Lupus 101

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Maybe you know someone with lupus, or you’ve heard celebrities like Selena Gomez and Toni Braxton share their stories and experiences with the disease. Lupus is challenging to diagnose, difficult to treat, and presents differently in each person. These facts make it an unpredictable and largely misunderstood disease, even though the most common type of lupus affects about 200,000 US adults, according to the Centers for Disease Control and Prevention. It’s also disproportionately represented in women, who account for 9 out of 10 diagnoses. While lupus and other diseases like it don’t yet have known causes, there are treatments to ease its symptoms and improve patients’ quality of life.

What is Lupus?

Lupus is an autoimmune disease, which means that the disease causes your body’s immune system to attack your own tissues and organs. This causes inflammation, which can affect many different body systems but most commonly targets your skin, joints, and internal organs like kidneys and your heart. There are four different kinds of lupus, with systemic lupus erythematosus (SLE)  being the most common. There is also cutaneous lupus, which is a form of lupus that is limited to the skin, and drug-induced lupus, which is a lupus-like disease caused by certain prescription drugs. More rarely, some infants develop neonatal lupus, which is a disease that affects infants of women who have lupus.

Symptoms and Diagnosis of Lupus

Due to the commonality of lupus signs and symptoms, the disease can be difficult to diagnose. However, lupus is often diagnosed through family history, complete physical exams, blood and urine tests, or a skin or kidney biopsy.

The most distinctive sign of lupus is a facial rash that resembles the wings of a butterfly unfolding across both cheeks. Although this rash occurs in many lupus cases, it is not universal. No two cases of lupus are alike, and symptoms also vary in severity and occurrence. Some symptoms may appear suddenly or develop over time, some may be mild or severe, and some may experience these symptoms permanently or only temporarily. A mild case of lupus with occasional flares of symptoms is the most common experience with lupus.  Often, the variety in lupus symptoms depends on which body systems are affected by the disease. The most common signs and symptoms include fatigue, fever, joint pain, stiffness and swelling, butterfly rash, skin lesions, fingers and toes that turn white or blue when exposed to cold or during stressful periods, shortness of breath, chest pain, dry eyes, and headaches.

Inflammation caused by lupus can affect many areas of your body, including your kidneys, your brain and central nervous system, blood cells, lungs, and heart. Kidney failure is the leading cause of death among those with lupus, due to the damage that inflammation can cause on your kidneys. People with lupus are also immunocompromised and more vulnerable to other infections. This can be due to the disease and its treatments, both of which can weaken the immune system. Lupus can also lead to bone tissue death, owing to a decline in blood supply to the bone that eventually leads to the bone’s collapse. Women with lupus also have an increased risk of miscarriage.

Lupus Causes and Risk Factors

Although experts do not know what causes lupus, the disease does run in families and the combination of genetics and environment may lead to the development of the disease.  People with inherited predisposition for lupus may develop the disease due to environmental triggers such as sunlight, infections, medications, and more. Experts also think that lupus can develop in response to certain hormones like estrogen. Additionally, it is thought that your age and sex can increase your risk of lupus, since it is more common in women and those between the ages of 15 and 45.

Treatment of Lupus

While there’s no cure for lupus, treatments can help control symptoms. Some medications used to treat lupus include anti-inflammatory drugs (NSAIDs) and corticosteroids to help reduce swelling and pain, as well as antimalarial drugs to treat joint pain, skin rashes, fatigue, and lung inflammation. BLyS-specific inhibitors can be used to limit the amount of abnormal B cells found in people with lupus. Immunosuppressive agents and chemotherapy is also often utilized in severe cases of lupus, when lupus affects major organs and other treatments do not work.