Lupus is a chronic autoimmune disease that causes inflammation of various parts of the body, especially the skin, joints, blood and kidneys. The immune system normally protects the body against viruses, bacteria and other foreign materials, but in an autoimmune disease like lupus, the immune system loses its ability to tell the difference between foreign substances and its own cells and tissues. The immune system then makes antibodies directed against “self”.
Although the cause of lupus is unknown, some researchers suspect that individuals are genetically predisposed to lupus. Also indications are that environmental factors such as infections, antibiotics, ultraviolet light, extreme stress and certain drugs play a critical role in triggering lupus.
Lupus can be difficult to diagnose as the symptoms come and go and mimic many other illnesses. Some of these symptoms are transient joint and muscle pain, fatigue, a rash caused or made worse by sunlight, low grade fever, hair loss, sores in the nose and/or mouth, appetite loss, or sensitivity of the fingers to the cold.
Lupus Diagnosis can be difficult. Physicians will look at the patient's entire medical history, including any lab tests. (There is no single test that can diagnose lupus.) To assist physicians in the diagnosis process, the ACR (American College of Rheumatology) established a list of 11 criteria. In order to diagnose Lupus. The physician will look for (4) or more symptoms in a patient. Since Lupus symptoms can come and go, it is important to remember that not all symptoms may appear at the same time; furthermore, keeping a history of your symptoms at home in order to present to your doctor can be helpful.
Lupus is not AIDS. Lupus is not cancerous, contagious or rare. Based on the results of several nationwide telephone surveys, the Lupus Foundation of America, Inc. estimates that approximately 1,500,000 Americans have a form of lupus. Lupus occurs 10 to 15 times more frequently among adult females than males, even though it can affect men and women of all age groups. Lupus develops most often between ages 15 and 44.
Lupus is two to three times more common among African Americans, Hispanics, Asians, and Native Americans. According to the Lupus Foundation of America, Inc., only 10 percent of people with lupus will have a close relative (parent or sibling) who already has lupus. Only 5 percent of children born to lupus parents will develop lupus.
- Malar Rash - This rash can be shaped like a butterfly and may present over the cheeks and/or nose.
- Discoid Rash - This rash can be raised, scaly, or disk-shaped patches usually found on areas exposed to the sun.
- Photosensitive Reaction to sunlight, causing a skin rash, or making a rash worse.
- Oral Ulcers - Sores in the nose or mouth, which are usually painless.
- Arthritis-like swelling or tenderness usually found in two or more joints.
- Serositis - Pleuritis or pericarditis, an inflammation of the lining of the lungs or heart. Symptoms may include but are not limited to pain when taking a deep breath.
- Neurological Disorders - this may include unexplained seizures, convulsions and/or psychosis.
- Renal Disorder - Excessive protein and cell casts (abnormal sediment) found in a urine sample.
- Hematologic Disorder - Hemolytic anemia (low number of red blood cells), leukopenia (low number of white blood cells), or thrombocytopenia (low number of platelets).
- Antinuclear Disorder also known as ANA - this is positive in most (95%) people with lupus, but can also be positive with other diseases and in healthy people.
- Immunologic Disorder- Blood test which shows a positive anti-double stranded DNA test, positive anti-Sm (antibody to ribonucleoprotein), anti-Ro (SSA), anti LA (SSB), or a false positive syphillis test (VDRI).
Other possible symptoms may include, but are not limited to, extreme fatigue, low grade fever (with no other explainable cause) or hair loss.
There are many categories of drugs for the treatment of lupus. Of all these drugs, only a few are approved specifically for lupus by the Food and Drug Administration (FDA): corticosteroids, including prednisone, prednisolone, methylprednisolone, and hydrocortisone; the antimalarial, hydroxychloroquine (Plaquenil®); monoclonal antibodies (Benlysta®); and non-steroidal anti-inflammatories including aspirin. However, many medications are used to treat the symptoms of lupus.
Lupus patients are generally treated by a rheumatologist, a doctor who specializes in diseases of the joints and muscles. If lupus has caused damage to a particular organ, other specialists will be consulted as well, such as a dermatologist for cutaneous lupus (skin disease), a cardiologist for heart disease, a nephrologist for kidney disease, a neurologist for brain and nervous system disease, or a gastroenterologist for gastrointestinal tract disease. An obstetrician who specializes in high-risk pregnancies will be needed when a woman with lupus is considering a pregnancy.
Once you have been diagnosed with lupus, your doctor will develop a treatment plan based on your age, symptoms, general health, and lifestyle. The goals of any treatment plan are to: reduce inflammation caused by lupus, to suppress your overactive immune system, to prevent flares, and treat them when they occur, to control symptoms like joint pain and fatigue and to minimize damage to organs.
It is important to become a part of your medical management team by keeping record of symptoms, in that way you can help your physician know when a change in therapy is needed.
Your physician may regularly monitor your disease through lab tests to determine lupus activity in your body. Changes in blood test results may indicate the disease is becoming active even before you develop symptoms of a flare up. Early detection of the increase in disease activity may decrease the chance of permanent tissue or organ damage and reduce the time you may need to take high doses of medication.
It is also important to be familiar with the side effects of your medication. Persons with a chronic illness treated by prescription drugs should keep a prescription drug book in their home. This will make it easier to explain to your physician the nature of any medication side effects that you experience. Never abruptly stop taking a prescribed medication without first talking to your physician.
Remember, you can help your physician by being open and honest. A healthy dialogue can result in better medical care for anyone seeking medical treatment.