Understanding Lupus Disease: Risk Factor, Symptoms and Management

Lupus is a chronic inflammatory disease in which an individual’s immune system starts attacking its own tissues and organs. This autoimmune response causes inflammation in many parts of the body including joints, skin, kidneys, blood cells, brain, heart, and lungs. This disease is difficult to diagnose as its signs and symptoms may be similar to other diseases and ailments.

 

One of the major features of lupus is facial rash. Persons with lupus present with facial rash that looks like the wings of a butterfly unfolding across their both cheeks. However, this feature is not present in every individual suffering from lupus. Many individuals experience a mild version of lupus. However, the disease can get serious if not treated properly. As there is no permanent cure for lupus, treatment aims to relieve or ease the signs and symptoms.

 

Signs and Symptoms:

Signs and symptoms caused by lupus depend upon the parts of the body affected by this disease. Symptoms usually appear when you’re entering adulthood. The most commonly affected parts of the body are joints, skins, heart, blood, lungs, brain and kidneys. Symptoms and their severity differ between individuals. Therefore, no two lupus presentations are the same. However, the most common symptoms and signs include:

 

  • Fever
  • Rashes i.e. butterfly rash on the cheeks
  • Shortness of breath
  • Skin problems
  • Tiredness
  • Joint pain
  • Body aches
  • Headaches
  • Loss of memory
  • Sjogren’s syndrome
  • Hair loss also called alopecia areata

 

What is Lupus photosensitivity?

Excess sunlight can be harmful to anyone. Many individuals suffering from lupus have photosensitivity. They are sensitive to UV radiations present in the sunlight. As a result, when they are exposed to UV light, they can experience certain symptoms such as:

  • Rash
  • Internal swelling
  • Joint pain
  • Fatigue

If you have lupus and are going out, it is always the best idea to wear sun-protective clothing and apply sunscreen.

 

Causes of Lupus:

While the exact causes of lupus are not known, a combination of multiple factors is thought to be behind the development of lupus. Some of these factors are:

 

  • Environment: The environment contains many potential triggers like smoking, stress, and many types of toxins. Exposure to these triggers can make a person prone to develop lupus.
  • Genetics: Researchers have discovered more than 50 genes associated with lupus. A family history of lupus also puts a person at an increased risk of developing lupus.
  • Hormones: Research has indicated that disturbed hormone levels such as estrogen levels can lead to lupus.
  • Infections: There is a lot of research going on to understand the links between infection such as cytomegalovirus and Epstein-Barr virus (EBV9) and lupus.
  • Medications: Some drugs such as hydralazine, procainamide, and quinidine can, if used for a long time, cause a type of lupus termed drug-induced lupus erythematosus (DIL). Other drugs such as tetracycline and TNF blockers can also contribute to this condition.

 

Always bear in mind that a person can have lupus even in the absence of the causes mentioned above.

 

Risk factors:

Certain factors can increase the risk of developing lupus. They include:

 

  • Sex: Females are more likely to develop lupus than males However, the disease can be more severe in men.
  • Age: Though lupus can develop at any age, most people suffering from it are between the ages of 15 and 40.
  • Race or ethnicity: Certain ethnic groups are more susceptible to developing lupus. These groups include African Americans, Hispanics, Asian Americans, or Native Americans.
  • Family history: family history of lupus poses a greater risk of developing the condition.

 

It is important to note that possessing these risk factors does not necessarily mean that you’ll necessarily have lupus. But it means that you’re just at increased risk of developing this disease as compared to those who don’t possess risk factors.

 

How is Lupus diagnosed?

There is not a single blood test or imaging study that can specifically diagnose lupus. Your doctor will check your signs and symptoms and will rule out other diseases that could also cause those symptoms. Extensive research has shown that there are antibodies that are highly specific to lupus, including double-stranded DNA (ds-DNA) and the Smith (Sm) antibody.

Overall diagnostic workup of a person having lupus would include:

 

  • Clinical features
  • Detailed medical history
  • General physical examination
  • Complete Blood Count (CBC)
  • Double-stranded DNA (ds-DNA) and the Smith (Sm) antibodies levels
  • Erythrocyte Sedimentation Rate (ESR)
  • C-reactive protein (CRP) test
  • Complete Urine Examination (CUE)
  • Chest X-rays
  • ECG
  • Echocardiography
  • Tissue biopsy

 

Types of Lupus:

The type of lupus is associated with the part of the body that is affected. There are the common types of lupus:

  1. Systemic lupus erythematosus (SLE)
  2. Neonatal lupus
  3. Cutaneous lupus
  4. Drug-induced lupus
  5. Lupus nephritis

 

Is lupus curable?

Currently, there’s no permanent cure for this disease. However, there are many different types of treatments that ease the signs and symptoms. Aims of treatment in lupus are:

 

  • Treating the symptoms
  • Preventing the flares of lupus from occurring
  • Minimizing the amount of damage to joints and organs

 

Treatment:

Your healthcare provider will assess your condition thoroughly and formulate a plan for the best management of your lupus. Severity of signs and symptoms will dictate the treatment regimen.  Medications can help to address lupus symptoms in several ways such as calming your immune system. The most commonly used lupus medications are:

 

  • Non-steroidal anti-inflammatory drugs (NSAIDs) such as naproxen and Ibuprofen
  • Antimalarial drugs such as quinolone
  • Corticosteroids like prednisone and hydrocortisone
  • Immunosuppressive drugs such as methotrexate, mycophenolate mofetil, azathioprine, mycophenolic acid
  • Biological agents such as Belimumab

 

Carefully following the treatment is crucial in managing lupus. While using any of these medications, keep an eye on your symptoms or any side effects of these drugs. If you observe any side effects, it’s important to consult your doctor. They will modify the drug or its dosage.

 

Apart from the medications, doctors also recommend lifestyle changes. These lifestyle changes help in coping with lupus successfully.

 

  • Avoiding unnecessary exposure to ultraviolet (UV) light
  • Consuming a nutritious, healthy balanced diet with plenty of fresh fruits and vegetables, whole grains and moderate amounts of meats, poultry, and fish
  • Taking vitamin and calcium supplements
  • Quit smoking
  • Exercise regularly.

For more information, advice and support see Lupus UK.

 

The Takeaway Message:

If you or a beloved one has lupus, the signs and symptoms can be managed successfully. It’s possible to live a normal life with lupus. You need to take extra care of yourself and take the medications prescribed by your doctor regularly. Maintaining a healthy lifestyle, controlling the symptoms and reducing the flare-ups would help you in coping with this disease successfully.

If you are worried about lupus, speak to your doctor.

References

Maidhof, W., & Hilas, O. (2012). Lupus: an overview of the disease and management options. P & T : a peer-reviewed journal for formulary management, 37(4), 240–249.

Prystowsky, S. D., & Gilliam, J. N. (1975). Discoid lupus erythematosus as part of a larger disease spectrum. Correlation of clinical features with laboratory findings in lupus erythematosus. Archives of dermatology, 111(11), 1448–1452.

Cooper, G. S., Dooley, M. A., Treadwell, E. L., St Clair, E. W., & Gilkeson, G. S. (2002). Risk factors for development of systemic lupus erythematosus: allergies, infections, and family history. Journal of clinical epidemiology, 55(10), 982–989. https://doi.org/10.1016/s0895-4356(02)00429-8

Hou, C., Jin, O., & Zhang, X. (2018). Clinical characteristics and risk factors of infections in patients with systemic lupus erythematosus. Clinical rheumatology, 37(10), 2699–2705. https://doi.org/10.1007/s10067-018-4198-8

Kuhn, A., Bonsmann, G., Anders, H. J., Herzer, P., Tenbrock, K., & Schneider, M. (2015). The Diagnosis and Treatment of Systemic Lupus Erythematosus. Deutsches Arzteblatt international, 112(25), 423–432. https://doi.org/10.3238/arztebl.2015.0423

Rodríguez Huerta, M. D., Trujillo-Martín, M. M., Rúa-Figueroa, Í., Cuellar-Pompa, L., Quirós-López, R., Serrano-Aguilar, P., & Spanish SLE CPG Development Group (2016). Healthy lifestyle habits for patients with systemic lupus erythematosus: A systemic review. Seminars in arthritis and rheumatism, 45(4), 463–470. https://doi.org/10.1016/j.semarthrit.2015.09.003

Pettersson, S., Boström, C., Eriksson, K., Svenungsson, E., Gunnarsson, I., & Henriksson, E. W. (2015). Lifestyle habits and fatigue among people with systemic lupus erythematosus and matched population controls. Lupus, 24(9), 955–965. https://doi.org/10.1177/0961203315572716

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