Lupus: Diagnosis, Causes, & Treatment
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Do you sometimes wonder how Grammy award-winning
singer Seal got his butterfly-shaped
rashes on his cheeks? Turns out that what he got isn’t a birthmark or acne
scars. His iconic facial rashes were caused by an insidious and hard-to-diagnose disease called lupus.
Lupus
is one of the world's most devastating and unpredictable diseases. It is a
chronic autoimmune disease that has a brutal impact on a person who suffers.
Lupus
is a condition that only a few people know about. In 2015, lupus gained even more
attention from the public after singer Selena Gomez announced that she had been
diagnosed with it in her late teens. She has likewise undergone chemotherapy
and a recent kidney transplant to cope with this disease.
Lupus Facts
❏
Lupus is a chronic autoimmune disorder caused
when the immune system becomes hyperactive and attacks healthy organs or areas in
the body. It can be mild or life-threatening.
❏
It’s not contagious. You cannot catch or pass
lupus to other people, not even through sexual contact.
❏
It's not
related to cancer.
❏
Symptoms
usually start in early adulthood or anywhere from the teen years into the 30s.
What is Lupus?
●
Lupus is a chronic autoimmune disease. It means the immune system becomes
hyperactive and mistakenly attacks healthy body cells and tissues.
●
Under normal
function, our body's immune system makes proteins called antibodies which fight
off antigens such as viruses, bacteria, and germs. The antibodies attach
themselves to harmful antigens which can cause the disease.
●
Auto-antibodies
cause inflammation and swelling that can damage organs and tissues of the
body including the joints, skin, kidneys, heart, lungs, blood vessels, and
brain.
●
This
disorder usually occurs in women. Symptoms typically start in early adulthood,
anywhere from the teen years into the 30s.
●
People with
lupus generally experience flare-ups and periods of remission. That’s why early
signs are easy to dismiss.
●
Doctors
believe that lupus results from both genetic and environmental stimuli.
●
There is no
cure for lupus and its symptoms, but it can be controlled with medication.
Treatments for Lupus include corticosteroids, immunosuppressive drugs, and
lifestyle changes.
There are four known types of lupus:
1. Systemic Lupus Erythematosus (SLE)
Systemic Lupus Erythematosus (SLE) is the most common form of lupus, and
it affects many parts of the body. The most characteristic of the symptoms of
SLE is the butterfly rash or malar rash that appears in the bridge of the nose
and cheek.
2. Discoid (Cutaneous)
Discoid is a kind of lupus that
causes a rash or lesion on the skin, usually when exposed to sunlight. It does
not include the body’s internal organs, but pain may accompany the rash.
3. Drug-induced Lupus (DIL)
DIL is similar to SLE usually caused by an
overreaction to certain medications. Symptoms typically disappear after the
patient stops or discontinues taking these medications.
4. Neonatal
Lupus
In rare cases, it occurs when an
infant acquires auto-antibodies from its mother with SLE. This condition can
cause skin, anemia, or liver problems. Symptoms resolve within the first six
months of the infant's life.
Causes of Lupus
The reason for the abnormal auto-immunity that causes the disease
is still unknown. However, scientists believe that genetics, epigenetics, and environmental factors
are involved.
Symptoms and Signs
People with lupus may experience different symptoms from one another because
the disease can affect any part of the body.
The typical symptoms include the following;
● Extreme fatigue
● swelling in joint pain
● facial rash (butterfly rash)
● unexplained fevers (more than 100 F)
● hair loss
● sensitivity to the
sunlight
● seizures
● nose or mouth
sores
● chest pain
Diagnosis
Typically, when a person has several features of the disease
including signs and symptoms, the doctor will conduct several complete and
accurate medical histories, physical examinations, laboratory tests, and other diagnostic studies
to determine if you
indeed have the disease or to make a diagnosis and to monitor the progress of
the disease once diagnosed.
The most useful tests include the following; complete blood
count (CBC), urinalysis, blood chemistries, complement levels, erythrocyte
sedimentation rate (ESR), ANA, and another autoantibody.
Treatments
Still, there is no known cure for lupus. However, it can be treated effectively with medications according
to the severity of the signs and symptoms.
Factors such as age, type of drugs a patient is taking, and overall
health are considered.
Specific treatments and medications most commonly used to control lupus include the following:
●
Steroids or prednisone and related
derivatives of cortisone. Creams can
be directly applied to rashes
●
Hydroxychloroquine (Plaquenil). It is used to help keep control of mild
lupus-related problems, such as skin and joint disease
●
Cyclophosphamide (Cytoxan). A drug for chemotherapy, it is useful in
reducing the activity of the immune system.
●
Azathioprine, a medication originally used to prevent the rejection of transplanted
organs.
●
Methotrexate (Rheumatrex). Another chemotherapy medication is used to
suppress the immune system. Its use is for skin disease, arthritis, and
non-life threatening forms of illness that have not responded to drugs such as
low doses of prednisone or hydroxychloroquine.
●
Cyclophosphamide (Cytoxan) and mycophenolate
mofetil (CellCept). It is also
a drug for chemotherapy and is useful in
reducing the activity of the immune system.
It is usually used t treat severe lupus, especially lupus that affects
the kidney.
●
Belimumab (Benlysta). It is a monoclonal antibody that reduces the
activity of white blood cells (lymphocytes) that make autoantibodies.
●
Rituximab (Rituxan) belongs to a class of drugs called monoclonal that reduces the
activity of white blood cells (lymphocytes) that produce autoantibodies.
Alternative or complementary approaches may help cope with or reduce some of the patient's pressure from the situation. Certain activities include:
●
Eat well. Proper nutrition is an
essential treatment plan for the disease
●
Exercise and enough rest
●
Don’t smoke and void alcohol
●
Play it safe
in the sun
●
Treat fevers
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Get to know your condition.
●
Ask for help.
Lupus continues to present many unanswered questions. However, the outlook for people living with lupus is improving each decade with the development of more accurate monitoring tests and treatments. It is essential to understand the illness.
If you or your family member has the above symptoms and manifestations, talk to your doctor before you make any assumptions
References
Elish D, Silverberg NB. Neonatal lupus
erythematosus. Cutis. 2006;77:82–86
Pons-Estel GJ, Alarcon GS, Scofield L,
et al. Understanding the epidemiology and progression of systemic lupus
erythematosus. Semin Arthritis Rheum. 2010;39:257–268. Free article (PubMed)
D’Cruz DP. Systemic lupus
erythematosus. BMJ. 2006;332:890–894 Free article (PubMed)
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