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Lupus is an autoimmune disease in which the immune system attacks the body’s healthy tissues due to an inability to distinguish its own tissues from foreign invaders.
As a result, the body produces autoantibodies that target healthy tissue, mistaking it for an invader. This attack leads to inflammation in the joints, skin, and other organs. Lupus is a long-term disease that occurs more commonly in women than in men. (1)
How Common Is Lupus?
Fortunately, lupus is not common. In the United States, the prevalence of lupus is about 100 cases per 100,000 populations. (2)
Lupus also may afflict young persons. Approximately 65% of individuals with lupus are between ages 16 and 55, and childhood lupus is a serious condition. Most often, women are diagnosed with lupus in their late 30s and early 40s. (3)
Causes of Lupus
The exact cause of lupus is unknown, but studies on its possible causes are being conducted. The following factors influence the genes, leading to the disease:
- Environment: Smoking, sunlight, viruses, and certain medicines may trigger symptoms in people carrying lupus-associated genes.
- Hormones: Estrogen may contribute to the development of lupus since it is found to be common in women in their prime reproductive period when estrogen levels are high.
- Immune system problems
- Severe stress or infection: Extreme stress or chronic infection can trigger lupus in individuals carrying genetic factors.
Treatment for Lupus
Lupus has no permanent cure yet, but certain treatment modalities can help reduce the severity and frequency of its flare-ups.
Lupus treatment is primarily directed toward:
- Managing and controlling the symptoms, such as pain and fatigue
- Slowing down or preventing complications, such as organ damage
- Preventing flare-ups and possibly putting the disease into complete remission
- Improving the individual’s overall quality of life (4)
Commonly used medications
The following medications are commonly used to manage the symptoms of lupus:
- Mild cases of lupus can be treated with anti-inflammatory medications, such as ibuprofen or naproxen, and topical cortisone creams if rashes are present.
- For more moderate cases, anti-malarial medications such as hydroxychloroquine may be used. This drug is quite effective, generally safe, and well-tolerated in most individuals, although rarely, eye toxicity can occur. Therefore, all persons on this medication should be monitored regularly by an eye doctor.
- Many individuals with lupus need corticosteroids, such as prednisone, but doctors aim to keep the dose as low as possible to avoid harmful side effects. High doses administered in severe cases are usually coupled with immune suppressants.
- Dehydroepiandrosterone (DHEA), a male hormone produced in the adrenal gland, may be beneficial and reduce the need for prednisone. While it is available as an OTC drug, it should not be taken without a prescription.
- Many individuals with lupus require multiple medications for disease control. Examples of these medications include azathioprine, methotrexate, mycophenolate mofetil, belimumab, and cyclophosphamide.
- Some individuals with systemic lupus erythematosus (SLE) have blood coagulation problems and are at risk for blood clots, pulmonary embolism, and stroke. They typically require blood thinners.
- Those with lupus nephritis often must be treated very aggressively to prevent kidney failure, while others require treatment primarily guided by symptoms.
Note: The medications mentioned above often come with certain deleterious side effects, which need to be discussed with your doctor to avoid any complications later.
Prednisone, for example, can increase the chances of infection, stretch marks, osteoporosis, weight gain, and high blood pressure, but at the same time, it works quickly to help subside inflammation and thereby prevents organ damage.
Drugs to avoid
Bactrim and Septra are antibiotics that can lead to lupus flare-ups. Therefore, their use must be avoided. They are also known as sulfa antibiotics as they contain sulfonamide in addition to sulfamethoxazole and trimethoprim.
These drugs are generally used for the treatment of bacterial infections such as urinary tract infections. However, in individuals with lupus, they can increase sun sensitivity and lower the blood count.
Diagnosing Lupus
Diagnosing lupus is difficult because no single test can definitively diagnose it. Also, the disease has so many potential manifestations and each affected individual is unique.
- The diagnosis is made based on several clinical and laboratory criteria. A thorough history and physical examination, blood and urine testing, and sometimes tissue biopsy are required. (5)
- Laboratory testing is done because an analysis of the presence and pattern of autoantibodies can be very useful in establishing a diagnosis. Additional laboratory studies help rule out the presence of anemia and kidney or liver problems. An elevated sedimentation rate and C-reactive protein indicate systemic inflammation.
Lupus vs. Rosacea
Lupus and rosacea are vastly different and warrant different treatments. While lupus is an autoimmune disorder, rosacea is a chronic skin ailment with no discernible cause but a list of triggers.
However, both these conditions are often confused with each other since they exhibit many similar symptoms, such as facial redness and photosensitivity.
The risk of misdiagnosis is still very much a concern since there is no concrete way to differentiate between the two.
Most-Asked Questions About Lupus
Can drinking alcohol worsen lupus?
Generally, no, although alcohol should always be consumed in moderation for a variety of health reasons.
Some of the medications used in lupus management may interact adversely with alcohol, so this remains an important consideration.
Can lupus increase your chances of developing cancer?
Yes. There appears to be an increased risk of malignancies in individuals with chronic inflammatory and autoimmune diseases such as lupus.
Moreover, some of the medications used to treat lupus, such as azathioprine and cyclophosphamide, are known to increase the risk of cancer. (6)
Does lupus increase the chances of infertility?
Yes. In women, premature ovarian failure may accompany lupus. More commonly, the stress related to the illness contributes to anovulatory cycles and difficulty with conception.
However, many women with lupus are able to become pregnant without much difficulty. In fact, a frequent concern is the best means for birth control for a woman with lupus. (7)(8)
Is lupus fatal?
There is no cure for lupus, but those who have it can lead long, fruitful lives with necessary treatment and regular follow-ups.
The risk of death depends upon various factors, which include the severity of the condition and how well the body responds to the treatments.
Is lupus contagious?
No, none of the different types of lupus are contagious. It is a specific kind of autoimmune disorder that does not spread from person to person.
Risk Factors for Lupus
From children to adults, no one is safe from lupus, but some people have a higher risk of developing it than others. Gender, age, and ethnicity/race can increase the chances of developing lupus.
Common Complications Associated With Lupus
Lupus and the way it is treated can give rise to several complications:
- Scarring of the skin
- Kidney failure
- Stroke
- Joint deformities
- Bone fractures
- Hip destruction (also called avascular necrosis)
- Heart attack
- Pregnancy complications
- Cataracts
When to See a Doctor
The severity of lupus can range from mild to life-threatening, and only a doctor who specializes in this disease can determine the appropriate course of action for each individual patient.
So, anyone with the slightest inkling of lupus must get prompt and proper medical assistance. Your doctor will educate you about your condition and how to cope with it in the best way possible.
Medical interventions, along with doctor-recommended self-care measures, will help ensure proper functionality, as well as improved quality of life.
In addition to a rheumatologist who is the primary point of contact, you may have to consult a cardiologist, pulmonologist, and nephrologist for the symptoms and complications that occur in the wake of lupus.
Final Word
Given that the symptoms of lupus vary in type and degree across different individuals, no single standard treatment applies to all cases.
Your doctor will first examine your symptoms and accordingly prescribe a mix of different medications that are deemed appropriate for your individual case. This has to be accompanied by proper diet and lifestyle changes.
A majority of lupus cases can be managed with treatment, regular follow-ups, and proper self-care, enabling the affected individual to achieve an average life span.
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