Lupus

What is lupus?

Lupus is an autoimmune disease in which the immune system attacks healthy tissue and triggers inflammation. The exact cause of lupus is unknown, although it tends to run in families.

Certain factors can raise a person’s risk of lupus. These include:

• Gender: About 90% of people who get lupus are women.

• Age: Lupus can occur at any age but is most often diagnosed between ages 15 and 44.
• Genetics: Lupus sometimes runs in families and studies suggest a genetic contribution to the disease
• Race: African Americans, Asian Americans, and Hispanic Americans are affected more than other racial and ethnic groups.

Lupus affects many body parts, including the skin, joints, blood, and vital organs like the heart, lungs, and kidneys. Complications include scarring on the skin, kidney failure, heart attack or stroke, bone fractures, joint damage, and cataracts.

Lupus can increase a person’s risk of other health conditions and complications including:

●                Sensitivity to light

●                Fatigue

●                Dry eye

●                Depression

●                Seizures

●                Anemia

●                Raynaud’s syndrome

●                Osteoporosis

●                Lung disease

There are four types of lupus:

• Systemic lupus erythematosus (SLE). SLE is the most common type, affecting about 70% of people with lupus. SLE can cause inflammation throughout the body and damage tissue in affected organs including the joints, skin, brain, lungs, kidneys, and blood vessels. 
• Cutaneous lupus erythematosus. This type affects the skin and can occur alone or alongside SLE. Anywhere between 5% and 25% of people with cutaneous lupus will develop SLE. When the immune system attacks the skin, it causes inflammation and thick rashes or sores that might itch or burn. For many people, an early sign is a butterfly-shaped rash on the cheeks and nose, which might be triggered by exposure to sunlight. A subtype called discoid lupus causes thick, circular lesions, mainly on the scalp and face, and can result in scarring.
• Medication-induced lupus. Certain medications can trigger flare-ups, which abate when you stop taking the drug.
• Neonatal lupus. Some babies are born with the disease.

What are the symptoms of lupus?

Lupus can affect different body parts, so there many possible symptoms. Not everyone with lupus will experience the same symptoms or severity. Some might experience only mild symptoms, while in others, lupus can be life-threatening.

Symptoms can manifest at any time. Intense flare-ups can be triggered by sun exposure, infections, and some medications. Early warning signs of lupus include fatigue, fever, muscle and joint pain, a butterfly-shaped rash on the face, and skin lesions that appear or worsen with sun exposure.

Other common symptoms include:

●                A general feeling of unwellness

●                Loss of appetite

●                Weight loss

●                Swelling of the joints

●                Photosensitivity (a sensitivity to light that causes flare-ups)

●                Hair loss

●                Rash with firm, round, red plaques on the skin (discoid rash)

●                Ulcers in the mouth, nose, and genital areas

How is lupus diagnosed?

Lupus is most commonly diagnosed based on symptoms, physical examination, and laboratory tests. Your doctor first looks for common symptoms and signs, such as skin rashes, ulcers inside the mouth, and tenderness or swelling of the joints. They will also check for signs of inflammation of the membrane covering the heart or lungs.

If your doctor suspects lupus, they will order a blood test to check for an antinuclear antibody (ANA). Almost all people with lupus have this antibody in their blood, but not everyone with a positive ANA test has lupus. If the test is positive, your doctor will order additional blood tests to look for antibodies that are specific to lupus and for other evidence of lupus (such as tests for inflammation or kidney disease).

How do you treat lupus?

There is no cure for lupus, but several medications can help treat and manage symptoms. These include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs, such as ibuprofen (Advil) or naproxen (Aleve), help with pain, inflammation, and swelling.
• Antimalarials. These drugs can help prevent flares and manage inflammation and pain. Studies show that people treated with these medications have less active disease and organ damage. Examples of antimalarial drugs include hydroxychloroquine (Plaquenil), chloroquine (Aralen), and quinacrine (Mepacrine).
• Corticosteroids These medications reduce inflammation and reduce pain, rashes, swelling around the joints and other symptoms and signs of lupus. Examples include prednisone (Deltasone), hydrocortisone, methylprednisolone (Medrol), and dexamethasone (Decadron).
• Immunosuppressants. These drugs lower immune system activity. Examples include azathioprine (Imuran), methotrexate (Rheumatrex, Folex, Methotrexate LPF), cyclophosphamide (Cytoxan, Neosar), mycophenolate mofetil (CellCept), belimumab (Benlysta) and anifrolumab (Saphnelo).

Your doctor may prescribe additional drugs to prevent or treat complications of lupus, such as osteoporosis or cardiovascular disease.