Our immune system is a very tenacious system. Our bodies are confronted with hundreds if not thousands of microbes a day. The reason why we are not constantly plagued with illness is because our immune system combats these microbes with a vigilant effort without us even realizing it. Picture your immune system as the “warriors” and “defenders” of your body and overall health. Our body’s defense cells have naturally evolved into perfect machines for fighting off the majority of foreign microbes that we may encounter in a given day. Under normal circumstances, your immune system’s “defenders” are known as proteins called antibodies. These antibodies are specific to each microbe where their job is to identify and kill any foreign threat. Now imagine if your immune system’s antibodies began to attack your body’s healthy tissues and cells. Your immune system can no longer distinguish between a foreign invader and a normal cell. Consequently, antibodies would have the same killing effect on normal and healthy cells as it would on foreign microbes. Your immune system, the defender of your body, has for lack of better words turned into the worst Benedict Arnold and now threatens your own vitality.
Unfortunately, it is very common when the bodies’ own immune system begins to attack normal cells. These types of conditions are term autoimmune diseases (“auto” meaning “self”) and can display a plethora of symptomologies. A common, but a disease that is difficult to detect is a disease known as lupus.
The U.S. National Library of Medicine defines lupus as an autoimmune disease that can damage almost any part of the human body specifically skin, joints, and/or organs. Due to the nature of this disease, it is frequently defined as a chronic disease due to signs and symptoms lasting for six week and longer. In lupus, the immune system produces autoantibodies that attack the healthy parts of the body resulting in severe damage and inflammation. It is a disease that is marked by cycles of “flare-ups” followed by periods of remission. The reason lupus can be difficult to detect is because it displays many symptoms that mimic other disease-states. Lupus is a very serious condition; however, it is well known that lupus is not a universally fatal disease and with proper medical care, it is still very possible to live a complete, and happy life.
According to the Lupus Foundation of America it is estimated that 1.5 million Americans, and at least 5 million people worldwide have a form of lupus; systemic lupus being the most common type (more on this later). Even though lupus can threaten men and women, 90% of individuals diagnosed with the lupus are women. Most people will develop lupus between the ages of 15-44. It is also more frequently diagnosed in African-American, Hispanic, and Asian decent. Given that there are many forms of lupus and each one in a given person can present differently, it is very difficult for doctors to produce an exhaustive list of symptoms. However, doctors have been able to observe a couple conventional symptoms that are associated with the majority of cases, including:
- Chest pain upon deep breathing
- Butterfly-shaped red rashes, most commonly on the face
- Extreme fatigue
- Mouth ulcers
- Painful or swollen joints and muscle pain
- Unexplained fever
- Hair loss
- Pale or purple fingers or toes from cold or stress (Raynaud’s phenomenon)
- Sensitivity to the sun
- Swelling in legs or around eyes
- Swollen glands
Several Kinds of Lupus
According to the John Hopkins Lupus Center, there are five main types of lupus:
- Systemic Lupus Erythematosus (SLE). As mentioned above, this is the most common type of lupus with 70% of cases being of this type. Systemic simply put means that the disease can affect many parts of the body. Symptoms of (SLE) can range from mild severe where chronic inflammation presents itself in the skin, kidneys, and joints. This form of lupus can also have serious effects on the lungs, nervous system, and heart.
- Discoid Lupus Erythematosus. This kind of lupus only affects the skin. Symptoms observed are large, red, and raised rashes that appear on the face, scalp, or elsewhere. These rashes are scaly but are not itchy and may last for a couple of days to years. A small number of cases of (DLE) may develop into (SLE).
- Subacute Cutaneous Lupus Erythematosus. This kind of lupus is caused by a high sensitivity to the sun where large, red, raised rashes appear on parts of the body exposed to sun. The lesions typically do not cause scarring.
- Drug-Induced Lupus Erythematosus. This kind of lupus is caused by medications. Many classes of medications can cause this type of lupus. Some better known classes are: oral contraceptives, blood pressure medications, thyroid medications, antiseizure medications, antibiotics, and antifungals. Symptoms are similar to those of (SLE) and typically go away after the drug is discontinued.
- Neonatal Lupus Erythematosus. This is a form of lupus that affects babies of women who carry certain antibodies. Doctors suspect that neonatal lupus is caused in part by autoantibodies in the mother’s own blood. At birth, the child may have a skin rash, liver problems, and low blood counts. These symptoms gradually go away over several months. In rare instances, babies with neonatal lupus may have congenital heart block. Only 40% of women who give birth to children with neonatal lupus actually have lupus themselves; on the contrary, neonatal lupus is rare, and most infants of mothers with (SLE) are entirely healthy.
Understanding the Cause of Lupus
Lupus is a very complex disease and the direct cause is not fully understood. Researchers are beginning to understand that genetics and the environment play a significant role in developing lupus; but more is still to be discovered. Scientists believe there is no single gene that predisposes someone to lupus but rather a number of different genes that may be involved in determining someone’s chances of developing lupus. Hopefully, in the near future researchers will have completely identified the genes involved, which could eventually lead to better ways to treat and perhaps even prevent lupus.
As mentioned above, it can be very difficult to diagnose lupus. It may take months to even years for your medical team to accurately diagnose you with lupus. Because of the transient symptoms of lupus, your doctor will conduct a thorough medical exam as well as have complete knowledge of your medical history. These two components, along with laboratory tests will give your physician a more clear understanding as to if you truly have lupus or a disease-state that is mimicking the symptoms of lupus.
There is not one test alone that can determine if someone has lupus. Usually your doctor will order several laboratory tests to rule in or out lupus. The most useful tests identify certain autoantibodies often present in the blood of people with lupus. For example, the antinuclear antibody (ANA) test is commonly used to look for autoantibodies that react against the nucleus of a normal and healthy cell. Most people with lupus test positive for ANA; however, there are a number of other causes of a positive ANA besides lupus, including infections and other autoimmune diseases. In addition, some doctors may order a blood test to identify specific antibodies that are frequently observed in people with lupus, although not all people with lupus test positive for these and not all people with these antibodies have lupus. A medical exam, history, laboratory tests, and even certain biopsies will give your doctor a complete picture to determine if a person has lupus.
Thanks to the advances in medicine, there is not a wide range of effective treatments for treating lupus. Given that lupus is such a varying disorder, the symptoms, age, sex, and lifestyle will all contribute to what your doctor decides is the best plan for you. Physicians use a wide spectrum of medications throughout the lifetime of the patient when combating lupus. Some patients have found relief from the following options when treating lupus:
- Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
- BLyS-specific inhibitors
Your physician has several goals in mind when developing a tailored treatment plan. Some goals include: treat and prevent flares ups, reduce inflammation, minimize organ damage, and stabilize other symptoms such as fatigue and joint pain. Making a correct diagnosis of lupus is going to require great communication between you and your physician. Be honest and upfront with your physician as to what is or is not working within your treatment plan. Staying in regular contact with your physician about new symptoms and your treatment plan will lead a much more fulfilled and happier life when having to live with lupus.
How long have you suffered from lupus and what has helped you persevere? Please let us know!
Tags: Systemic Lupus Erythematosus, lupus, butterfly rash, autoimmune disorder, immune system, pain management, chronic pain
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