What is a Lupus?
Lupus is a disease that occurs when your body's immune system attacks your own tissues and organs (autoimmune disease). Inflammation caused by lupus can affect many different body systems- including your joints, skin, kidneys, blood cells, brain, heart and lungs.
Types of lupus
There are some types of lupus that just affect the skin – such as discoid lupus erythematosus and subacute cutaneous lupus erythematosus. Some medications can also cause lupus-like side effects.
However, the term "lupus" is most often used to describe a more severe form of the condition called systemic lupus erythematosus (SLE), which can affect many parts of the body, including the skin, joints and internal organs.
Symptoms range from mild to severe, and many people will have long periods with few or no symptoms before experiencing a sudden flare-up, where their symptoms are particularly severe.
Even mild cases can be distressing and have a considerable impact on a person’s quality of life.
How is Lupus diagnosed?
Lupus, also called systemic lupus erythematosus, is not always easy to diagnose because it can be similar to other conditions.
Symptoms include inflammation of different parts of the body including the lungs, heart, liver, joints and kidneys.
The GP will usually do some blood tests. High levels of a type of antibody, combined with typical symptoms, means lupus is likely.
You might be referred for X-rays and scans of your heart, kidney and other organs if the doctor thinks they might be affected.
Once lupus is diagnosed, you'll be advised to have regular checks and tests, such as regular blood tests to check for anaemia and urine tests to check for kidney problems.
What are the symptoms?
No two cases of lupus are exactly alike. Signs and symptoms may come on suddenly or develop slowly, may be mild or severe, and may be temporary or permanent. Most people with lupus have mild disease characterized by episodes — called flares — when signs and symptoms get worse for a while, then improve or even disappear completely for a time.
The signs and symptoms of lupus that you experience will depend on which body systems are affected by the disease. The most common signs and symptoms include:
- Fatigue
- Fever
- Joint pain, stiffness and swelling
- Butterfly-shaped rash on the face that covers the cheeks and bridge of the nose or rashes elsewhere on the body
- Skin lesions that appear or worsen with sun exposure
- Fingers and toes that turn white or blue when exposed to cold or during stressful periods
- Shortness of breath
- Chest pain
- Dry eyes
- Headaches, confusion and memory loss
What causes lupus?
SLE is an autoimmune condition, which means it is caused by problems with the immune system. For reasons not yet understood, the immune system in people with SLE starts to attack and inflame healthy cells, tissue and organs.
As with other more common autoimmune conditions, such as rheumatoid arthritis, it is thought a combination of genetic and environmental factors may be responsible for triggering SLE in certain people.
SLE is an uncommon condition where around 90% of cases occur in women. The condition is most common in women of childbearing age (between the ages of 15 and 50), but it can also affect people of other ages.
The condition tends to be less common in people of white European origin and more common in those of African, Caribbean or Asian origin.
The causes of lupus are not fully understood. Possible causes include:
- viral infection
- certain medicines
- sunlight
- puberty
- childbirth
- menopause
What are the treatments?
There is currently no cure for SLE, but there are different medications that can help relieve many of the symptoms and reduce the chances of organ damage.
These medications include:
hydroxychloroquine – a medicine that has historically been used to treat malaria, but can also help treat some symptoms of SLE
corticosteroids – anti-inflammatory medications
immunosuppressants – a group of medicines that suppress your immune system
With good levels of support from friends, family and healthcare professionals, many people with SLE are able to manage their condition effectively.
Complications
Around 1 in every 3 people with SLE will develop a potentially serious kidney disease called lupus nephritis, which is caused by prolonged inflammation of the kidneys.
Lupus nephritis tends to develop relatively early in the course of SLE, usually within five years of diagnosis.
Symptoms of lupus nephritis can include:
- swelling of your feet (oedema)
- headaches
- dizziness
- blood in your urine
- a frequent need to urinate
Lupus nephritis can also cause high blood pressure (hypertension). If left untreated, it can put you at risk of developing life-threatening problems such as a heart attack or stroke.
In many cases, lupus nephritis does not cause any noticeable symptoms. However, this does not mean the condition is not dangerous, as the kidneys could still be being damaged.
If you have SLE, it is likely you will need to have regular blood tests so the condition of your kidneys can be carefully monitored. If you develop lupus nephritis, it can usually be successfully controlled using immunosuppressants such as mycophenolate mofetil or cyclophosphamide.
In a small number of cases, the kidney damage can become severe enough to require treatment with dialysis (where a machine is used to replicates many of the kidneys' functions) or a kidney transplant.
Cardiovascular disease (CVD) is a general term for any type of health condition that affects the heart and arteries. It is often associated with blood clots and atherosclerosis (hardening and narrowing of the arteries).
Examples of CVD include coronary heart disease, angina (chest pain caused by the heart not receiving enough blood), heart attack and stroke.
People with SLE are more likely to develop CVD than the general population, because SLE can cause your heart and arteries to become inflamed and damaged.
If you have SLE, you can reduce your risk of CVD by making health lifestyle chances, such as:
stopping smoking if you smoke
eating a healthy, balanced diet low in saturated fat, sugar and salt, and containing at least five portions of fruit and vegetables a day
maintaining a healthy weight
exercising regularly – at least 150 minutes (two-and-a-half hours) a week of exercise strenuous enough to leave you slightly out of breath is recommended
cutting down on your alcohol consumption
Sources
Lupus symptoms & treatments - Illnesses & conditions | NHS inform
Lupus - NHS (www.nhs.uk)