What Is Lupus?

Lupus is a chronic autoimmune disease that occurs when the immune system attacks the body’s tissues and organs. The resulting inflammation translates into a list of symptoms and impacts various systems in the body. This includes issues with the skin, blood vessels, nervous system, kidney damage, heart, brain, blood cell count, and lungs.

Lupus prognosis is often challenging because several of the lupus symptoms can look like other disorders. One of the most noticeable symptoms of lupus is the butterfly facial rash, which resembles butterfly wings unfolding across the bridge of the nose and cheeks. The butterfly rash develops in many, but not all cases. There are several types of lupus,such as cutaneous lupus, discoid lupus, etc.,  but the most common form is systemic lupus erythematosus (SLE). It can be mild or severe and can affect different parts of the body. In some cases, SLE leads to lupus nephritis, an autoimmune kidney disease, characterized by inflammation of the kidneys. 

Some people are more prone to developing lupus, and it can be triggered by infection, certain drugs, and sometimes sunlight. Nine out of every ten patients with lupus are female. Although there is no cure for lupus, treatments have been developed that offer effective symptom management.

Symptoms

Symptoms of lupus are spread out, impacting a range of body systems, and can vary in degree of severity and duration. Lupus tends to manifest differently from patient to patient and symptoms can come on quickly or slowly over time. Symptoms may be present for short episodes (flare ups), or for a much longer duration of time, and sometimes may even be permanent. Most patients experience mild disease characterized by episodes that tend to get worse before subsiding, or completely disappearing for a time. Symptoms of lupus include:

• Joint pain, stiffness and swelling (sometimes leads to increased risk of osteoporosis)
• Fatigue (sometimes severe or chronic)
• Fever for unknown reason
• Butterfly-shaped facial rash across the bridge of the nose and cheeks or rashes elsewhere on the body
• Pericarditis which can cause chest pain (sometimes shortness of breath)
• Skin rash or lesions that appear or worsen with sun exposure (photosensitivity)
• Fingers and toes that turn white or blue when exposed to cold or when under stress (Raynaud's phenomenon)
• Hair loss
• Weight loss
• Anemia
• Blood clots
• Dry eyes
• Headaches, confusion and memory loss

Causes

Lupus develops when the body’s immune system begins attacking its own tissues and organs. There can be a variety of genetic or environmental factors that contribute to the development of lupus. Although the cause of lupus is still mostly unknown, factors that seem to trigger lupus include:

• Sunlight: Some patients with lupus develop a photosensitivity (sensitivity to the sun) and will develop skin lesions from being in the sun.
• Infections: In some patients, an infection can trigger lupus or cause a relapse of symptoms.
• Medications: Side effects of some types of medications can trigger lupus, such as certain high blood pressure medications, medications for rheumatoid arthritis, anti-seizure medications and antibiotics. Typically, drug-induced lupus tends to clear up once medications are stopped. Rarely, lupus complications may persist even after the drug is discontinued.

Other risk factors related to developing lupus include gender, age, and race. Lupus is more common in females. Most often the age range for lupus falls between the ages of 15 and 45 years old. It is also more prevalent among African-Americans, Hispanics, and Asian-Americans.

Diagnosis

Lupus can be difficult to diagnose and may take months to several years to get an accurate diagnosis. Getting a diagnosis for lupus is challenging because the symptoms can be so spread out and often mimic other diseases. There is no singular test or assessment that generates a diagnosis. Medical professionals often use multiple diagnostic assessments and tests to make a diagnosis. Some of the common tests and assessments used for diagnosis are listed below:

• Lab Tests: Urine and blood tests will test a patient’s blood counts, kidney functioning, liver functioning, and will try to rule out any systemic issues. Specific tests might include an ANA test (antinuclear antibodies test), a urinalysis, complete blood count (CBC), erythrocyte sedimentation rate, and kidney and liver assessments. The CBC test run by a healthcare professional helps in determining the number and type of white blood cells, red blood cells and platelets in the blood. 

• Imaging Tests: Tests would include chest x-rays and an echocardiogram, which would check for unusual shadows in the lungs and for any abnormalities of the heart, as lupus can contribute to heart diseases, causing chest pain or heart attack. 

• Biopsy: May be ordered if there has been damage to the kidney or if a skin biopsy is needed for diagnosis confirmation.

If you are experiencing any symptoms of lupus, please contact your Baptist Health primary care physician so they can begin diagnostic procedures and create a treatment plan. Remember that symptoms differ from patient to patient, and lupus may take weeks, months, or years to accurately diagnose.

Treatment

Lupus treatment will look different for each patient, depending on the specific symptoms, as well as the severity and longevity of the symptoms. A medical professional will create a lupus care treatment plan specific to a patient’s symptomatology. Although there is no cure for lupus, there are several treatment options that can help with symptom management. Often, treatment will change over time as symptoms come and go. It is important to make regular appointments with your physician in order for the treatment plan to be modified as symptoms change.

There are several forms of treatment for lupus. Specific treatments may change over the course of time, depending on the presentation of symptoms. Pain management is an important part of treatment for lupus. A few medications used for pain management are nonsteroidal anti-inflammatory drugs (NSAID’s), antimalarial drugs, corticosteroids, immunosuppressants, and biologics. Additionally, symptom management may also be helped by lifestyle changes, home remedies, alternative or supplemental medicines, and by finding a support group or support system.

Please contact your Baptist Health primary care physician if you are experiencing any symptoms of lupus so that a diagnosis can be determined and a specific treatment plan can begin to help with symptom management.