Lupus

Overview

Lupus is an autoimmune disease. There are many types of lupus.  The most common form is systemic lupus erythematosus, which affects many parts of the body—the heart, lungs, kidneys, joints, skin and brain—as the term systemic implies. Systemic lupus erythematosus is often referred to as SLE or lupus. Lupus affects each person who has it differently.

Lupus In Depth

Other forms of lupus include discoid lupus erythematosus, which causes a skin rash; subacute cutaneous lupus erythematosus, which causes sores on parts of the body exposed to the sun; drug-induced lupus, which can be caused by medications; and neonatal lupus, a rare condition that affects newborns.

Lupus can affect anyone, but it’s more prevalent in women than in men—nine out of 10 people with lupus are women. African-American women are three times more likely to get lupus than White women, and it’s also more common in Hispanic/Latino, Asian, and American Indian women.

What Is It?

The immune system protects your body from illness and infection by attacking foreign substances. With an autoimmune disease such as lupus, however, the immune system attacks healthy cells and tissues. As a result, many parts of your body can be damaged; these include: joints, skin, kidneys, heart, lungs, blood vessels, and the brain.

What Causes It?

There is no known cause of lupus. Genes may play a role, as lupus sometimes seems to run in families, but it’s likely that a number of factors contribute to its development. Other factors that may trigger symptoms include the environment, stress, sunlight, and certain medicines.

Symptoms

Symptoms of lupus vary, and they may also come and go. A “flare” refers to a time when you are experiencing symptoms. Flares may be mild to severe.

Some of the common symptoms of lupus include:

  • Pain or swelling in joints
  • Muscle pain
  • Fever with no known cause
  • Red rashes, most often on the face
  • Chest pain when taking a deep breath
  • Hair loss
  • Pale purple fingers and toes
  • Sensitivity to the sun
  • Swelling in legs or around eyes
  • Mouth ulcers
  • Swollen glands
  • Feeling very tired

Additional symptoms, which are less common, include:

  • Anemia
  • Headaches
  • Dizzy spells
  • Feeling sad
  • Confusion
  • Seizures

Diagnosis

Diagnosis of lupus can be difficult because there is no single test to identify the condition. Instead, your doctor may use several tests and steps to diagnosis lupus, a process that can take months or years. Your doctor may perform the following to diagnosis lupus:

  • Medical history
  • Complete exam
  • Blood tests
  • Skin biopsy
  • Kidney biopsy

Treatment

There is no cure for lupus. The goal of treatment is instead to prevent flares, treat flares when they do occur, and reduce organ problems and other complications. Your doctors may prescribe medications to treat lupus directly as well as other conditions related to lupus; these include high cholesterol, high blood pressure, and infection.

Because lupus may affect different parts of your body in different ways, you may need to see several kinds of doctors. Specialists who may be part of your healthcare team include:

  • Your family doctor
  • Rheumatologists (doctors who specialize in arthritis and other diseases that cause swelling in the joints)
  • Clinical immunologists (doctors who specialize in immune system disorders)
  • Nephrologists (doctors who specialize in kidney disorders)
  • Hematologists (doctors who specialize in blood disorders)
  • Dermatologists (doctors who specialize in skin diseases)
  • Neurologists (doctors who specialize in problems with the nervous system)
  • Cardiologists (doctors who specialize in heart and blood vessel problems)
  • Endocrinologists (doctors who specialize in gland and hormone problems)
  • Nurses
  • Occupational or physical therapist
  • Psychologists
  • Social workers

Medicines that your doctors may prescribe include aspirin or similar medicine to treat swollen joints and fever as well as creams for a rash. For severe cases of lupus, medical treatment may include immunosuppressive drugs, antimalaria drugs, corticosteroids, and chemotherapy drugs.

For Women with Lupus

Two concerns particular to women with lupus are pregnancy and contraception.

  • Pregnancy: Even though pregnancy in women with lupus is considered high risk, most women with lupus can and do have healthy babies. They are encouraged to seek counseling before becoming pregnant, to see their doctors often, and to be prepared for a flare during pregnancy.
  • Contraception: According to recent studies, oral contraceptives, or birth control pills, are safe for women with lupus. Reliable birth control is necessary for women who do not wish to become pregnant and for those who are taking medicines that could be harmful to an unborn baby. Women should asked their doctor if any of the medicines that they’ve been prescribed carry such risks.

Living with Lupus

Because there is no cure for lupus, learning to live with disease and manage its symptoms will help you protect your health and maintain a good quality of life. A critical step in managing the symptoms of lupus is learning to recognize the warning signs of a flare. If you treat or stop these warning signs, you may be able to prevent a flare or make it less severe. Some people experience the following before a flare:

  • Feeling more tired
  • Pain
  • Rash
  • Fever
  • Stomachache
  • Headache
  • Dizziness

Steps you can take to prevent a flare include:

  • Learning the warning signs of a flare
  • Setting realistic goals and priorities so that you don’t over exert yourself
  • Limiting the time you spending in the sun
  • Eating a healthy diet
  • Finding ways to manage stress
  • Getting enough rest and quiet
  • Exercising moderately when possible (always consult your doctor before starting an exercise plan)

Another important part of living with lupus is that you see your doctor regularly, even when you’re feeling good. Regular visits to the doctor can help you manage your condition by looking for changes in symptoms, predicting and preventing flares, changing your treatment plan as needed, and detecting side effects of treatment.

Having lupus can also be stressful and take an emotional toll. Many people manage stress by exercising and finding other ways to relax (yoga and meditation, for example). The support of family, friends, your doctors, community groups, and support groups can help you cope emotionally.

By staying actively involved in your own treatment, you’re more likely to have less pain, make fewer visits to the doctor, feel better about yourself, and remain more active. You’ll also learn to manage your energy, as it is likely limited, so that you can enjoy the events and activities that are most important to you.

Resources

American College of Rheumatology

American Autoimmune-Related Diseases Association, Inc.

Lupus Foundation of America

SLE Lupus Foundation

Sources

Systemic lupus erythematosus (SLE or lupus). Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/arthritis/basics/lupus.htm. (Accessed October 2010).

Lupus. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health_Info/Lupus/do_i_have_lupus.asp. (Accessed October 2010).

Lupus: What Is Lupus? National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health_Info/Lupus/lupus_ff.asp. (Accessed October 2010).