What is Lupus?
Lupus is one of autoimmune diseases that can affect anyone. This autoimmune disease is an abnormal condition of immune system in which body attacks its own tissues. One of most common signs of the lupus is rashes in face that looks like butterfly wings. However this symptom may not be present in all patients with lupus.
Lupus mostly affects the females of childbearing age. It also affects the men, the children and the teenagers and is usually developed between ages of 15 to 45 years.
Types of Lupus:
1.The Systemic Lupus Erythematosus (SLE):
2. The Discoid Lupus Erythematosus (DLE):
3. The Subacute Cutaneous Lupus Erythematosus:
4. The Drug-induced Lupus Erythematosus (DIL):
5. The Neonatal Lupus:
1. Systemic Lupus Erythematosus (SLE):
SLE is common form of the lupus. About 70% of the patients are diagnosed with this type of lupus. A patient with the SLE may experience the mild to moderate symptoms. SLE mostly affects individuals between 15 to 45 years.
2. Discoid Lupus Erythematosus (DLE):
DLE is the chronic skin condition. A patient diagnosed with the DLE may have the red, raised rash on face, scalp or any other parts of body.
3. Subacute Cutaneous Lupus Erythematosus:
Subacute cutaneous lupus erythematosus are lesions on skin that appear when exposed to sun.
4. Drug-induced Lupus Erythematosus (DIL):
DIL is caused due to usage of the certain medications, such as the hydralazine, the isoniazid, and the Procainamide. These drugs causes rash, fever and hair loss, these symptoms disappear once if the drug is discontinued.
5. Neonatal Lupus:
Neonatal lupus is the condition that occurs when auto-antibodies present in the pregnant woman are passed to baby. It is the temporary condition in the newborns and symptoms disappears within few months.
What Causes Lupus?
The exact cause of the lupus remains unknown. However, the lupus occurs when immune system damages its healthy tissues.
With lupus immune system malfunctions and losses its ability to differentiate between antigens (The foreign substance) and healthy tissues. This contributes to formation of excess antibodies that attacks body’s healthy cells and causes pain, damage and the inflammation of different parts of body.
These antibodies are known as the auto-antibodies, and most common auto-antibody with lupus is the antinuclear antibody (ANA).
Symptoms of Lupus:
The symptoms of the lupus can develop anytime between ages of 15 to 30 years. Patients with the lupus may have flare-ups of symptoms along with the period of remission. The symptoms of the lupus usually depend on region where it is affected. The most common symptoms of lupus may include:
- The Skin rash on the face or any other parts of the body
- The Intense fatigue
- The Fever
- The Hair loss
- The Severe joint pain, stiffness and joint swelling
- The Weight loss
- The Worsening of skin lesions when exposed to sunlight
- The Shortness of breath
- The Dry eyes
- The Headache
- The Dizziness
- The Anemia
- The Confusion
- The Dry mouth
- The Memory loss
- The Nose, mouth or throat sores
- The Poor circulation in fingers and toes
Risk Factors for Lupus:
Factors that increase risk of Lupus include:
Lupus can develop at any part of age, but individuals between 15 to 45 years are at increased risk of developing the lupus.
The Females are at greater risk of lupus than the males. Both males and females produce the estrogen ,the hormone responsible for development and regulation of the reproductive system, but production of this hormone is greater in the females.
Estrogen is known as an immune-enhancing hormone and its production increase during menstrual cycle and pregnancy due to this reason women are at higher risk of the lupus.
Individuals having the family history of lupus are at increased risk. The genes that help immune system to recognize and respond to foreign organisms get changed in patient with lupus.
Africans, the Asians, the Hispanics, the Native Americans are at increased risk of developing lupus.
Environmental factors act together with the genetics and the hormonal factor and trigger risk of lupus. Certain environmental factors that trigger lupus include:
- Exposure to the ultraviolet rays causes death of the cells present in skin and triggers lupus.
- Exposure to certain chemicals, such as the silica from agriculture or the industrial settings also increases risk of lupus.
- Use of certain medications, such as the trimethoprim-sulfamethoxazole, the sulfasalazine, and the tolbutamide makes individual more sensitive to sun and increase risk of lupus.
- An injury or the infections due to Epstein-Barr virus.
- Smoking impairs circulation and triggers symptoms of lupus.
Complications of Lupus:
Lupus causes the inflammation that affects various parts of body and may lead to the complications, such as:
- The Kidney damage
- The Stroke
- The Preeclampsia (The high blood pressure during pregnancy)
- The Seizures (electrical disturbances in brain due to altered activity of the nerve cell)
- The Blood and blood vessel problems
- The Lung disease, such as pneumonia
- The Heart diseases, such as heart attacks,
- In rare conditions, lupus may increase risk of cancer, avascular necrosis of bone tissue, and miscarriage.
Diagnosis of Lupus:
Lupus is usually very difficult to diagnose with a single laboratory test as it mimics action of several other medical conditions. Doctor usually initiates diagnosis by reviewing medical history, the family history and signs and symptoms of individual.
The doctor recommends certain laboratory tests, such as:
Antinuclear Antibody (ANA) Test:
ANA test is simple, primary diagnostic test for evaluating the lupus. In ANA, blood sample is collected and is examined. A positive test reveals presence of the high levels of antibodies in body, which indicates hyperactive immune system.
Complete Blood Count:
Complete blood count is performed to evaluate levels of all blood components, such as the red blood cells, white blood cells, blood platelets, and hemoglobin. If blood count is reduced, it indicates the anemia, which is one of common symptoms of lupus.
Erythrocyte Sedimentation Rate:
Erythrocyte sedimentation rate is the type of blood test, performed to determine time at which the red blood cells settle down. If the RBCs settle down faster than usual time it indicates lupus.
Urinalysis is done to determine levels of proteins or RBCs in urine. Increased levels of the proteins and the RBCs occur when lupus has affected kidneys.
In some conditions the kidney function test, the liver function test, the chest X-ray and the echocardiogram are also performed if doctor suspects that lupus is affecting kidneys, liver, lungs or heart. Sometimes the skin biopsy is also performed to confirm lupus affecting skin.
Treatment for Lupus:
Lupus does not have complete cure. The treatment mainly focuses on reducing signs and symptoms of patient and preventing flares and the organ damage. The doctor changes drug therapy whenever signs and symptoms flare and subside. The doctor may recommend:
Nonsteroidal anti-inflammatory drugs (NSAIDs).
NSAIDs, such as the ibuprofen and naproxen, help reduce mild pain and swelling in the joints and muscles.
may help reduce the swelling, tenderness, and pain. In high doses, they can calm immune system.The longer the person uses these drugs, the harder it becomes to lower dose. Stopping this medicine suddenly can harm your body.
Medicines that treat the malaria also treat joint pain, skin rashes, fatigue, and the lung inflammation. Two common antimalarial medicines are the hydroxychloroquine and chloroquine phosphate. Studies found that taking the antimalarial medicine can stop lupus flares and may help people with the lupus live longer.
These drugs limit amount of abnormal B cells found in people with the lupus.The belimumab, blocks action of the specific protein in body that is important in e response.
These medicines may be used in the severe cases of lupus, when lupus affects the major organs and other treatments do not work. These medicines can cause the serious side effects because they lower body’s ability to fight off the infections.
Prevention of Lupus:
The risk of lupus can be prevented by:
- The Smoking cessation
- The Exercising regularly
- The Eating a healthy and well-balanced diet
- The Avoiding long-term exposure to the sun
- The Applying moisturizer before exposing to sun (source)
Common Questions That Are Asked
How is lupus treated?
There is no cure for the lupus but treatments can help you feel better and improve the symptoms. Your treatment will depend on the symptoms and the needs. The goals of treatment are to:
- Prevent the flares
- Treat the symptoms when they happen
- Reduce the organ damage and other problems
- Reduce the swelling and pain
- Calm your immune system to prevent it from attacking organs and tissues in your body
- Reduce or prevent the damage to the joints
- Reduce or prevent the organ damage
Will I need to see special doctor for my lupus?
Maybe. Start by seeing family doctor and the rheumatologist, a doctor who specializes in diseases of joints and muscles such as lupus. Depending on symptoms or whether your organs have been hurt by lupus, you may need to see other types of the doctors. These may include the nephrologists, who treat kidney problems, and the clinical immunologists, who treat immune system disorders.
Can I die from lupus?
Yes, lupus can cause death. But, thanks to the new and better treatments, most people with the lupus can expect to live long, healthy lives. The leading causes of the death in people with lupus are the health problems that are related to lupus, such as the kidney disease, infections, and heart disease.
Work with doctor to manage lupus. Take the medicine as your doctor tells you to and make the healthy choices, such as not smoking, eating the healthy foods, getting the regular physical activity, and managing your weight.
What are lupus flares?
The times when the symptoms get worse and you feel sick are called the flares. Flares can come and go. You may have the swelling and the rashes one week and no symptoms next. Sometimes the flares happen without the clear symptoms and are seen only with the laboratory tests.
What are some triggers for lupus flares?
Common triggers include:
- Overwork and not enough rest
- Being out in sun or having close exposure to the fluorescent or halogen light
- Stopping your lupus medicines
Other types of medicines
Even if you take medicine for the lupus, you may find that some things trigger the flare. For instance, your symptoms may still flare after you’ve been out in sun or after hard day at work, even if you are taking lupus medicine.
Should I change what I eat because I have lupus?
Maybe. You may have to make changes to what you eat based on symptoms or treatment plan. Ask doctor if you need to eat special foods or limit other foods because of lupus.
If steroids and the other medicines cause you to gain weight, you may want to follow a low-calorie eating plan.
Because people with the lupus need to avoid sun, you may lack vitamin D.Your doctor may advise you to take a vitamin.
Vaccines that are very safe for people with lupus include:
- The flu shot (Make sure you request flu shot and not nasal spray. The nasal spray has live form of the virus that is not recommended for people with the lupus)
- Pneumonia vaccine
- Human papillomavirus (HPV) vaccine
- Tetanus, diphtheria, and acellular pertussis (Td/Tdap) vaccine
What can I do to cope with lupus?
Dealing with the chronic disease like the lupus can be challenging. Concerns about health and the effects of the lupus on your work and the family life can be stressful. Talk to doctor and others about symptoms and feelings. You also may want to consider the counseling or joining support group. Many people find it helpful to talk to others who may be having similar experiences.(source)
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