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Lupus, also called systemic lupus erythematosus (SLE), is a chronic inflammatory condition that can affect any part of the body, including the skin, joints, kidneys, heart, lungs, and nervous system. It is one of the most common autoimmune diseases (diseases in which the immune system attacks its own body tissues).
Lupus is an unpredictable lifelong condition that typically affects young women between 18 and 45 years of age, but it can affect men and those older or younger as well. It is estimated that lupus affects over 1 in 1,000 Canadians. Between the ages of 15 to 45, women are diagnosed with lupus 8 times more frequently than men. In the early days of treating lupus, doctors only recognized the most severe cases and there were very limited treatments. As a result, the survival rate was not very good. Today, doctors usually recognize cases much earlier, and more mild cases, and there are now better ways of managing the disease. As a result, while there is still no cure for lupus, the survival rate is close to 90% 10 years after diagnosis.
However, available treatments all have risks and side effects, so people with lupus sometimes have to choose between those risks and the effects of their disease. In some cases, the disease is more moderate and minimal treatment is needed.
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It's generally believed that lupus is caused by alterations in the immune system. The body's immune system normally fights foreign bacteria and viruses; however, with lupus, the immune system may fail to recognize "self" substances and will make antibodies that attack the body's own tissue. This is called autoimmunity.
The exact cause of lupus is still unknown. Multiple factors are involved in the development of the disease, including heredity and environmental factors. It is recognized that sunlight causes symptoms to flare up.
Other triggers include viral infections, the stress of illness, sometimes pregnancy, and certain medications. Because more women are affected than men, another theory suggests a relationship with estrogens.
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With lupus, symptoms may flare up every once in a while and then go away for a period of time. This symptom-free period is called remission. Unfortunately, it is difficult to determine how long a period of remission will last.
Lupus may be mild or severe, and may result in a range of symptoms such as:
Complications of lupus may involve inflammation that can affect other areas of the body (such as the kidneys, central nervous system, and heart). If complications occur, they usually appear during the first few years after the initial diagnosis.
Kidney inflammation as a result of lupus is usually without symptoms at first, and unfortunately many people may not even notice it until the problem is advanced. Once it progresses, there may be other signs such as bloating, ankle swelling, and abnormal blood and urine tests. Ultimately kidney failure may develop.
Your doctor should closely monitor you for signs of early Kidney Disease, such as protein and other abnormalities in the urine.
Lupus also commonly accelerates and worsens atherosclerosis (hardening of the arteries), so your doctor may also monitor for risk factors like high blood pressure, cholesterol, and Diabetes. Your doctor may also advise you to not smoke. It is very important to get treatment for atherosclerosis.
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An antinuclear antibody (ANA) test is the most important test for lupus, as almost all people with lupus will have elevated blood levels of antinuclear antibodies. However, a diagnosis will not be based on ANA results alone, because many people have positive ANA tests without lupus, and they can also occur in other autoimmune diseases. The ANA is a very non-specific test, and elevated levels may not last in some people. The diagnosis of lupus is based upon multiple factors, including other blood tests, in addition to the ANA.
Your medical history and a physical examination done by your doctor will play an important role in making the diagnosis. Other laboratory studies such as tests of kidney function, as well as joint X-rays and MRI (magnetic resonance imaging) scans, will help determine the extent of the disease.
Some people may need heart tests and an electroencephalogram (a test to measure electrical activity of the brain) to detect neurolupus (lupus that affects the brain).
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The use of medication to treat lupus depends on the severity of the disease. In some cases, medication may not even be necessary.
Commonly prescribed medications include:
Although all of these medications can be helpful and sometimes even life-saving, they have potentially very serious side effects. You should discuss the benefits and risks carefully with your doctor. You may also want to discuss your medications with health care professionals who are experienced in their use, such as rheumatologists (doctors who specialize in the diagnosis and treatment of Arthritis and other diseases that affect the joints, muscles, and bones).
For those who have lupus, the following tips may be helpful:
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