What Is Lupus?
Doctors define lupus as an autoimmune disease. That means the immune system mistakes normal, healthy cells and attacks them as if they're foreign agents.
This causes symptoms of inflammation, like swelling, redness, and pain.
Lupus is somewhat rare. Its most common type, SLE, affects about 5 out of 100,000 people in the U.S.
Lupus often involves periods of illness called "flares" and times of remission, where symptoms get better.
Is lupus a very serious disease?
Lupus can be very serious. In severe cases, it can damage the heart and lungs and even affect the brain.
Routine checkups help people avoid these problems.
What Are The Different Types of Lupus?
- Systemic lupus erythematosus (SLE) is the most common type, making up 70% of all lupus cases. It can affect the skin, joints, and organs. Some people with SLE also get discoid lupus, a form of cutaneous lupus.
- Cutaneous-only lupus affects the skin. The most common form is discoid lupus, which causes red, scaly lesions on the skin. Cutaneous lupus often gets worse with too much sun exposure.
- Drug-induced lupus is a rare side effect of certain medicines. It often goes away when a person stops taking the drug.
- Neonatal lupus affects newborns and is very rare. In most cases, it goes away in the first six months of life and requires minimal treatment.
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What Causes Lupus?
There's no single cause of lupus. But, genetics, environmental triggers, and hormones can increase the risk.
Researchers have found many genetic changes linked to lupus. No known gene causes lupus, nor is there a single genetic test to confirm lupus.
Studies have found that lupus occurs more often after contact with certain viruses, including the Epstein-Barr virus (EBV).
That said, most people who get EBV won't get lupus.
Certain medicines and chemicals, like silica, can also trigger lupus.
Researchers have linked high amounts of sun exposure with a higher risk of lupus. It can also worsen symptoms in people who have lupus.
Estrogen and prolactin (the hormone that makes milk when breastfeeding) can also play a role in lupus.
What Are the Risk Factors and Complications of Lupus?
Lupus risk factors
- Age. While lupus can occur at any age, symptoms most often start from the ages of 15 to 44.
- Gender.Women make up 90% of those living with lupus.
- Genetics. People who have a close family member with an autoimmune issue are more likely to get lupus.
- Klinefelter syndrome. People with this disorder are 14 times more likely to get lupus than the general population.
- Racial or ethnic background.Lupus is more common in African American, Hispanic, Asian, and Native American women.
- Smoking. The risk of getting lupus increases with how much a person smokes.
Complications of lupus
Untreated inflammation from lupus can cause serious health problems.
These include:
- Breathing issues.
- Fractures.
- Heart problems.
- Kidney damage.
- Memory and thinking problems, or seizures.
- Pregnancy problems, like preterm birth or miscarriage.
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What Are The Signs and Symptoms of Lupus?
People may have mild or severe lupus symptoms. Your symptoms vary from day to day.
Lupus symptoms include:
- Chest pain when you breathe deeply.
- Fatigue.
- Hair loss.
- Headaches.
- Joint pain and stiffness.
- Joint swelling.
- Low-grade fevers (100.4°F to 101°F).
- Muscle pain.
- Pale or purplish fingers or toes.
- Skin rashes (see cutaneous-only lupus symptoms below)
- Swelling around the eyes.
- Swelling in the hands.
- Swelling in your legs or feet.
- Swollen glands.
People with cutaneous-only lupus may have one or more of these symptoms:
- A rash on the nose and cheeks that has a butterfly shape.
- Hair loss.
- Rashes from sun exposure.
- Round, scaly rashes on the face or body.
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How Do You Diagnose Lupus?
There's no single test for lupus. Instead, doctors put different pieces together to arrive at a diagnosis.
Doctors diagnose lupus partly based on your symptoms and after ruling out other reasons.
Your doctor will ask you:
- What symptoms you have and how often.
- When your symptoms started.
- What causes your symptoms to get worse.
- Whether a family member has lupus.
Your doctor will likely do a physical exam to assess your heart rate, reflexes, and health. In many cases, they'll also order tests.
Certain results can make it more likely lupus is the cause of your symptoms. Or test results might point to another diagnosis.
Lab tests include:
- Blood tests to check for antibodies that reveal an overactive immune system and to rule out other diseases.
- Urine tests to see if inflammation is causing problems with your kidneys.
- A biopsy where a doctor removes a small skin sample to look for signs of inflammation. They might also do a kidney biopsy if blood or urine tests suggest kidney problems.
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What Are the Treatment Options for Lupus?
While there's no cure for lupus, early diagnosis and treatment can help you manage lupus symptoms. Treatment can also reduce the chance of lasting damage to your organs or tissues.
Because it differs for each person, UPMC lupus experts choose treatments based on your unique needs.
Doctors often increase medicines during times of 'flares' and reduce the dosage as your symptoms go away. This can help avoid severe side effects from taking steroids or other drugs on a long-term basis.
People with lupus need to see their provider on a routine basis. Timely testing and treatments prevent lupus-related health problems.
Medications to treat lupus
Medicine can treat pain with lupus, prevent further issues, and lower immune overactivity. Most drugs for lupus are oral, but people with severe lupus may, at times, need IV medicines.
Doctors often prescribe:
- Non-steroidal anti-inflammatory medications (NSAIDs) reduce pain. These drugs can cause kidney damage, so you should use them under your doctor's orders.
- Hydroxychloroquine can help resolve joint pain and prevent issues like blood clots. It has few side effects and is often one of the first drugs people with lupus receive.
- Corticosteroids reduce swelling in the body. Long-term use can lead to liver damage and other serious problems, so doctors limit these medicines. They can help resolve flare symptoms in the short term.
- Biologic medicines made from living organisms block certain proteins the immune system makes. These targeted treatments may be ideal for people with severe forms of lupus.
- Immunomodulating medicines reduce immune overactivity in a different way than steroids and help avoid the overuse of steroids.
- Medicines to address lupus-related health problems. Therapies may prevent or treat problems with your heart and blood vessels, nervous system, or kidneys, for instance.
- Topical medicines can treat cutaneous-only lupus and rashes in people with SLE.
Lifestyle changes
You can also avoid lupus flares if you learn to:
- Avoid triggers (such as using sunscreen).
- Manage stress.
- Work out.
How Long Can You Live With Lupus?
Thanks to treatments, 80% to 90% of people with lupus have a normal life span.
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