Lupus: Symptoms, Types and Treatment
Lupus is an auto-immune disease that goes on for long term.
Your body’s immune system goes into overdrive and starts attacking your own tissues and body organs.
Lupus mostly affects women of ages 15 to 44.
This guide discusses the causes, symptoms and treatment of lupus so that you can identify your symptoms timely.
The signs and symptoms are difficult to identify because they exist in other diseases too.
However, one distinctive sign is the presence of a butterfly-shaped face rash on the cheeks.
Each person with lupus has different symptoms from another.
People have bouts of flare-ups before the symptoms settle down.
Some people may have permanent symptoms, others temporary.
Your symptoms may also be severe or mild and develop gradually or instantly.
Most people undergo a mild disease with occasional flares.
The symptoms relapse for some weeks and then settle down or even disappear for a while.
However, symptoms differ according to the affected organ or body system.
Most common symptoms are:
- body rash or butterfly-shaped rash on the cheeks
- fingers also toes becoming white or blue in cold and due to stress
- pain in joints
- stiffness and swelling of joints
- pain in chest
- fever and fatigue
- skin lesions that can get worse due to sun exposure
- shortness of breath
- hair loss
- sores in mouth or nose
You may not have all these symptoms at once.
In fact, you may not get some of them ever.
However, you should immediately go to a doctor if you have a constant fever, rash and joint pains.
Types of Lupus
There are several types of lupus.
These include systemic lupus erythematosus (SLE) and discoid lupus.
Drug-induced lupus and neonatal lupus are a part of SLE.
The most common type of lupus is SLE (systemic lupus erythematosus).
Systemic Lupus Erythematosus (SLE)
As the name suggests, SLE is a systemic condition, therefore, it affects all the body.
This type can either be mild or severe, however, it is more severe than the other types.
This is because it affects other many organs and causes inflammation in joints, heart, kidneys and other body organs either solely or as a combination.
SLE has phases of relapse (flare-ups) and remission.
This means there are times where there are no symptoms and times when the disease is more active than normal.
Some people get SLE due to a drug reaction.
These drugs are usually used for treating high blood pressure, thyroid and a few antibiotics, antiviral medicines and oral contraceptive pills.
Medicines that cause this condition are Hydralazine used for hypertension, and Isoniazid antibiotic taken for Tuberculosis (TB).
Drug-induced lupus accounts for only 10 percent of SLE cases.
Moreover, it usually ends when you stop taking the drug.
Around 1 percent of babies born to mothers with SLE and autoantibodies will have neonatal lupus.
Babies will have a skin rash, low blood counts and a few of them may have anemia and liver problems.
The rashes will disappear in some time however, some infants may have a congenital heart block.
This means their heart cannot pump regularly requiring a pacemaker.
This condition can be life-threatening for the infant.
Therefore women with autoimmune diseases such as SLE need to be constantly checked by their doctor during pregnancy.
Discoid lupus erythematosus
DLE or cutaneous lupus only affects the skin.
Rashes may appear on the neck, face and scalp. Later these rashes can turn thick and scaly also resulting in scarring.
These scars can either be short term and last a few weeks or last years and also recur.
DLE only affects the skin and not the internal organs.
However, DLE can rarely turn into SLE.
Subacute cutaneous lupus erythematosus is another kind of lupus that occurs due to sun exposure.
Skin lesions and rashes form on areas that are sensitive to sunlight (photosensitivity).
However, this does not cause scarring.
Essentially lupus is caused by your own immune system attacking your body.
In an autoimmune disease, the immune system does not identify the differences between healthy tissues and unwanted substances.
Therefore antibodies start attacking the tissues and antigens. This leads to inflammation and tissue damage causing pain.
People with lupus have autoantibodies, commonly the antinuclear antibody (ANA).
It reacts with the cell nucleus and attacks the DNA of the cells which have thin walls to allow permeation.
Thus, lupus affects a few organs and not all.
Lupus has been linked to genetic and environmental factors.
People with an inherited predisposition to the disease can get it when an environmental factor triggers it.
Environmental triggers include infections that can trigger or release lupus, sun exposure and medicines such as the heart medicine Procainamide.
Risks and Complications
Lupus can affect more than one organ and can get serious.
The inflammation spreading to kidneys, lungs and central nervous system can damage the organs.
Hormones, genetics and environmental factors can contribute to the disease.
Hormones could be the reason behind lupus affecting more women.
9 out of 10 cases of lupus are of women.
Moreover, most cases of lupus are between 15 to 42 years of age which are the childbearing years.
There is a lack of evidence but this has been linked with the hormone estrogen.
Estrogen is present in both men and women however, the woman’s body produces it more.
Genetics may not directly be responsible for the disease however an inherited predisposition to this disease can increase your chances of getting it.
Therefore, some people are more likely to get lupus than others.
Lupus is more prevalent in people of color and Hispanics, Asians, blacks than Caucasians.
Lupus may also happen to people with no family history of the disease but of other autoimmune diseases.
Exposure to sunlight, certain medications and viral infections can trigger SLE symptoms.
Moreover, increased use of tobacco due to smoking can also increase your chances of getting the disease.
Lupus can cause severe damage to tissues and organs.
One of the main causes of death in people with lupus is kidney failure.
If it impacts the central nervous system, it can cause minor issues like headaches and dizziness to major ones like seizures, memory and vision problems.
Moreover, it can inflame the heart arteries and membranes which increases the chances of a heart attack and other cardiovascular diseases.
It can cause blood clotting and blood vessel inflammation, even anemia.
Furthermore, it can inflame pleurisy, which makes breathing painful. Additionally, there can be bleeding in the lungs and pneumonia due to this condition.
You are at an increased risk of infection since this disease weakens the immune system.
Pregnant women with lupus may have high blood pressure which risks preterm birth and miscarriage.
Rarely it could also increase your risk of getting cancer and bone tissue death.
Diagnosing lupus requires a number of tests because the symptoms resemble other diseases.
Moreover, these signs occur over a period of time rather than all at once.
Your doctor will carry out lab tests, imaging and a biopsy to accurately diagnose this disease.
A blood test will be carried out to determine the blood cells count.
This checks for the red blood cells, white blood cells, platelets and hemoglobin in your blood.
Henceforth, it identifies anemia and low white blood cells and platelet count that are present in this disease.
Erythrocyte sedimentation rate blood test checks for the speed at which red blood cells settle at the bottom of a tube.
If they are faster then a systemic disease like lupus may be present.
An Antinuclear antibody test can identify the presence of antinuclear antibodies in your system.
Most people with this disease have a positive ANA but this test alone cannot assuredly tell a presence of lupus.
A blood test may also be done to check the health of your liver and kidneys. If they are affected, they may indicate lupus.
A urinalysis checks the protein and red blood cells in your urine.
Their increase signifies lupus affecting the kidneys.
A chest X-ray can reveal inflammation and build-up of fluid in your lungs.
This helps identify the presence of lupus affecting your lungs.
Kidney and skin biopsy can diagnose lupus.
Kidneys are harmed in this disease and a small sample is taken by a needle or incision to identify the harm and devise the best treatment.
Your treatment will vary according to the disease’s severity.
Since this is a long-term disease with no definite cure, you will have to regularly visit your doctor.
Moreover, you will find yourself changing medicines frequently depending on your flares.
Drugs like hydroxychloroquine help reduce the flares by affecting the immune system.
This is an anti-malarial drug, used mostly to treat malaria.
However, you will require regular eye exams after taking it because one rarely occurring side effect is the damage of the retina.
Non-steroid anti-inflammatory drugs like ibuprofen can reduce pain and swelling.
Your doctor may also prescribe stronger NSAID’s.
However, side effects come with prolonged use such as kidney problems.
Corticosteroids such as methylprednisolone are used to treat serious inflammation in the brain and kidneys. Side effects may include weight gain, osteoporosis and diabetes but after prolonged use.
Furthermore, immunosuppressants like azathioprine may help reduce the activity of the immune system thus, helping in severe lupus.
Lupus is a systemic disease hence, you have to maintain a lifestyle with it.
You can incorporate a few lifestyle changes that can help you to deal better with your flares when they occur.
Visit your doctor regularly to prevent flares.
Your doctor will keep your medical health in check by regular tests which will allow them to change your medicines when needed and to prevent complications.
Exercise regularly to keep your bones and heart strong and remain healthy overall.
Quit smoking because it can worsen the effect of this disease on your heart and lungs.
Be cautious of sun exposure since it can trigger your flares.
Cover your skin by wearing shirts with long sleeves and pants.
Moreover, always use a sunscreen with an SPF above 55.
Also, include Vitamin D and Calcium supplements in your routine by consulting your doctor.
Lupus is a long term disease. It may not be curable but it can be controlled.
Therefore keep visiting your doctor regularly to prevent it from getting serious and developing complications.