Definition & Overview

Lupus erythematosus, also referred to as Systemic Lupus Erythematosus (SLE) or simply lupus, is a type of autoimmune disease. Like other types of autoimmune diseases, SLE occurs when the immune system begins to attack healthy cells instead of only harmful bacteria or viruses.

The body’s immune system fights viruses and bacteria by producing antibodies. People with lupus produce autoantibodies, otherwise known as abnormal antibodies. Instead of fighting infectious agents, the autoantibodies attack healthy cells and tissue.

Because lupus is associated with the immune system, the disease can affect any part of the body, such as the skin, kidneys, heart, lungs, joints, and nervous system. The part of the body that it affects determines the type of lupus that the patient is suffering from. Lupus that affects only the skin is referred to as cutaneous lupus erythematosus or lupus dermatitis while the one that affects the internal organs is called Systemic Lupus Erythematosus. SLE is the most common type.

Lupus is more common in women than in men. However, the exact cause or causes of the condition are unknown. What is known, however, is that there is no cure for the disease, but the symptoms can be treated and managed. Once a person contracts the disease, it will be a lifelong condition. Fortunately, with the right treatment, patients can live normal lives.

Cause of Condition

While the exact cause of SLE is unknown, doctors, scientists, and researchers have identified several factors that are likely to contribute to the development of SLE. These are the following:

  • Environmental factors: Ultraviolet rays, emotional or physical stress, trauma, medications, and a virus may trigger the condition.

  • Heredity: It is common for people with lupus to have family members who also have the condition.

  • Gender: Lupus is more prevalent in women than in men, which has led researchers to believe that the female hormone estrogen plays a role in its development. It’s important to note that although the above factors may trigger lupus in some people, having those factors does not necessarily mean that you’ll also develop the condition.

Key Symptoms

Lupus is a lifelong condition and there will be times when the affected person will display certain symptoms. The symptoms will likely disappear (remission), but they will most certainly come back at a later date (relapse). Some of the most common symptoms are fatigue, hair loss, anemia, blood-clotting problems, headaches, swollen and painful joints, Reynaud’s syndrome, and butterfly rash.

Since lupus affects the internal organ, the person will also show symptoms of the organ it is attacking. For instance, if the disease attacks the heart, the symptoms will likely be associated with a heart condition. If it attacks the skin, the person will display rashes and photosensitivity. If lupus is attacking the renal system, the person will experience renal failure and/or acute nephritic disease.

Because there is no cure for lupus, doctors only provide treatment for its symptoms. As earlier stated, the patient may go into remission for a certain period but will most certainly experience a relapse in the future. However, by avoiding the known triggers, it is possible to reduce the risks of relapse.

Who to See & Types of Treatment Available

If you’re experiencing any of the general symptoms of lupus, such as loss of appetite, nausea, joint pains, fatigue, and low-grade fever, consult your family doctor right away. These symptoms are associated with many different diseases, so it is not likely that the doctor will suspect lupus immediately.

In fact, due to the wide variety of symptoms, no single test can provide an accurate diagnosis of the condition. To help doctors diagnose SLE, the American Rheumatism Association came up with 11 criteria for diagnosing lupus. To consider the presence of the condition, the patient must display 4 or more of these criteria:

  • Photosensitivity – the presence of skin rashes when exposed to sunlight
  • Arthritis – at least two or more swollen joints
  • Kidney problems - a kidney biopsy will determine if a kidney disease is lupus related.
  • Abnormalities in blood count – When a complete blood count (CBC) indicates low white or red blood cells or platelet count, it could indicate the presence of anemia, leucopenia, or thrombocytopenia.
  • Ulcers in the mouth, nose, or throat
  • Presence of antinuclear antibodies in the blood
  • Abnormal immune test results
  • Presence of a butterfly rash
  • Hyperpigmentation or hypopigmentation
  • Pericarditis or Pleuritis – a condition characterized by the inflammation of the lining tissue that surrounds the heart and lungs
  • Brain Irritation

If lupus has been confirmed, the doctor will perform other tests to determine the severity of the damage to the organ. These tests include kidney, skin, or nerve biopsy; blood chemistry testing, analysis of body fluids, and tissue biopsies.

The doctor will then formulate a treatment plan based on the extent of the condition. The main goals of the treatment are to relieve the symptoms, prevent further damage to the internal organ, and slow down the immune system.

The patient will also be advised to rest when the disease is active. Fatigue is a common symptom and trigger. If the patient lacks sleep or has poor sleep quality, there is a good chance that the condition will worsen.

Once you’ve been infected with lupus, you’ll have it for the rest of your life. However, avoiding the triggers will lessen the risks of the disease causing severe damage to your organs. Supplements, such as Omega 3 fish oils have been proven to reduce the activity of the disease, thus decreasing the risk of heart failure and other related heart diseases.

Together with supplements, your doctor will provide different medications, such as non-steroidal anti-inflammatory drugs (NSAIDs) to control pain.

References:

  • Crow MK. Etiology and pathogenesis of systemic lupus erythematosus. In: Firestein GS, Budd RC, Gabriel SE, et al, eds. Kelley's Textbook of Rheumatology. 9th ed. Philadelphia, PA: Saunders Elsevier; 2012:chap 79.
  • Crow MK. Systemic lupus erythematosus. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 274.
  • Bertsias G, Sidiropoulos P, Boumpas DT. Systemic lupus erythematosus: Treatment - renal involvement. In Hochberg MC, Silman AJ, Smolen JS et al, eds. Rheumatology. 5th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 132.
  • Ruiz-Irastorza G, Ramos-Casals M, Brito-Zeron P, Khamashta MA. Clinical efficacy and side effects of antimalarials in systemic lupus erythematosus: a systematic review. Ann Rheum Dis. 2010;69:20-28.
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