What Is Lupus?

shutterstock_148632053Lupus, Latin for “wolf”, is a chronic autoimmune disease.  Basically meaning the body’s immune system mistakenly attacks healthy tissue instead of harmful bacteria or viruses.

Tracing back to the 14th century, lupus and cancer were both common names for an ulcerous disease.  Cancer could involve any tissue, but lupus specifically refereed to afflictions of the skin.  In the 16th century Paracelsus compared the ulcers to a hungry wolf eating flesh because he thought the lesions were taking up excessive blood supply, leaving less for surrounding tissue.

Currently, there are several different types of lupus and the symptoms for each can vary greatly. Lupus causes long term inflammation and the results can cause a wide range of symptoms.  There is no known cause of lupus but it’s thought to be the result of a combination of genetic and environmental factors.

The body has a natural defense against bacteria viruses and other harmful foreign organisms in the form of our immune system.  Normally, an organ known as the thymus produces certain types of cells (T cells) that recognize our own healthy cells by recognizing what is known as MHC molecules.  When these T cells become restricted, your body can become unable to recognize our own healthy cells from harmful foreign cells.  The result can be an autoimmune disease like lupus.

There are over 80 known types of autoimmune diseases. Some common ones include: Multiple Sclerosis, Graves disease, Rheumatoid arthritis, type 1 diabetes, celiac disease and more recently known narcolepsy.

We all know the common symptoms of an immune response.  After all, who hasn’t had a cold or flu and felt the reaction from the body fighting the problem.  Things like; inflammation, fever, weakness, fatigue, and painful joints.  An autoimmune disease will first begin to present in this same way.  The damage caused to healthy tissue as a result of this autoimmune response will vary depending on the systems affected.

In the case of lupus, they can be things like; extreme fatigue, anemia, swelling in the feet, hands or around the eyes, chest pain when breathing deeply, hair loss, sun or light sensitivity,  abnormal blood clotting, and a butterfly-shaped rash across the cheeks and nose.

There are several different types of lupus, including; Systemic lupus erythematosus (SLE), Discoid lupus erythematosus, drug induced lupus, neonatal lupus and sub-acute cutaneous lupus erythematosus.  See “types of lupus” below for an explanation of each.

lupusThe type most people think of when talking about lupus, is SLE. This type can be systemic, affecting several different parts of the body.  The symptoms can range from mild to serious and can even lead to death. It affects approximately 1.5million Americans, and approximately 16,000 new cases are diagnosed each year.  Unfortunately ladies, 90% of SLE cases are women between the ages of 15 and 45.

Because lupus symptoms can begin like those of any natural immune response, and because it can affect so many different body systems, there is no single test that can be used to diagnose it.  One common method is to test for antibodies known as antinuclear.  It’s known people with higher than normal levels of these antibodies have a 50% chance of having an autoimmune disease, and 95% of people with SLE have these antibodies present. Unfortunately these types of antibodies are present in people who don’t have an autoimmune disease.  Your doctor will have to use these results in combination with your signs and symptoms to accurately diagnose you.

Some common signs they might look for while paring the antibody results include; Pleuritis, which is inflammation of the lining around the chest cavity. This can cause pain when breathing.  Inflammatory conditions of the lung, commonly known as pneumonia. Non-painful kidney problems resulting in things like dark urine, swelling of legs, ankles or fingers known as edema. Central nervous system problems that cause headaches, dizziness, vision problems, seizures, memory disturbances, and stroke.  Heart problems like inflammation of the heart itself, known as myocarditis or endocarditis, or inflammation of the lining of the heart known as pericarditis.

Like so many other autoimmune diseases, there is no known cure for lupus.  The treatment revolves around symptom control.  Minimizing inflammation, reducing pain, and stopping the development of serious organ damage.

As you would expect, drugs to treat inflammation like aspirin, ibuprofen, and other non-steroidal anti-inflammatories (NSAIDs) are commonplace.  For more serious inflammatory responses Corticosteroids can be used.  Immunosuppressive medication and antimalarial drugs are often used.  In some cases anticoagulants (anti-clotting) drugs are prescribed.

Because lupus can present in so many different ways, and the symptoms mimic so many different types of problems, it can take several years to appropriately and accurately diagnose someone with it.  In fact, there are 11 criteria involved with lupus.  7 are related to your symptoms and 4 have to do with lab tests.  You will need to have 4 of the 11 criteria before you doctor will consider diagnosing you with the disease.

So don’t get frustrated with your doctor if it takes a while.  The postulate, “if it looks like a duck and quacks like a duck, it must be a duck” does not apply.  Because in this case, all of the problems are ducks and they all kind of look the same.  Duck hunting anyone!

Types of lupus:

Systemic lupus erythematosus- The most commonly talked about type, it can affect several different body systems at the same time.  Central and peripheral nervous systems, digestive tract, heart, lungs, and skin. The presentation really revolves around the systems involved and how they’re affected.

Discoid lupus erythematosus- This type only involves the skin and presents with a red, raised rash.  Usually on the face and scalp, the raised area can become scaly and thick.  The rash can last for days, weeks, or even years.  If you have discoid lupus there is a small chance you could develop SLE.

Sub-acute cutaneous lupus erythematosus- This type of lupus is also skin related, and refers to skin lesions that appear on body parts exposed to the sun.  They don’t tend to cause scaring.

Drug-induced lupus- As the name implies, this type of lupus is caused by certain types of medications.  Including anti-seizure, high blood pressure, antifungals, antibiotics, thyroid medications, and oral contraceptives, they all can cause similar symptoms as SLE.  The main difference is that the symptoms go away when you stop the medication.

Neonatal lupus- This is a rare type of lupus that occurs in the newborn babies of women with SLE.  At birth the babies can have a rash, liver problems or low blood counts.  The symptoms will usually go away over the course of months, however the babies can have serious long term complications.  Things like congenital heart blocks caused by fibrous tissue interfering with electrical impulses in the child’s heart.  Ladies with SLE, not to worry, most infants of mothers with SLE are born absolutely healthy.

 

**This is an article we wrote for our friends over at Today I Found Out.  You can see it here.  In honor of lupus awareness month (may) we received permission to republish this article on our website.  Thanks Today I Found Out! **

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