What is Lupus?
Lupus is a chronic autoimmune disease that can affect the skin, joints, and/or organs. For people with lupus, the immune system attacks not only foreign invaders, like germs, but also healthy tissue. These attacks, called flares, cause inflammation, pain, and damage to otherwise healthy skin, joints, or organs.
People with lupus have times when their symptoms are mild or non-existent; these times are known as remissions.
With good medical care, people with lupus can lead full lives.
Types of Lupus:
Systemic Lupus Erythematosus: This type of lupus involves the major organ systems and is what people generally think of when you say "lupus." It can be mild or severe. Severe complications can include inflammation of the kidneys that restricts the body's ability to filter waste, pulmonary hypertension, inflammation of the nervous system resulting in memory loss, confusion or strokes, and coronary artery disease.
Cutaneous Lupus Erythematosus: This kind of lupus affects the skin only. Those affected can have many different kinds of rashes and sores. The most common rash is raised, red, scaly and disc shaped, hence its name, "discoid rash." Rashes tend to appear in areas most exposed to sunlight or in the mouth, nose, and vagina. Approximately 10% of those with cutaneous lupus will also have systemic lupus.
Drug-induced Lupus Erythematosus: This type of lupus includes symptoms like those of systemic lupus, but does not generally result in severe complications. Symptoms disappear within about 6 months after the patient stops taking the particular medication. Medications that can cause drug-induced lupus include hydralazine (for high blood pressure or hypertension), procainamide (for irregular heart rhythms), and isoniazid (for tuberculosis). Not all people who take these medications will develop drug-induced lupus.
Neonatal Lupus: This rare form of lupus affects the babies of women who have lupus. The antibodies of the mother affect the baby in the womb, so the baby can be born with a skin rash, liver problems, or low blood cell counts. These problems disappear completely after several months.
Even more rarely, the baby can have a serious heart defect. With proper testing, doctors can identify most at-risk mothers, and their babies can be treated before or at birth.
Most babies of mothers with lupus are perfectly healthy.
Causes of Lupus:
Studies have not found a specific gene or group of genes that causes the disease, though it occurs more often in families where there are sufferers of other auto-immune diseases.
Generally, an environmental factor is what causes the onset or a flare of the disease in people who are susceptible. Environmental factors include:
- Ultraviolet rays (from the sun or from lightbulbs)
- Sulfa, tetracycline, and antibiotic drugs
- Colds and/or viruses
- Emotional stress
- Physical stress (such as surgery, pregnancy and birth)
Research has not yet determined whether estrogen, stress, and/or pollution causes or exacerbates lupus symptoms. Research does indicate that diet and aspartame consumption do not affect the disease.
Symptoms of Lupus:
Lupus has a wide range of symptoms that can flare and disappear unpredictably. As some symptoms disappear, other ones may occur. Common symptoms include:
- Extreme fatigue
- Swollen or painful joints, arthritis
- Swollen feet, hands, and/or legs
- Swelling around the eyes
- Anemia or low white blood cell or platelet counts
- Pain in chest when taking deep breaths
- Rashes: butterfly shaped rash across cheeks and nose, raised red patches on skin, rash due to sun exposure
- Hair loss
- Abnormal blood clotting
- Ulcers in nose and/or mouth
- Fingers turning white or blue when cold
- Kidney problems that appear in urine tests
Diagnosis of Lupus:
Lupus can take years to diagnosis due to the erratic nature of symptoms. In addition, there is no single test that can identify the disease, and symptoms of other autoimmune diseases are may be similar.
In general, a physician will review a patient's symptoms and perform lab tests to rule out other conditions. Most systemic lupus patients will show evidence of four or more of the above symptoms.
Treatment of Lupus:
There is no cure for lupus; however, 80-90% of people with lupus have a normal lifespan. There are medications used to manage the disease.
There are 3 types of drugs that are used to treat lupus itself: corticosteroids, the antimalarial drug hydroxychloroquine, and aspirin.
Other medications are used to treat the symptoms associated with lupus. Some common medications given to treat lupus symptoms include diuretics, antihypertensive drugs (to lower blood pressure), anticonvulsants, antibiotics, and bone strengthening drugs.
The goal of treatment is to:
- Reduce the inflammation caused by lupus
- Suppress the overactive immune system
- Prevent and/or treat flares
- Control symptoms like joint pain and fatigue
- Minimize the damage to organs
Lupus Foundation of America: This site can probably answer any question you have about lupus, as well as provide access to experts who can answer questions and connections with fellow sufferers. Their patient and family resources section has great information on prescription assistance, health insurance, disability and clinical trials.
National Institute of Arthritis and Musculoskeletal and Skin Diseases: This site gives an overview of lupus and its treatment. It includes current news and a section for handling pregnancy and contraception for women with lupus.
American College of Rheumatology: This site gives a shorter overview of systemic lupus. It can also help you find a rheumatologist in your area.
Cure 4 Lupus: This site was created by people diagnosed with lupus. In addition to an overview of the disease and lists of resources, there are articles by people with lupus and a calendar of related events.
Lupus Alliance of America: The LAA helps those with lupus find support and services in their local communities and spread awareness of the disease.
SLE Lupus Foundation: This group provides events, counseling, and assistance for those living in New York and LA. The site also covers clinical trials, an overview of the disease, and the latest news.
Lupus Research Institute: Research group with news and advocacy information for lupus sufferers.