Lupus

What Is Lupus?

Lupus is an autoimmune disease, which means that the immune system mistakes the body’s own tissues as foreign invaders and attacks them. Some people with lupus suffer only minor inconvenience. Others suffer significant lifelong disability.

Lupus affects people of African, Asian, or Native American descent two to three times as often as it affects whites. Nine out of 10 people with lupus are women. The disease usually strikes between age 15 and 44, although it can occur in older individuals.

There are two kinds of lupus:

  • Discoid lupus erythematosus (DLE)
  • Systemic lupus erythematosus (SLE)

DLE mainly affects skin that is exposed to sunlight and doesn’t typically affect vital internal organs. Discoid (circular) skin lesions often leave scars after healing of the lesions.

SLE is more serious: It affects the skin and other vital organs, and can cause a

raised, scaly, butterfly-shaped rash across the bridge of the nose and cheeks that can leave scars if untreated. SLE can also affect other parts of the skin elsewhere on the body.

Aside from the visible effects of systemic lupus, the disease may also inflame and/or damage the connective tissue in the joints, muscles, and skin, along with the membranes surrounding or within the lungs, heart, kidneys and brain. SLE can also cause kidney disease. Brain involvement is rare, but for some, lupus can cause confusion, depression, seizures, and strokes.

Blood vessels may come under attack with systemic lupus. This can cause sores to develop on the skin, especially the fingers. Some lupus patients get Raynaud’s syndrome, which makes the small blood vessels in the skin contract, preventing blood from getting to the hands and feet — especially in response to cold. Most attacks last only a few minutes, can be painful, and often turn the hands and feet white or a bluish color. Lupus patients with Raynaud’s syndrome should keep their hands warm with gloves during cold weather.

What Causes Lupus?

No single factor is known to cause lupus. Research suggests that a combination of genetic, hormonal, environmental, and immune system factors may be behind it. Environmental factors, ranging from viral and bacterial infections to severe emotional stress or overexposure to sunlight, may play a role in provoking or triggering the disease. Certain drugs, such as the blood pressure drug hydralazine and the heart rhythm drug procainamide, may cause lupus-like symptoms. High estrogen levels resulting from pregnancy may aggravate lupus.

What Are the Symptoms of Lupus?

Lupus improves at times, and worsens at others. Symptoms of lupus may include:

  • Profound fatigue
  • Low-grade fever
  • Severe joint pain and muscle aches
  • Skin rash on the face or body
  • Extreme sun sensitivity
  • Weight loss
  • Mental confusion and seizures
  • Chest pain on taking a deep breath
  • Nose, mouth, or throat sores
  • Enlarged lymph nodes
  • Poor circulation in fingers and toes
  • Bald patches and hair loss

Call Your Doctor About Lupus If:

  • You have any of the symptoms listed above or suspect you have lupus.
  • You have a family history of lupus and have experienced some of the symptoms above. Be even more alert for these symptoms if a close family member — your mother, father, or sibling — has lupus.
  • Lupus can be deadly. If you think you may have lupus, see a doctor right away. Treatment is much more successful if begun early and followed faithfully.

 

Understanding Lupus — Treatment

People are living longer and better with lupus than ever before. Although there’s no cure for lupus, there are treatments and lifestyle changes that can help you manage your symptoms.

Treatment for lupus — also known as systemic lupus erythematosus (SLE) — depends on your symptoms and how severe they are. Treatment can help:

  • Ease your symptoms
  • Bring down inflammation
  • Prevent and relieve flares
  • Prevent organ damage and other health problems

 

Anti-Inflammatory Drugs

If you have lupus, you may have joint pain and swelling, especially in your fingers, wrists, or knees. Sometimes you may have a fever. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can usually help you ease both of those problems.

You can buy them without a prescription. Sometimes they can irritate your stomach, so take them with food or milk.

Antimalarial Drugs

Some medications used to treat malaria can also treat lupus. They are used to treat skin rashes, mouth sores, and joint pain. They may also reduce your risk of blood clots, which is a concern in some people with lupus.

Antimalarial drugs protect against skin damage from ultraviolet rays in sunlight and may protect your body against organ damage linked to lupus. Side effects like stomach upset tend to be rare and mild.

Corticosteroids

Lupus makes parts of your immune system overactive, so it attacks healthy tissue by mistake. Corticosteroids weaken this immune response. Your doctor may prescribe them if lupus causes problems in your heart, lungs, kidneys, brain, or blood vessels.

Taken as a pill or IV, corticosteroids work fast to ease the swelling, warmth, and soreness in joints caused by inflammation. They can also prevent long-term organ damage.

Corticosteroids can have serious side effects like:

  • Greater chance of infections
  • Fragile bones or bone damage, especially in the hip
  • Muscle weakness
  • Diabetes
  • Cataracts

You may also have weight gain, bloating, and mood changes from taking corticosteroids. So your doctor will likely give you the lowest dose possible and taper them off if your symptoms go away for a time

Immunosuppressive Drugs

Like corticosteroids, these drugs curb your immune system, bring symptoms under control, and help prevent long-term organ damage. They can also have severe side effects. For example, they can make it hard for your body to fight infections and raise your chances for some kinds of cancer.

Your doctor may prescribe them if corticosteroids have not helped your symptoms.

Immunosuppressive drugs are sometimes used together with corticosteroids. That way you’ll be taking a lower amount of each type of drug, reducing the possible side effects of each drug.

With both types of drugs, you and your doctor need to weigh the risks of side effects against how well they improve your lupus symptoms.

Anticoagulants and Monoclonal Antibodies

Your doctor may also prescribe two other types of drugs:

Anticoagulants. These thin your blood to prevent blood clots, a life-threatening lupus symptom.

Monoclonal antibodies. Benlysta (belimumab), the first drug created just to treat lupus, was approved by the FDA in 2011. Given intravenously (in the vein), it targets specific immune cells. It may help reduce your need for steroid treatment, but it has not been tested thoroughly for the most severe forms of lupus. Rituxan (Rituximab) is another monoclonal antibody that has sometimes been used to treat lupus when other treatments have not been successful.

Lifestyle Changes

Having a healthy lifestyle will help you feel better and prevent flares. It can also help prevent problems linked to lupus, like kidney disease, heart attack and stroke.

Try these tips:

  • Eat a well-balanced diet.
  • Quit smoking(or don’t start) to protect your heart and blood vessels.
  • Get plenty of rest to ease fatigue, a common lupus symptom.
  • Exercisemost days to help sleep, mood, and heart health.
  • Always use sunscreenwhen you go out.
  • Get pneumoniaand flu vaccines to protect against infections.