The month of May is recognized worldwide as Lupus Awareness Month. Systemic lupus erythematosus is the most common form of lupus – it is what most people mean when they refer to “lupus.” Systemic lupus erythematosus (SLE) is an autoimmune disease. This means the body’s natural defense system (immune system) attacks healthy tissues. This chronic disease if not managed correctly can result in serious complications.
What is lupus?
Lupus is a systemic autoimmune disease that occurs when your body’s immune system attacks your own tissues and organs. Inflammation caused by lupus can affect many different body systems — including your joints, skin, kidneys, blood cells, brain, heart and lungs. Lupus is not contagious.
Lupus can be difficult to diagnose because its signs and symptoms often mimic those of other ailments. The most distinctive sign of lupus — a facial rash that resembles the wings of a butterfly unfolding across both cheeks — occurs in many but not all cases of lupus.
Some people are born with a tendency toward developing lupus, which may be triggered by infections, certain drugs or even sunlight. While there’s no cure for lupus, treatments can help control symptoms. Symptoms can be improved if treatment starts early, hence the need to make the diagnosis early.
What causes Lupus?
Lupus occurs when your immune system attacks healthy tissue in your body (autoimmune disease). It is likely that lupus results from a combination of your genetics and your environment.
It appears that people with an inherited predisposition for lupus may develop the disease when they come into contact with something in the environment that can trigger lupus. The cause of lupus in most cases, however, is unknown. Some potential triggers include:
• Sunlight. Exposure to the sun may bring on lupus skin lesions or trigger an internal response in susceptible people.
• Infections. Having an infection can initiate lupus or cause a relapse in some people.
• Medications. Lupus can be triggered by certain types of blood pressure medications, anti-seizure medications and antibiotics. People who have drug-induced lupus usually get better when they stop taking the medication. Rarely, symptoms may persist even after the drug is stopped.
What are some symptoms of lupus?
Symptoms for lupus can vary but if you have the following symptoms you should see your doctor:
• joint pain and stiffness
• extreme tiredness that will not go away no matter how much you rest
• skin rashes – often over the nose and cheeks
These are the main symptoms of lupus.
As well as the 3 main symptoms, you might also have:
• weight loss
• swollen glands
• sensitivity to light (causing rashes on uncovered skin)
• poor circulation in fingers and toes (Raynaud’s)
Symptoms can flare up and settle down
Often the disease flares up (relapses) and symptoms become worse for a few weeks, sometimes longer.
Symptoms then settle down (remission). The reason why symptoms flare up or settle down is not yet known.
Some people do not notice any difference and symptoms are constant
How do doctors make the diagnosis of lupus?
As lupus symptoms can be similar to lots of other conditions, it can take some time to diagnose it correctly.
Once a detailed history is taken, your doctor will usually do some blood tests. High levels of a type of antibody, combined with typical symptoms, mean lupus is likely.
You might be referred for X-rays and scans of your heart, kidney and other organs if your doctor thinks they might be affected.
Once lupus is diagnosed, you will be advised to have regular checks and tests, such as regular blood tests to check for anaemia – and urine tests to check for kidney problems which lupus can cause.
Treatment
Treatment for lupus depends on your signs and symptoms. Determining whether your signs and symptoms should be treated, and what medications to use, requires a careful discussion of the benefits and risks with your doctor.
As your signs and symptoms flare and subside, you and your doctor may find that you will need to change medications or dosages.
Pregnancy and lupus
Lupus can cause complications in pregnancy.
See your gynaecologist/obstetrician before trying to get pregnant to discuss the risks – and so your medication can be changed if necessary.
Lupus and hormones
SLE affects women more than men. Women also may experience severe problems related to their menstrual periods. These observations have led some medical professionals to believe that the female hormone oestrogen may play a role in causing SLE. However, more research is still needed to prove this theory.
Lifestyle and home remedies
If you have Lupus there are things you can do to care for your body. Simple measures can help you prevent lupus flares and, should they occur, better cope with the signs and symptoms you experience. The following are recommended:
• See your doctor regularly. Having regular checkups instead of only seeing your doctor when your symptoms worsen may help your doctor prevent flare-ups, and can be useful in addressing routine health concerns, such as stress, diet and exercise that can be helpful in preventing lupus complications.
• Be sun smart. Ultraviolet light can trigger a flare, so you should wear protective clothing — such as a hat, long-sleeved shirt and long pants — and use sunscreens with a sun protection factor (SPF) of at least 55 every time you go outside.
• Get regular exercise. Exercise can help keep your bones strong, reduce your risk of heart attack and promote general well-being.
• Do not smoke. Smoking increases your risk of cardiovascular disease and can worsen the effects of lupus on your heart and blood vessels.
• Eat a healthy diet. A healthy diet emphasizes fruits, vegetables and whole grains. Sometimes you may have dietary restrictions, especially if you have high blood pressure, kidney damage or gastrointestinal problems.
• Ask your doctor if you need vitamin D and calcium supplements. There is some evidence to suggest that people with lupus may benefit from supplemental vitamin D. A 1,200- to 1,500-milligram calcium supplement taken daily may help keep your bones healthy.
Conclusion
SLE is a chronic autoimmune disease that can affect many adults, but is more common in females. We are still not sure what causes this condition and making the diagnosis can be challenging as its symptoms often mimic other diseases. At this time there is no cure for this disorder, but several medications are available to manage its symptoms and prevent complications. Early diagnosis is important to successfully control the symptoms of lupus. If you have symptoms suggestive of lupus see your doctor for an evaluation, but remember it might take some time before the diagnosis is confirmed.
Ask Your Dr is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG is an obstetrician/Gynaecologist and Family Doctor with over thirty-seven years in clinical practice. Dr Brett Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 497 5828).
