Lupus is a chronic disease of the immune system. It is characterized by an autoimmune disorder in which your immune system attacks the tissues of your body. Although it can affect anyone, lupus mainly affects young women or women of childbearing potential, about 9 women for 1 man.
Lupus seems to come from a Latin word which means wolf. It is attributed this name because of its invasive and destructive characteristic. It is a severe and destructive disease that tends to damage your whole body through a variety of symptoms.
Lupus Causes and Risk Factors
Although a genetic connection is suspected, the causes of lupus are unknown; no viral or infectious cause has been identified. When you have lupus, your immune system that was supposed to produce antibodies against antigens reacts inappropriately by producing antibodies against your own healthy tissues. The anti-DNA antibodies are mostly responsible for manifestations of the disease.
Certain factors are known to trigger the symptoms of lupus:
- Sun exposure – protect yourself from sunlight; ultraviolet rays can trigger outbreak of symptoms
- Lack of Exercise – Regular exercise prevents occurrence of lupus symptoms and improve your well-being.
- Medication – Do not take any medication without your doctor’s recommendations. The following are some of the drugs that can trigger symptoms of lupus: Chlorpromazine, hydralazine, isoniazid, methyldopa, penicillamine, procainamide, quinidine and Sulfasalazine
- Stress – stress can cause or exacerbate the symptoms of lupus
- Lack of sleep – it is recommended that lupus patients spend 8 to 10 hours of sleep to get more engery and help your body minimize the pain caused by the disease
- Unhealthy diet – a poor diet can contribute to the symptoms of lupus; drink abundantly fruits and cruciferous vegetable juice (a juicer is recommended).
- Tobacco and alcohol – besides cancer and cardiovascular problems, tobacco and alcohol are triggers of lupus symptoms.
Lupus Signs and Symptoms
The majority of patients may suffer some of the symptoms described below; symptoms can vary from one individual to another. The first attack often appears after a particular event: stress, pregnancy, taking medication, sun exposure. In fact, symptoms that occur depend greatly on the type of lupus.
There are actually four types of lupus: Discoid lupus, Drug-induced lupus, Neonatal lupus and Systemic lupus erythematosus (SLE).
Discoid lupus – this form of lupus that can cause major skin problems: red, raised rash on the face, scalp, mouth lining or other parts of your body that may last for months or years. Unlike SLE, discoid lupus can cause scarring on your face which can affect your look.
Drug-induced lupus – this opportunist form of lupus is triggered by certain medications such as chlorpromazine, hydralazine, isoniazid, methyldopa, penicillamine, procainamide, quinidine and Sulfasalazine. Unlike discoid lupus, drug-induced lupus has minor symptoms and often goes away when the medicine in question is stopped. In addition, drug-induced lupus is more common in men. It presents almost the same symptoms as systemic lupus erythematosus.
Neonatal lupus – neonatal lupus is a very rare condition that is caused by the transplacental passage of maternal autoantibodies: anti-SSA, anti-SSB, or anti-U1-RNP. It affects approximately 1 child per 10 000 births. Its most common clinical manifestations include:
- heart problems
- Skin rash
- Low blood counts (thrombocytopenia)
- Liver abnormalities (cholestasis)
Systemic lupus erythematosus (SLE) – this is the most common type of lupus. It is characterized by a hyper-stimulation of the B lymphocyte population (B-cells), substances responsible for making antibodies against antigens. Those auto-antibodies attack normal tissues. Once your body’s tissues are attacked by its own immune system, they become damaged and inflamed. In response to this disorder, your system presents the following symptoms:
- Skin rash
- Loss of hair
- Swelling of the pleura of the lungs (pleurisy)
- Inflammation of the pericardium (pericarditis)
- Blurred vision
- General ill feeling (malaise)
- Joint pain and swelling
- Weight loss
- Loss of appetite
- Butterfly rash on cheeks and bridge of nose
Sometimes the disease can affect your vital organs such as kidney or central nervous system. There is no treatment to get rid of Systemic lupus erythematosus; it is a chronic disease that can be put into remission for many years.
How is lupus diagnosed?
Because skin eruptions are often the first symptoms of lupus, your doctor can diagnose the disease by a physical examination on the dermatological signs. However, to confirm the diagnosis, further investigations by serological tests and biopsies are often made:
- Complete blood count (CBC), perfomed to measure your red blood cells, white blood cells, platelets and amount of hemoglobin
- SED rate (erythrocyte sedimentation rate), used to detect and monitor infection and inflammation in your body
- Antinuclear antibody (ANA) test – used to detect antinuclear antibodies (ANA), substances produced by your immune system that attack your body’s own tissues
- Liver and kidney assessment, done to monitor how well your kidney and liver are functioning
- Electrocardiogram (ECG), perfomed to check for the electrical activity of your heart
- Chest x-ray, done to detect fluid or inflammation in your lungs
- Urinalysis, used to find out if the lupus has affected your kidney, which can be indicated by high levels of protein or red blood cells in your urine.
The treatment is tailored to the severity and extent of the disease. If you have an acute or less severe lupus, you can be treated with low doses of corticosteroids, anti-inflammatory drugs and antimalarial drugs. In case of more severe of lupus, your oncologist can find it necessary to administer high doses of steroids for a short period, in combination with other immunosuppressants such as cyclophosphamide or azathioprine. Certain chemotherapy drugs such as cyclophosphamide and azathioprine have the ability to reduce the rate of white blood cells; however, their use requires very close monitoring.
The treatment of discoid lupus is mainly based on the use of Antimalarial drugs. The most common anti-malarial medications used in the US in the treatment of systemic lupus include hydroxychloroquine (Plaquenil), chloroquine (Aralen), and quinacrine (Atabrine).
Corticosteroids are also used to treat skin disorders caused by systemic lupus; they are useful in topical use.