Lupus is a chronic autoimmune disease, which means that instead of just attacking foreign substances, your immune system turns against healthy tissue; leading to inflammation and damage to various parts of the body, including the joints, skin, kidneys, heart, lungs, blood vessels, and brain.
There are four different types of Lupus.
- Systemic Lupus Erythematosus: The main type of lupus. Affecting nearly any part of the body. When people talk about lupus they are generally referring to SLE.
- Discoid Lupus Erythematosus: Affects only the skin. People with this form of lupus experience a circular rash on the face, neck, and scalp.
- Drug Induced Lupus Erythematosus: Occurs after taking certain prescription medications. Not everyone who takes the medication will develop lupus. Drug induced lupus can affect many body systems like SLE, but signs and symptoms will cease once the medications are out of the body.
- Neonatal Lupus Erythematosus: The rarest form of lupus. Affects newborns. A mother with certain antibodies that are linked to autoimmune diseases can pass them to the developing fetus. Even if the mother has no signs or symptoms of an autoimmune disease. Neonatal lupus may last several months before disappearing; serious cases can cause congenital heart block.
Systemic Lupus Erythematosus can range from mild to life-threatening and should always be treated by a doctor. An estimated 1.5 million Americans are affected by lupus. It is believed that at least 5 million people throughout the world have a form of lupus. Lupus strikes mainly women of child bearing age (15-44). However, men, children, and teenagers can develop the disease as well. More than 16,000 new cases are reported annually across the country.
There are many different symptoms and can vary depending on what body system the disease affects. In general lupus symptoms may include: Fatigue, fever, weight loss or gain, joint pain, butterfly-shaped rash on the face that covers the cheeks and bridge of the nose, skin legions that appear or worsen with sun exposure, mouth sores, hair loss, fingers and toes that turn blue when exposed to cold or stressful situations, shortness of breath, chest pains, dry eyes, easy bruising, anxiety, depression and memory loss.
Even though doctors don’t know what exactly causes lupus in most cases they have identified factors that may increase the risk of the disease. Which are: age, sex, race, and sunlight. Exposure to the sun may bring on a lupus response in susceptible people. It isn’t well understood why ultra violet radiation has this effect. Antibodies that, are normally present in the body then latch onto proteins initiating an inflammatory response. Damaged skin cells seem to die more frequently in people with lupus, leading to more inflammation.
Lupus can be very difficult to diagnose. Signs and symptoms vary considerably from person to person. They also may overlap different diseases or conditions. Nearly all people with lupus experience fluctuations in disease activity. At times the disease may become severe and at other times subside completely.
The American College of Rheumatology has developed clinical and laboratory criteria to help physicians diagnose and classify lupus. If you have four of the 11 criteria at one time or individually overtime, you will most likely be diagnosed with lupus. The criteria identified by the ACR include:
- Face rash, which doctors call a malar rash that is butterfly-shaped.
- Scaly rash, called a discoid rash, which appears as raised scaly patches.
- Sun-related rash, which appears after exposure to sunlight.
- Mouth sores, which are usually painless.
- Joint pain and swelling that occurs in at least two joints.
- Swelling of the linings around the lungs or the heart.
- Kidney disease
- A neurological disorder, such as seizures or psychosis.
- Low blood counts, such as low red blood count, low platelet count or a low white blood count.
- Positive antinuclear antibody tests, which indicate that you may have an autoimmune disease.
- Other positive blood test that may indicate an autoimmune disease, such as a positive double-stranded anti-DNA test, positive anti-Sm test, positive anti-phospholipids antibody test or false positive Syphilis test.
Laboratory tests that may be used to diagnose lupus include:
- Complete blood count. This test measures that number of red blood cells, white blood cells and platelets as well as amount of hemoglobin. Results may indicate you have anemia, which commonly occurs in lupus. A low white blood count or platelet count may occur in lupus as well.
- Erythrocyte Sedimentation rate. This blood test determines the rate at which red blood cells settle to the bottom of a tube in an hour. A faster than normal rate may indicate a systemic disease. The sedimentation rate isn’t specific for any one disease, may be elevated if you have lupus.
- Kidney and liver assessment. Blood tests can assess how well your kidneys and liver are functioning.
- Urinalysis. An examination of a sample of urine may show an increased protein level or red blood cells in the urine, which may occur if lupus has affected your kidneys.
- Antinuclear antibody (ANA) test. A positive test for the presence of these antibodies- produced by your immune system- indicates a stimulated immune system which is common in lupus and other autoimmune diseases.
- Chest X-Ray. An image of your chest may reveal abnormal shadows that suggest fluid or inflammation in the lungs.
- ECG (Electrocardiogram). This test measures the pattern of electrical impulses generated by the heart. It can help identify irregular rhythms or damage.
- Syphilis test. A false positive syphilis test can indicate anti-phospholipids antibodies in your blood, another indication of lupus.
Treatments for lupus depend on your symptoms. Determining whether your signs and symptoms should be treated and what medications to use requires a careful discussion of risks and benefits.
There are 3 different types of medications commonly used to treat lupus. Non Steroidal anti-inflammatory drugs commonly called (NSAIDS) such as Advil, and Aleve. Anti Malarial drugs; there are no known connections between malaria and lupus but these drugs have proved useful in treating symptoms. Corticosteroids; these drugs counter the inflammation of lupus, but can have serious long term side effects. Treatments for more aggressive lupus may include high doses of corticosteroids. Immuno suppressive drugs, which suppress the immune system, are used for extreme cases of the disease.
Health professionals continue to search for better ways to care for and treat people with lupus. Understanding what causes the disease and why certain people are more likely to develop it may one day lead to promising new treatments for, or even prevention. Researchers continue to look for new treatments and ways to modify existing ones so they can eliminate side effects and improve the quality of life for people who have lupus.
The outlook for people with lupus was once grim, but diagnosis and treatment has improved considerably with treatment, most people can lead active lives.