SLE

What is lupus?

Lupus is a disease which can affect joints, muscles and other parts of the body. It is often described as an auto-immune disease. This means that for some unknown reason people with lupus seem to develop antibodies (which usually fight bacteria and viruses) that attack healthy tissues instead. This produces inflammation in different parts of the body resulting in pain and swelling. Lupus can also affect the skin, heart, lungs, nervous system, kidneys and blood and in particular the immune system. Lupus is a chronic, systemic disease. This means that it lasts a long time, probably for the rest of your life. However, nearly all people with lupus have periods when the disease is dormant (remissions). But, periods of remissions differ for each individual. While some people experience complete and long-lasting remissions, for others, the disease remain in a chronic (long-lasting) state of activity.

 

Who gets lupus?

Lupus tends to affect women in their childbearing years. However, lupus can occur in young children or in older people. The number of women affected outnumber men by nine to one. Studies carried out on Asian migrants have shown that Indians and Chinese are twice as likely to suffer from lupus as compared to Caucasians. Lupus also had more severe clinical manifestation in Asian than in Caucasians.

 

What causes lupus?

We don’t know the cause of lupus. Some people seem to inherit the tendency to get a disease like lupus. Research suggests that an unidentified virus may trigger the tendency and bring on the disease. A few drugs taken for conditions like high blood pressure or tuberculosis can cause symptoms just like lupus but these symptoms always disappear when the drug is stopped. Exposure to sunlight seems to trigger lupus in some people. the prospects of pulling this deal off.

 

Lupus Symptoms

Lupus can present in many different ways. The onset is usually gradual, with the development of vague feelings of disease until some specific lupus symptoms develop. Common symptoms include:

• Fever
• Headache
• Fatigue
• Depression
• Loss of appetite
• Weight loss
• Easy bruising
• Aches & pains
• Edema/swelling
• Hair loss Swollen glands

The following symptoms and signs are much more suggestive of lupus:

• A rash over the cheeks and bridge of the nose
• Rashes after exposure to the sun or ultraviolet light
• Ulcers inside the mouth
• Arthritis of two or more joints i.e, the joints hurt and are swollen
• Pleurisy – pain in the chest on deep breathing
• Seizure
• Anemia
• Raynaud’s – fingers turning white and/or blue in the cold

 

Diagnosing Lupus

Lupus is usually easy to diagnose when an individual has many of the more characteristic symptoms and signs, but is made more difficult if only a few are present. Laboratory tests are then usually conducted to help confirm or reject the diagnosis, These tests may include a blood count and urine analysis. More specific laboratory tests look for antibodies, in particular antibodies to the nuclei of cells (the ANA or Anti-Nuclear Antibody test) and antibody to DNA. Over 99 per cent of people with lupus have a positive ANA test. However, only about 30 per cent of people with a positive ANA test have lupus.

 

Treatment

Lupus is an unpredictable disease but in most cases it can be successfully treated. Once an effective treatment program has been started, it is important for the patient to keep to it faithfully and to inform the doctor of any change in symptoms so that the medications can be modified.

 

Medications

• Corticosteroids
  Prednisolone is the most commonly used drug. Steroids are powerful drugs that suppress inflammation and are commonly used in controlling lupus. It is important for the patient to keep to the prescribed dose. Flare-ups of disease can occur if the dose is reduced too rapidly. NEVER ALTER YOUR DOSE OF CORTICOSTEROIDS WITHOUT FIRST DISCUSSING IT WITH YOUR DOCTOR, SINCE STOPPING THEM OR CHANGING THE DOSE QUICKLY CAN MAKE YOU VERY ILL.
• Antimalarial Drugs
  Antimalarial drugs seem to be effective in reducing inflammation and controlling skin problems. These drugs increase resistance to sun exposure.
• Aspirin and Other Anti-Inflammatory Drugs
  Aspirin and other anti-inflammatory drugs such as Indocid, Clinoril, Brufen and Naproxen may be the only medications the doctor will prescribe. These drugs control pain and reduce inflammation.
• Immunosuppressive Drugs
  Immunosuppressive drugs are usually used in conjunction with corticosteroids to control more severe disease. If you’re taking an immunosuppressive, regular blood tests will be done because the drug can interfere with the formation of blood cells.
• Ointments/Skin creams
  Your doctor may prescribe a cream containing a sunscreen to protect against sun exposure. Corticosteroid containing creams are used to control skin rashes.

 

Pregnancy and Lupus

Pregnancy may mean special problems for the woman with lupus since the disease affects people in their child-bearing years. The majority of women have normal pregnancies, although there is an increased risk of early miscarriage. There may be worsening of symptoms after delivery. It is important for the patient and doctor to discuss and plan the best time for the patient to have a child.

 

Coping with lupus

In a chronic disease like lupus, social and emotional problems are common. You may experience feelings of anger, fear and depression. It is extremely helpful to be able to talk about how you feel with someone close to you or someone who has had similar problems.