The Complex Nature of Lupus

Systemic lupus erythematosus usually referred to as lupus, is an autoimmune disease that causes harm to a variety of organs in the body. It affects 1 in every 2,000 individuals, and it is more common in women and in those of African descent.

Like other autoimmune diseases, the immune system of someone who has lupus reacts erratically. However, this disease causes damage to multiple areas of the body, including joints, kidneys, brain, skin, heart, lungs, and blood.

Lupus is a disease with a very complex nature, resulting in many combinations of symptoms that can mimic other illnesses. Because of this, most cases are difficult to diagnose.

WHAT IS LUPUS?

Lupus is an inflammatory autoimmune disease that is characterized by remissions and exacerbations. In other words, there are periods when the illness is not active, and others when symptoms can be severe.

When a person’s immune system is working properly, it recognizes a foreign invader – such as bacteria or an injury – and it sends specialized cells and chemicals to fight infection and begin healing. Your white blood cells act as the army, with many different regiments to kill and remove infecting organisms. Other cells, such as blood platelets, and many different bodily chemicals create an inflammatory response that isolates the foreign substance from your healthy tissue. If your body has been exposed to a harmful foreign substance, like a virus, your immune system creates antibodies that will recognize this substance in the future and go right to work protecting you from it if it ever reappears.

When someone has an autoimmune disease such as lupus, all of these wonderful protective mechanisms go to work against your own body. In the case of lupus, the cells of your skin, blood, nervous system, kidneys, heart, lungs, and joints are some of the targets of the illness. The immune system’s mistaken response and resulting inflammation is what causes the symptoms.

WHAT ARE THE SYMPTOMS OF LUPUS?

Although the mechanism behind the illness is the same, this is where the likeness often ends between individuals who have lupus. While some people have what are considered “classic symptoms,” most people with lupus have a variety of combined symptoms.

Initially, most people who have lupus complain of generalized fatigue and achiness, fever, poor appetite, and possibly weight loss. Often, they may have blurry vision and eye swelling, difficulty sleeping, and depression.

Almost all people with lupus experience joint pain and swelling. Some may have shortness of breath or pain with breathing, while others may have abdominal cramping. Basically every system of the body can be affected by this illness.

Joints

Most people with lupus experience joint pain as an early symptom. More than one joint is generally affected but only a few at a time. The location of pain and stiffness often moves from area to area, and unlike other inflammatory arthritis conditions, both sides of the body are not necessarily affected in the same way.

Skin

Most people with lupus also have some type of skin problem, with the most common being the butterfly rash – also called the malar rash – across the nose and cheeks. It almost looks like sunburn, and it often appears and disappears at random times.

Occasionally, something called discoid lesions appear. These are raised and patchy areas of the skin which often scar. Hair loss may also occur, as well as ulcers of the mouth. Raynaud’s phenomenon can also occur with lupus, but it usually occurs on its own – this is often a reaction to cold temperatures, stress, cigarette smoking, and caffeine, in which the blood vessels of the hands and feet constrict, causing fingers and toes to become very cold and purple or red.

Finally, people with lupus may have photosensitivity, where they develop a rash in response to exposure to the sun. This is not the same thing as an allergic reaction to sunlight.

Kidneys

If a person’s kidneys are affected by lupus, they can develop kidney insufficiency. This will usually be medically determined via blood and urine tests, and your doctor will monitor this issue regularly. If it is not treated, the kidneys can be scarred and left permanently damaged.

Lungs

The lungs can be affected in a number of ways by lupus. Inflammation of the lungs can result in “pleuritic” pain when breathing, and fluid in the lungs from inflammation will cause shortness of breath.

Digestive System

The most sensitive organ in the digestive system to lupus is the pancreas. Inflammation of the pancreas is called pancreatitis, and this will cause severe abdominal pain, nausea, and vomiting. However, a person with lupus can also develop inflammation of the bowel (colitis) that can cause abdominal pain, diarrhea, bloody stools, and bloating.

Heart

Lupus increases the risk of coronary artery disease, which can result in chest pain that should be evaluated in the emergency room. Another complication that needs emergency treatment is pericarditis, or inflammation around the heart. Also, the valves of the heart may become leaky, which can cause shortness of breath and generalized swelling.

Nervous System

The most common symptoms for the nervous system that are associated with lupus are confusion, memory loss, difficulty concentrating, anxiety, depression, headaches, seizures, neuropathy, and stroke.

Eyes

While blurry vision can occur, the most common eye problem people with lupus have is keratoconjunctivitis sicca. This causes dry eyes and a feeling of grittiness.

HOW IS LUPUS DIAGNOSED AND TREATED?

Lupus is diagnosed by assessing a combination of symptoms and blood tests. Generally, your doctor will be looking for a positive antinuclear antibody (ANA), as well as a number of other antibodies that your immune system will be producing if you have lupus.

People with lupus may also have anemia, low white blood cell (WBC) counts, low levels of lymphocytes, and thrombocytopenia (low platelet count). If there is kidney damage, there might be protein in your urine.

In addition, a great deal of information can be obtained by the symptoms experienced by a person with lupus, including joint pain, photosensitivity, mouth ulcers, the malar rash and other rashes, lung or heart inflammation, seizures, and even psychoses. If you are experiencing any of the more common symptoms of lupus, it is important to talk to your doctor. If it is left untreated, lupus can do irreparable damage to your body.

While there is no cure for lupus, there are many things that can be done to try to promote remissions and to limit damage to vital organs. It is important to eat a healthy and well-balanced diet. Fruits and vegetables, as well as lean sources of protein, will help you get the nutrients you need. People with lupus often need a higher caloric intake. Alcohol should be consumed only in moderation if at all, and sodium may need to be restricted in order to decrease swelling. Along with a healthy diet, exercise and being active will help keep your muscles strong and your energy up.

It is important to talk to your doctor about immunizations. Pneumonia and flu vaccines are recommended, but immunizations containing live viruses are generally not indicated. There are also certain medications that can make lupus worse, like sulfa antibiotics. Be sure to discuss this with your doctor.

WHO GETS LUPUS? 

Lupus can affect anyone, but some people are more likely to have it than others. Almost 85% of all people with lupus are women, and most are diagnosed between the ages of 20 and 39. Sex hormones, such as estrogen, may be a contributing factor in activating the abnormal response of the immune system with lupus, and this may explain why there is such a large representation of women of those who have the disease.

Additionally, people of African, Asian, and Hispanic descent are more likely to be diagnosed than Caucasians. Family history is a strong predictor of risk, and this includes history of autoimmune diseases in general.

While you must have a genetic predisposition for lupus in order to develop the illness, it is believed that stressors such as pregnancy, smoking, infections, emotional stress, exposure to sunlight, and surgery can trigger the initial exacerbation and subsequent flare-ups.

TREATMENT FOR LUPUS IN WOOSTER, OHIO

A number of medications may be recommended for you based on your symptoms. Hydroxychloroquine is the mainstay of therapy for lupus, and anyone with lupus should be taking it. Nonsteroidal anti-inflammatory drugs (NSAIDs) can be used to temporarily relieve joint pain. Sometimes steroids such as prednisone are used to suppress the immune system activity. There are also a number of clinical trials underway for the treatment of lupus.

If you have any questions about lupus or about immunological problems, or if you have any unusual symptoms, schedule an appointment with an experienced doctor at Wooster Community Hospital. Contact our friendly staff today by calling (330) 263-8144. We look forward to being your healthcare partner for a lifetime of health and wellness!