What is lupus?
Lupus is a autoimmune disease in which the immune system, for unknown reasons, becomes hyperactive and attacks normal tissue. This attack results in inflammation and brings about symptoms. It is a chronic inflammatory disease that can affect many parts of the body, including skin, joints, kidneys, blood cells, heart and lungs. Episodes of lupus tend to come and go throughout life and may cause one to feel tired and achy.
What are the different kinds of lupus?
There are four forms of lupus including:
- Cutaneous lupus erythematosus affects the skin. There are many different types of cutaneous lupus including:
- Chronic cutaneous LE (CCLE) which is sometimes called discoid.
- Subacute cutaneous LE (SCLE), and
- Acute cutaneous LE (ACLE).
- Systemic lupus erythematosus (SLE) attacks multiple systems in the body which may include: the skin, joints, lungs, blood, blood vessels, heart, kidneys, liver, brain and the nervous system.
- Drug-induced lupus may develop after taking certain prescription medications. Symptoms generally disappear, within weeks to months, after the drug is discontinued.
- Neonatal lupus, a fourth type, is a rare condition. It is not the same thing as SLE.
Who gets lupus?
Lupus can occur at any age, and in either sex. Nine out of ten people with lupus are women. During the childbearing years (ages 15-44) lupus strikes women 10-15 times more frequently than men.
What is the cause?
The cause is unknown, but doctors believe that it results from a combination of factors, which may include heredity, environment and hormones. Although lupus itself cannot be inherited, it is likely that inheriting a certain combination of genes makes one more susceptible to developing the condition. A viral or bacterial infection may then trigger the disease. Because so many more women than men have lupus, researchers are also looking at the possible involvement of hormones, such as oestrogen.
Although anyone can develop lupus at any age, common risk factors include:
- Sex. Women are approximately nine times more likely than men to develop lupus.
- Family history. Having a relative who has lupus increases the odds of developing the disease.
- Pregnancy. Lupus sometimes shows up for the first time during pregnancy or shortly after giving birth.
How is it diagnosed?
Lupus is often difficult to diagnose because symptoms vary from person to person and can fluctuate with time. In fact, the doctor may not initially consider the disease until the symptoms and signs become more obvious. Nearly all people with lupus experience changes in disease activity. At times, the disease may flare and at other times, there may be no evidence of the disease (remission).
In addition to using the clinical history and a physical examination to check for the classification criteria, the doctor will use laboratory tests. These may include:
- Complete blood count (CBC)
- Erythrocyte sedimentation rate (ESR)
- Kidney and liver function tests
- Anti-nuclear antibody (ANA) test
- Chest X-ray
- Syphilis test
What is the treatment?
Currently, there is no cure for lupus. But treatments can ease symptoms and reduce complications. Treatment of systemic lupus erythematosus (SLE) depends on which organs are affected and how severely. Because lupus may assume many forms, finding the most effective treatment may take time.
The doctor may recommend a variety of medications, including the following, in treating lupus:
- Nonsteroidal anti-inflammatory drugs. Aspirin or nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen and naproxen sodium may reduce joint and other tissue inflammation.
- Antimalarial drugs. There is no known relationship between lupus and malaria, and no one knows why antimalarial drugs help improve lupus. These medications may be useful for treating skin and joint problems and inflammation of the surface of organs like heart and lungs. These drugs may also prevent flares of the disease.
- Corticosteroids. These drugs counter the inflammation of lupus. The dosage depends on which organs are involved and how severely.
- Immunosuppressive medications. These drugs, such as azathioprine and cyclophosphamide , reduce one’s normal immune response. The doctor may prescribe them if lupus is widely affecting the organs, especially the kidneys. Other medications that may be used to treat lupus include methotrexate, chlorambucil , cyclosporine and mycophenolate. The doctor may prescribe them if corticosteroids are not effective.
In addition, managing lupus means taking good general care of oneself. One can take the following steps to improve the function of the immune system:
- Get adequate rest and regular exercise.
- Avoid smoking. Smoking increases the risk of cardiovascular disease and can worsen the effects of lupus on the heart and blood vessels.
- Limit alcohol. Alcohol can affect the liver, kidneys, heart and muscles, and may interact with medications.
- Eat a healthy, balanced diet.
In women with lupus who are considering pregnancy, it is necessary to seek medical counselling to determine what steps one can take to ensure the safest possible pregnancy. Planning and preparing for pregnancy can help reduce risks to the mother and the baby.