What is lupus?
Lupus is an autoimmune disease that affects the joints and causes inflammation in other systems as well.
Systemic lupus erythematosus (SLE) is an autoimmune disease in which the immune system of the body attacks its healthy tissue. It affects joints, skin, brain, lungs, kidneys and blood vessels, leading to inflammation and tissue damage of the affected organs. More than 90% of cases occur in females.
How does a person get lupus?
The exact cause of SLE is unknown; however, some environmental, genetic and hormonal factors may contribute to getting lupus.
Environmental factors
- Exposure to UV rays
- Microbial response
- Certain medications
- Silica dust
- Cigarette smoking
- Photosensitivity (sensitivity to sunlight)
Other risk factors
- Family history of SLE
- Female gender
- Chronic infections
- Use of estrogen in women undergoing menopause
- Vitamin D deficiency
- Pregnancy breastfeeding has shown to decrease the risk of SLE.
- Women of childbearing ages (15-44 years)
- High-risk ethnic backgrounds such as African Americans, Asians, Hispanics and Caucasians
Early-life risk factors
- Low birth weight (<2,500 g)
- Preterm birth (birth that occurs before the 37th week of pregnancy)
- Exposure to pesticides during childhood
What is usually the first sign of lupus?
Fatigue, fever, joint pain and weight changes are usually the first signs of lupus.
Some adults may have a period of SLE symptoms known as flares, which may occur frequently, sometimes even years apart and resolve at other times—called remission. Other symptoms include:
- Sun sensitivity
- Oral ulcers
- Arthritis
- Seizure
- Anemia
- Fever
- Loss of appetite
- Muscle aches
- Alopecia (hair loss)
- Facial rash (butterfly rash)
- Chest pain caused due to inflammation of the lining that surrounds the lung (pleuritis) and the heart (pericarditis)
- Raynaud’s phenomenon (poor circulation to the fingers and toes with cold exposure)
- Vasculitis (inflammation of blood vessels)
Apart from the above symptoms, nausea, indigestion, abdominal pain and confusion may also be seen in some patients.
What are the complications of lupus?
The complications that accompany SLE are as follows:
- Lupus nephritis (kidney failure)
- Dysphagia (difficulty in swallowing)
- Lymphadenopathy (swollen lymph nodes)
- Lupoid hepatitis (liver disease)
- Fibromyalgia (muscle pain and tenderness)
- Pancreatitis (inflammation in pancreas)
- Infections
- Coronary heart disease (damage or disease in the heart’s major artery)
- Blood clots
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Systemic Lupus Erythematosus
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How is lupus diagnosed?
Physicians diagnose SLE with the help of the following laboratory tests:
- Specific antibody tests for SLE (e.g., antinuclear antibodies, anti-double-stranded DNA) may be done
- Complete blood cell count (CBC) to screen for anemia and thrombocytopenia
- Serum creatinine for kidney disease
- Urinalysis for kidney disease
- Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) for inflammation
- Liver function tests
Radiographic tests such as computed tomography scan, magnetic resonance imaging and joint radiograph also detect abnormalities.
Ultimately, a skin biopsy is performed to confirm the diagnosis.
How is lupus treated?
There is no cure for SLE. Management of SLE depends on disease severity and disease manifestations.
Hydroxychloroquine is effective in the long-term treatment of SLE. Immunosuppressive medicines help to inhibit the activity of the immune system, which can be useful in treating SLE.
Nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids help to treat inflammation and pain in the muscles, joints and other tissues.
Can a person die from lupus?
SLE along with other medical conditions can be a contributing cause of death. Mainly, secondary conditions like kidney diseases, heart diseases or infection can be the contributing factor.