infection


• Digestive symptoms like bloating or abdominal pain

Red flags patients must never ignore

• Unintentional weight loss


• Persistent fever


• Scalp or facial pain/tenderness


• Loss of motor function


• Loss of sensation or new numbness


• Difficulty in urination or defecation


• Visual disturbances


• Colour changes or coldness in the fingers or toes

The cost of delayed diagnosis

The biggest risk is silent progression. When autoimmune diseases remain undetected:

• Inflammation continues unchecked


• Tissues and organs sustain slow, irreversible damage


• Patients lose the window for early therapeutic control

Misdiagnosed individuals often continue antihistamines or nasal sprays for months with no relief. Conditions such as lupus, vasculitis, autoimmune thyroiditis, multiple sclerosis, inflammatory bowel disease, and celiac disease frequently begin with vague, allergy-like manifestations — only to be recognised much later.



If the immune system is misfiring, allergen avoidance cannot fix it. Only timely medical evaluation can prevent long-term complications.



When to suspect it’s more than an allergy



Seek immediate medical attention if:

• Symptoms persist despite all allergy medications


• Complaints recur throughout the year, not seasonally


• Multiple systems are affected simultaneously


• Fever, joint stiffness, or swelling accompanies rashes


• Symptoms worsen gradually instead of fluctuating with allergens

A simple panel of blood tests and immune-function markers can usually distinguish allergy from autoimmunity. Early referral to an internal medicine specialist, immunologist, or rheumatologist can dramatically improve outcomes.



In a pollution-heavy country like India, it is natural to assume allergies. But doctors caution that not every rash, itch, or breathless spell is allergy-driven. When symptoms persist, evolve, or occur in unusual patterns, they may be signalling the onset of an autoimmune disorder.



Listen to your body when symptoms keep coming back. Your body is communicating that something deeper is going on. Recognising these signs early can protect your long-term health.



Dr. Dharmendra Kumar, Consultant – Internal Medicine, Amrita Hospital, Faridabad