Lupus

Lupus

What you need to know about Lupus

A chronic autoimmune disease called lupus has the potential to inflame your entire body. It isn’t always a systemic disorder, although it usually is a localised one.

An autoimmune illness is a disorder where your body’s immune system causes its own cells to become inflamed and break down.

Many lupus sufferers have a moderate form of the disease, but it can worsen if untreated. Since lupus currently has no known cure, treatment focuses on reducing inflammation and alleviating symptoms.

Symptoms of Lupus

The sections of your body affected by lupus will determine the symptoms you experience. Your body’s organs and tissues can be impacted by the inflammation caused by lupus, including your:

  • Joints
  • Skin
  • Heart
  • Blood
  • Lungs
  • Brain
  • Kidneys

Depending on the person, symptoms can change. They might:

  • Be permanent
  • Vanish randomly
  • flare-up now and then

Lupus cases vary widely from one another. The most typical symptoms and indicators, however, are as follows:

  • High temperature
  • Fatigue
  • Body aches
  • Joint pain
  • Rashes, including a butterfly rash on the face
  • Skin lesions
  • Shortness of breath
  • Sjögren’s syndrome, which includes chronic dry eyes and dry mouth
  • Pericarditis and pleuritis, both can cause chest pain
  • Headaches
  • Confusion
  • Memory loss

Lupus-related inflammation can also result in problems that affect other organs, including the:

  • Kidneys
  • Blood
  • Lungs

Read on to learn more about lupus symptoms.

Types of Lupus

There are four distinct forms of lupus, according to medical authorities:

  • Systemic lupus erythematosus
  • Cutaneous lupus
  • Neonatal lupus
  • Drug-induced lupus

Systemic lupus erythematosus

The kind of lupus that occurs most frequently is systemic lupus erythematosus (SLE). It’s likely that when someone says they have lupus, they are referring to SLE.

The fact that SLE frequently affects numerous separate organ systems in your body gives it its name. According to research, these include the

  • Kidneys
  • Skin
  • Joints
  • Heart
  • Nervous system
  • Lungs

Mild to severe SLE is possible. Symptoms of the disorder can worsen over time, and then get better. The Lupus Foundation of America claims that flares are when your symptoms get worse. Remissions are the times when they become better or disappear.

Increase your knowledge of SLE.

Cutaneous lupus

Usually, only your skin is affected by this type of lupus. Rashes and scarring lesions that are persistent may result from it. Numerous diverse varieties of cutaneous lupus were identified in a 2019 review, including:

  • Acute cutaneous lupus. This kind results in the typical “butterfly rash.” This rash turns red and develops on the cheeks and nose.
  • Subacute cutaneous lupus. The body develops a rash that is red, elevated, and scaly due to this type of cutaneous lupus. It usually doesn’t leave scars and frequently occurs in locations that have been exposed to sunlight.
  • Chronic cutaneous lupus. A purple or crimson rash results from this type. Additionally, it may result in hair loss, scars, and skin discolouration. It could also go by the name discoid lupus.

Whilst acute cutaneous lupus is frequently associated with lupus in other parts of the body, subacute and chronic cutaneous lupus commonly only occur on the skin.

Neonatal lupus

Infants with particular autoimmune antibodies in their parents at birth are affected by this extremely rare illness. Through the placenta, these autoimmune antibodies are passed from parent to foetus.

Parents with these antibodies do not necessarily all experience lupus symptoms. According to studies, roughly 25% of mothers who give birth to a kid with neonatal lupus don’t themselves have the disease. However, it’s anticipated that within three years, 50% of these mothers will exhibit symptoms.

Some signs of this syndrome are:

  • A skin rash
  • Low blood cells count
  • Liver issues following birth

While some babies may have heart development problems, the majority of symptoms subside after a few months.

If you have these antibodies, you must be continuously monitored during your pregnancy. Specialists on your care team may include a rheumatologist and a high-risk obstetrician, for example. A physician who focuses on fetal-maternal medicine is called an obstetrician.

Drug-induced lupus

The use of specific prescription drugs may result in drug-induced lupus (DIL). Drug-induced lupus erythematosus (DILE) is another name for the condition.

According to research, taking some prescription drugs over an extended period of time can cause DIL to manifest. It usually happens just a few months after starting the medicine.

Many medicines have the potential to lead to DIL. Several instances include:

  • Antimicrobials like pyrazinamide and the antifungal terbinafine (a tuberculosis medication)
  • Medications that prevent seizures, such as phenytoin (Dilantin) and valproate
  • Medications that treat arrhythmia, including quinidine and procainamide
  • Hydralazine and other blood pressure medications
  • Anti-TNF-alpha biologics, such as etanercept (Enbrel) and infliximab (Remicade)

Despite the fact that DIL mimics SLE symptoms, major organs are rarely affected by the disorder. But it can also result in pleurisy and pericarditis. DIL typically disappears a few weeks after ceasing the medicine that triggered it.

Obtain more details about DIL.

Diagnosis

To diagnose lupus, doctors don’t only need one blood test or imaging procedure. Instead, they take into account a person’s indications and symptoms and rule out any underlying diseases that might be the source of them.

According to research, several antibodies, such as the Smith (Sm) and double-stranded DNA (ds-DNA) antibodies, are quite specific to lupus. Additionally linked to SLE-related renal illness is the Sm antibody (nephritis).

Prior to performing a physical examination, your doctor will first ask you about your medical history. Your symptoms, including how long you’ve had them, and whether you have a history of lupus or other autoimmune disorders in your family will be discussed.

In addition to taking a thorough medical history and conducting a physical examination, a 2019 review states that your doctor might carry out the following tests to identify lupus:

  • A blood test. One of these might be a complete blood count. This test is used by doctors to identify the quantity and type of platelets, white blood cells, and red blood cells in a patient’s blood. They might also request testing for antinuclear antibodies, C-reactive protein, and erythrocyte sedimentation rate, which can all show increased immune system activity.
  • Urine test. You can find out if your urine has an elevated level of blood or protein by using a urinalysis. This may suggest that your kidneys are being impacted by lupus.
  • Imaging tests. Echocardiograms and chest X-rays are two imaging tests that could show swelling or inflammation in or near your heart and lungs.
  • Tissue biopsy. A biopsy, or sample of cells, can be taken by your doctor from a rash that resembles lupus. This could reveal whether cells typical of lupus sufferers are present. A kidney biopsy may be required to help decide the best course of action if renal disease is detected.

Causes

Although doctors are unsure of the precise aetiology of lupus, they believe that a variety of underlying variables may be involved. These consist of:

  • Environment. a review for 2019 Trusted Source found possible lupus triggers like smoking, stress, and contact with pollutants like silica dust.
  • Genetics. Over 50 genes connected to lupus have been found. A person may also be slightly more likely to get lupus if they have a family history of the disease.
  • Hormones. A review for 2019 According to a dependable source, abnormal hormone levels, such as elevated oestrogen levels, may be a factor in lupus.
  • Infections. Experts are still investigating the connection between lupus and diseases including CMV and Epstein-Barr, according to a 2021 study
  • Medications. DIL has been associated with long-term usage of some drugs, including hydralazine (Apresoline), procainamide (Procanbid), and quinidine. DIL can also occur in patients using TNF blockers for ailments such as rheumatoid arthritis (RA), inflammatory bowel disease, and ankylosing spondylitis. Tetracyclines, such as minocycline, which are used to treat rosacea and acne, can also cause DIL, albeit this is uncommon.

It’s also possible to have lupus while not having any of the known risk factors for the autoimmune illness listed below.

The likelihood of acquiring lupus may be higher in some populations. The following are examples of lupus risk factors:

  • Gender. Lupus affects more women than males, although men can also experience more severe symptoms.
  • Age. Despite the fact that lupus can strike at any age, it is typically diagnosed in patients between the ages of 15 and 44.
  • Family history. You run a higher risk of getting lupus if someone in your family has the disease.
  • Ethnicity. Lupus is more prevalent among People of Color, Black People, Hispanics, Latino, Asian People, Native Americans, Native Hawaiians, and Pacific Islanders in the UK than it is among Caucasians. In the aforementioned groups of persons, lupus might manifest earlier in life and in a more severe form. According to 2014 research, lupus affects 1 in 537 Black females in the United States. Researchers are unsure if this is caused by socioeconomic or genetic factors (or both.) The LUMINA study provides some insight into potential contributing elements. To understand why these groups are mostly affected by lupus, additional research is necessary.

Having lupus risk factors does not guarantee that you will develop the disease. It simply indicates that your risk is higher than that of people who don’t have risk factors.

Complications

Lupus-related problems come in a number of forms. They are brought on by the condition’s corresponding inflammation. Lupus complications could result in issues with the:

  • Kidneys. A 2020 study found that lupus-related inflammation can harm kidney tissue and even result in renal failure.
  • Blood or blood vessels. According to an analysis from 2020, lupus can cause inflammation of the blood vessels. Vasculitis is the term for this. Lupus can also cause issues with bleeding or blood clotting.
  • Heart. A 2020 study found that lupus can cause your heart and surrounding tissues to become inflamed. Your chance of developing heart disease, having a heart attack, or having a stroke may also increase.
  • Lungs. According to a paper published in 2020, lupus-related lung inflammation might make breathing difficult.
  • Nervous system. According to a 2017 analysis, lupus can cause seizures, migraines, and episodes of vertigo in the brain.

Additionally, infections are more likely to affect lupus sufferers. This is a result of both the illness itself and the fact that many drugs used to treat lupus depress or weaken the immune system.

It’s crucial that you follow the treatment schedule your doctor has created for you if you have lupus. By doing this, you can lessen the risk of organ damage and lupus flare-ups.

Lupus nephritis

According to a 2020 study, lupus nephritis is a significant consequence that can result from lupus. It takes place when your immune system targets the kidney’s blood-filtering function.

In order to receive timely treatment, it’s critical to know the signs of lupus nephritis. The signs and symptoms include:

  • Dark urine
  • Foamy urine
  • Bloody urine
  • Frequent urination, particularly in the evening or at night
  • Puffiness in the legs, ankles, and feet that gets worse as the day goes on
  • Weight gain
  • High blood pressure

Lupus nephritis has six separate stages, referred to as classes I through VI. The least severe class is I, while the most severe class is VI.

Learn more about the symptoms, causes, diagnosis, and treatment of lupus nephritis.

Lupus fatigue

One of the typical signs of lupus is fatigue. A 2012 study found that between 53 and 80 percent of lupus sufferers list exhaustion as one of their primary symptoms.

The specific reason for weariness in lupus sufferers is unknown. However, a few things could be behind it, like:

  • Bad sleep
  • Low level of exercise
  • Vitamin D deficiency
  • Obesity
  • Joint discomfort brought on by lupus
  • Drug side effects for lupus
  • Comorbid illnesses, such as thyroid disease, anaemia, or depression

The following actions can be taken to combat fatigue:

  • Recognize your physical limitations. Maintaining an active lifestyle is crucial, but moderation is key. Rest up in between activities.
  • Avoid taking naps during the day if possible. This may make it difficult for you to sleep at night.
  • Prioritize and plan your work. This enables you to more effectively schedule your time between periods of activity and rest. Try to combine your errands together, for instance, so that you don’t have to continue leaving the house when you’re out doing them.
  • Be honest about feeling worn out. Tell your loved ones how they can assist you.
  • Think about joining a local or online support group. By doing this, you can discover methods that other lupus sufferers use to deal with their weariness.

Lupus and depression

Lupus can sometimes be tough to manage. Having angry or depressed feelings is extremely typical. It’s crucial to recognise the difference between transient unpleasant emotions and diseases like depression.

People with lupus may experience depression frequently. A 2018 study found that an estimated 25% of lupus sufferers also experience depression. As a result, it’s critical to recognise the symptoms of depression so that you can get treatment. These consist of:

  • Sadness, hopelessness, or guilt are experienced
  • A poor sense of self
  • Sobbing, which might occur for no apparent reason
  • Having trouble concentrating
  • Difficulty sleeping or excessive sleep
  • Alterations in appetite that result in weight gain or loss
  • Observing that you’ve lost interest in activities that you once found enjoyable

Seek assistance if you recognise any of these symptoms in yourself. Therapy and medication are frequently effective ways to treat depression.

Lupus arthritis

Inflammation in your joints is a sign of arthritis. In the affected joints, this may result in swelling, discomfort, and a restricted range of motion.

Joint inflammation is frequently caused by autoimmune arthritis, such as RA. However, osteoarthritis, or wear and tear, which develops in our joints as we age, is a major contributing factor in many cases of arthritis.

According to research, arthritis frequently affects lupus patients. But lupus-related arthritis results from the disease’s characteristically high amount of cellular inflammation.

Compared to other inflammatory disorders like RA, the levels of tissue inflammation and destruction within the joints are often lower in lupus. But other individuals could have both lupus and RA.

There may be a hereditary connection between lupus and RA in this instance.

Lupus flare-up

A lupus flare occurs when your illness-causing lupus symptoms get worse. Explosions come and go. There are instances when a flare is preceded by warning indications and other times when they happen suddenly.

A flare can be brought on by a variety of factors. A 2016 assessment lists a few of them as follows:

  • Exposure to UV radiation, such as sunlight or fluorescent light
  • Stress
  • Not getting enough rest
  • Having an infection or injury
  • Certain types of medications
  • Not taking your lupus medications

While lupus medicine can help prevent flares from happening, you still might have one while taking it. For instance, even when you’re taking medicine, you can experience a flare if you’ve been working long hours without enough rest.

Lupus flare-up Symptoms

You may be alerted to the impending lupus flare by certain symptoms. Recognizing these symptoms can enable you to seek treatment more quickly. This might lessen the severity of the flare.

The following indicators of lupus flare-up:

  • Feeling more tired than usual
  • Rash
  • Pain, especially chest pain that may result from pericarditis or pleurisy
  • Fever
  • Upset stomach
  • Feeling dizzy
  • Severe headache
  • Raynaud’s phenomenon
  • Swollen lymph nodes

Lupus flares can be minor or severe in severity. Some flares may just result in a rash or joint pain, whilst more severe ones may harm your internal organs. Because of this, getting medical help is always important.

Treatment

While there isn’t a cure for lupus at the moment, there are drugs that can help you control your symptoms and stop flare-ups. A doctor will take into account the severity of your lupus symptoms while considering lupus therapies.

It’s crucial that you visit your doctor frequently. This enables them to keep a closer eye on your health and assess how well your treatment strategy is controlling your symptoms.

Over time, your lupus symptoms may also alter. As a result, your doctor may alter your prescription regimen or change the amount of an existing medication.

According to the National Health Service (NHS), your doctor could suggest lifestyle modifications in addition to medicine to help control your lupus symptoms. These might include items like:

  • Avoiding excess exposure to UV light
  • Eating a healthy diet
  • Taking supplements that may help to reduce symptoms, such as vitamin D, calcium, and fish oil
  • Getting regular exercise
  • Quitting smoking, if you smoke

Medical treatment

Depending on your symptoms and how severe they are, your doctor may prescribe a different drug. Several ways that medications can help with lupus symptoms include:

lowering your immunological response
lowering your level of swelling or inflammation aids in preventing harm to your joints or internal organs.
Examples of lupus drugs, per a 2019 review, include:

  • Medications that are non-steroidal anti-inflammatory (NSAIDs). These can lessen pain and swelling. Examples include over-the-counter drugs like Paracetamol and ibuprofen.
  • Antibiotics for malaria. The infectious disease malaria was once treated with these medications. Doctors now treat malaria with newer treatments since the organism that causes the disease has become resistant to older ones. Antimalarial drugs help treat lupus symptoms like fatigue, rashes, and joint discomfort. They can also aid in reducing lupus flare-ups. They are advised throughout pregnancy to lower the chance of complications from the pregnancy and the parent’s disease going worse.
  • Corticosteroids. These medications can lessen discomfort and swelling while also calming your immune system. They are available as tablets, topical creams, and injections, among other forms. Prednisone is a corticosteroid, as an illustration. Infections and osteoporosis are two unwanted consequences of corticosteroids. It’s critical to limit dosage and usage time.
  • Immune suppressants. Your immune system is suppressed by these drugs. They are normally only used when lupus is severe or is affecting numerous organs because they are quite potent and can reduce your body’s fight against infection. They’re also employed to lessen exposure to and consumption of steroids. They are also known as steroid-sparing drugs for this reason. Examples include azathioprine, mycophenolate mofetil, methotrexate, and mycophenolic acid. These drugs are utilised as lupus treatments off-label.
  • Biologics. Medications of a biological origin are known as biologics. A biologic called belimumab (Benlysta) is used to treat lupus. It’s an antibody that has the ability to stop a body protein necessary for the immune response.

It’s crucial to keep an eye on how your symptoms are affected by your prescriptions. Inform your doctor if your medicine has side effects or stops treating your symptoms.

Become more knowledgeable about the various lupus drugs.

Lupus diet

A particular diet for lupus sufferers has not been established by medical authorities. But a review for 2019 Several dietary adjustments, according to a reliable source, may be advantageous.

Try to consume a diet that is generally well-balanced. Various examples of this include:

  • Salmon, tuna, and mackerel are examples of omega-3-rich fish.
  • Calcium-rich foods include low-fat dairy products.
  • Sources of whole grain carbohydrates
  • A combination of vibrant fruits and veggies

You may need to watch your intake if you eat seafood rich in omega-3 fatty acids. These fish may have high mercury concentrations.

Additionally, due to the medications that people with lupus normally take, there are particular foods that they should generally avoid. The following are some examples of foods to avoid:

  • Alcohol. Numerous drugs and alcohol might have interactions. For instance, it may result in gastrointestinal bleeding in NSAID users. Inflammation risk may also rise as a result.
  • Alfalfa. Alfalfa seeds and sprouts contain the L-canavanine amino acid. This amino acid may cause lupus flare-ups by causing more inflammation.
  • Foods that are rich in cholesterol and salt. Limiting your intake of salt and cholesterol is good for more than simply your general health. Additionally, it aids in avoiding bloating and blood pressure increases brought on by the usage of corticosteroids.

Additionally, if you lack vitamin D and experience photosensitivity as a result of your lupus. A vitamin D supplement may be beneficial. Online stores sell vitamin D pills.

Find out more advice about eating well when you have lupus.

Outlook

While lupus might have an impact on your health, it need not reduce your quality of life. You can live as healthily as possible by concentrating on your meds and overall wellness.

You can work on your well-being at home in addition to adhering to your treatment plan by doing the following things:

  • Keeping busy and exercising frequently
  • Eating a balanced, nutritious diet
  • Finding methods to control stress
  • Being cautious to obtain enough sleep and avoid overworking oneself

You may also learn more about living with lupus by reading about other people’s experiences. You can explore the various lupus blogs that are available.

Dealing with a lupus diagnosis might be difficult at times. Sharing your experience with others through offline or online support groups may be beneficial.

Check out how one blogger manages to live with lupus.