Lupus, which is a condition that is characterized by chronic inflammation of tissues in the body, is caused by an autoimmune disease in the body. This means that the body’s immune system is attacking the body itself. The immune system in the body is designed to fight off infection in the body by producing antibodies to attack foreign bodies in the blood. When a person has lupus, the body produces abnormal antibodies that attack the tissues in the body rather than foreign bodies that may be in the blood. When abnormal antibodies attack the tissues in the body, inflammation occurs in those areas.
Lupus can affect many parts of the body because the abnormal antibodies can potentially attack any and all tissues in the body. In some cases, lupus can cause diseases of the skin, heart, lungs, kidneys, joints, and even the nervous system. When lupus affects the skin, and only the skin, it is called discoid lupus. When it affects the internal organs of the body, it is called systemic lupus erythematosus, or SLE for short.
Both types of lupus are more common among women than they are among men. It can also affect people of all ages, but is more common among those between the ages of 20 to 45 years old.
Heredity, viruses, ultraviolet light, and drugs are all believed to be contributors to a person acquiring lupus; the exact reason why people acquire it is unknown. It is known that genetics can increase the risk of a person acquiring autoimmune diseases. Some autoimmune diseases are more common among patients who are related. Lupus fits into this category.
Some scientists feel that the immune system in patients with lupus are more easily affected by viruses or ultraviolet light because in some cases, the symptoms of lupus are aggravated by even a small amount of exposure to sun light or a virus. It has also been found that some women with SLE have worse symptoms right before they begin their menstrual period, suggesting that a woman’s hormones play a role in SLE type lupus.
More recent studies have shown that an enzyme in the body called DNase1, and its inability to rid the body of dying cells may contribute to a person developing SLE. DNase1 normally breaks down dying cells in the body to help make it easier for the body to eliminate them, if it is not working properly, or has mutated, it would not function properly. Tests have been done on mice that have made scientists believe that the mutation of DNase1 is a key factor in why SLE is acquired.
Side effects of certain medications have also been found to trigger SLE in patients. These medications stimulate the immune system and trigger SLE. Medication induced SLE is not common, but it has happened. The symptoms are normally resolved when the medication is stopped.
Signs and symptoms for discoid lupus, the type that only involves the skin, are rashes that are often times found on the face and scalp. The rash is usually red and may have a raised border. Normally, the rash does not hurt or itch, but it can cause scarring and permanent hair loss in that area. Some people with this type of lupus can develop SLE in the future.
Signs and symptoms of SLE are fatigue, a low-grade fever, loss of appetite, muscle aches, mouth and nose ulcers, a rash on the face, an unusual sensitivity to sun light, arthritis, inflammation of the lining around the lungs and heart, and poor circulation in the fingers and toes when they are cold.
In more serious cases, SLE involves inflammation in the brain, liver, and kidneys. White blood cell count may be low, and blood clotting ability may be decreased which increases the risk of serious infection.
It is said that over half of the people with SLE have a very characteristic red, flat rash on their face that goes over the bridge of their nose. It is often referred to as the “Butterfly rash”. This rash neither hurts nor itches, but can become worse in the sun light. The inflammation of other organs in the body may also become worse with sun exposure.
Most people who have SLE will develop arthritis over time. This arthritis can cause swelling, pain, stiffness, and even deformities of the small joints in the hands, wrists, and feet. Occasionally, the arthritis brought on by SLE can be mistaken for rheumatoid arthritis because of the similarity between the two.
When the muscles become inflamed, they can hurt and become weakened. If the blood vessels become inflamed, injury to a nerve, the skin, or internal organ can happen due to the lack of circulation to that part of the body. If the lining of the lungs or heart are inflamed, it can cause very sharp chest pains. The chest pain may worsen with coughing, breathing deeply, and even changing the body’s position. Thankfully, the heart itself is rarely affected by SLE inflammation, but is has been shown that women with SLE have an increased risk of heart attack from coronary artery disease.
When the kidneys become inflamed because of SLE, protein can leak into the urine, there could be retention of bodily fluid, high blood pressure, and sometimes, kidney failure.
If the brain becomes inflamed, a person may have personality changes, thought disorders, seizures, and may even slip into a come. If there is damage to the nerves, numbness, tingling, and weakness to body parts such as the arms and legs is likely.
Due to lupus having the ability to affect so many different parts of the body, doctors have specific criteria to help properly diagnose people who have SLE. Unfortunately, some people who have SLE may never actually meet enough of the criteria to be diagnosed; others may develop enough symptoms for diagnosis only after months or years of seeing a doctor and being examined. There are eleven different criteria, and when there are four or more present, a diagnosis of SLE is strongly suggested, however; a diagnosis may be made even if only a few are met.
The criteria for a diagnosis of SLE are, a rash over the cheeks and bridge of the nose, a rash on the scalp or face that is red and may have a raised border, a rash on the skin that is in reaction to sun light, ulcers in the mouth, nose, or throat, two or more tender and swollen joints in the extremities of the body, inflammation to the lining around the heart or lungs, abnormal amounts of protein in the urine, seizures and/or psychosis that would indicate an irritation in the brain, low white cell, red cell, or platelets counts in the blood, a disorder in the immune system, and a positive ANA antibody test.
Although there are the specific eleven criteria for SLE, other tests can also be useful for determining the severity of the involvement of organs in the body. Routine blood tests to detect inflammation, blood chemistry tests, testing of internal body fluids, and tissue biopsies can be used.
There is no cure for SLE. Treatment helps to relieve the symptoms and protect the body’s organs by decreasing the amount of inflammation and the level of autoimmune activity in the body. Patients who only have mild symptoms often do not need any more than intermittent courses of anti-inflammatory medication, sometimes; they do not even need that. People who have more severe cases of SLE that involves internal organ damage may have to have high doses of corticosteroids along with other medications to help suppress the body’s immune system.
People who suffer from SLE need to rest more when the disease is more active. Poor quality of sleep is likely to cause fatigue. Patients should discuss their quality of sleep, any feelings of depression, lack of exercise, and self-care and coping strategies with their doctors. Doctors should also address these issues and explain how they can affect a patient’s over-all health.
There are medications to help manage SLE, but exercise is very important to help maintain muscle tone and the over-all range of motion in the joints. Occasional flare-ups of SLE can usually be managed with the use of different medications, but most people with SLE live happy, active, healthy lives. SLE is often aggravated by sun light, so those suffering from SLE should avoid sun exposure, using sunscreen and wearing clothes to help cover the arms and legs can be helpful. Medications should not be stopped without a doctor’s approval. Stopping them abruptly can lead to flare-ups. People with SLE are more likely to get an infection; any fever that is unexpected should be reported to a doctor right away. Regular visits to the doctor to monitor symptoms are very important in managing SLE.
Women who have SLE and become pregnant are considered to be high risk. They need to be monitored closely throughout the duration of the pregnancy and delivery. Risk of miscarriage and SLE flare-ups is high. Tests can be done to estimate the risk of miscarriage.
A mother with lupus can pass the antibodies to her baby. This can cause the baby to have a low red blood cell count, low white blood cell count, and a low platelets count. The baby may have a skin rash. Problems can develop in the baby’s heart and occasionally, the baby may need a pacemaker. Normally, when lupus antibodies are passed from mother to baby, the lupus clears itself after 6 months. This happens because the cells passed from the mother are slowly metabolized by the baby’s body.
Though there is no cure for lupus, more and more methods for treatment are being found. Treatments that are more effective. In the years to come, it is the hope that a cure can be found. In the meantime, those who suffer from lupus should learn all they can to help them manage the symptoms and live better lives.
