Lupus, while challenging, can be treated

The disease can strike people of all ages, but it is most frequently diagnosed between the ages of 15 and 45

By: Leonard Grossman, M.D.
   Lupus is the name of a chronic autoimmune disease that causes
inflammation in various parts of the body, including the joints, skin, heart
and lungs, kidneys and blood cells.
   The immune system is the body’s main defense against harmful
bacteria and viruses, but in people who have lupus, the immune system attacks
healthy tissue, as well. This is the meaning of autoimmunity.
   Lupus is not a disease that is directly inherited through
the genes. In fact, only 5 percent of children born to a parent who has lupus
will develop the disease. But doctors believe that certain genes make certain
people more susceptible to the disease, and having a relative who has lupus
can increase the odds of developing it.
   Medical research suggests that exposure to other environmental
factors can trigger lupus. Such triggers might include viral or bacterial infections,
long-term use of certain prescription drugs, and ultraviolet radiation found
in sunlight. Another factor could be hormones, particularly estrogen, which
may explain why the majority of people afflicted with lupus, about 90 percent,
are women.
   The disease can strike people of all ages, but it is most
frequently diagnosed between the ages of 15 and 45. It affects 1 in 4,000 people
in the United States. The outlook for people with lupus was once very grim.
Today, with early diagnosis, proper care and new medicines, most people with
lupus can lead active, normal lives.
   The most common symptoms of lupus typically develop at intervals,
rather than appearing all at once, and can get worse in episodes called "flares."
The symptoms might improve or even disappear completely for long periods of
time, going into remission.
   Lupus can be hard to diagnose because it often mimics other
illnesses that are not as serious. It’s been called a disease "with a thousand
faces" because it manifests in different ways from person to person. Symptoms
can start with fatigue, fever and joint pains. The overwhelming majority of
patients will have joint and/or skin involvement within the first year of their
disease.
   There is no single laboratory test yet developed that can
diagnose lupus. The American College of Rheumatology (ACR) has developed a set
of criteria to help doctors diagnose lupus. The ACR says having 4 of the 11
criteria at one time or over a period of time means a diagnosis of lupus is
likely and medical attention should be sought immediately.

  • "Wolf Bite" or Malar rash: One in 3 people with lupus develops a distinctive
    rash that doctors once thought resembled a wolf bite, hence the name lupus,
    which is the Latin word for wolf. The rash develops across the cheeks and
    bridge of the nose and is butterfly-shaped.
  • Discoid rash: raised, scaly patches on the skin anywhere on the body.
  • Photosensitivity: These rashes can become severe when the skin is exposed
    to the sun or even harsh indoor lighting, such as fluorescent bulbs.
  • Oral ulcers that last for more than two weeks.
  • Arthritis: The areas afflicted are primarily the knees, wrists, fingers
    and hands, which can swell and have joint pain.
  • Kidney Problems: Lupus can wreak havoc on the kidneys by causing a condition
    that affects their ability to filter toxins. Glomerulonephritis can lead to
    kidney damage and can eventually lead to kidney failure. Fortunately, this
    is uncommon, and medication can prevent or delay its occurrence.
  • Brain/Central Nervous System Problems:, Lupus can affect the brain and central
    nervous system with symptoms that can range from something as mild as a headache
    to dizziness, vision problems, seizures and stroke.
  • Heart/Lung Problems: One of the most serious symptoms of lupus is pericarditis
    — inflammation of the pericardium, the sac surrounding the heart.
    This condition can cause shortness of breath and chest pain. Lupus can cause
    an inflammation of the chest cavity lining known as pleurisy. It can also
    cause pulmonary hypertension — high blood pressure in the lung’s blood
    vessels.
  • Blood Disorders, including anemia, low platelets or a low white cell count.
  • Anti-nuclear antibody: This test, often called the ANA, is present in more
    than 95 percent of patients with lupus. Unfortunately, patients with other
    autoimmune diseases and even some healthy people can have an ANA.
  • Immunological Disorder: an indication of an autoimmune disease.

   There are certain health risks posed by lupus, especially
for younger women in their childbearing years. Women with lupus have a higher
risk of miscarriage. They are more likely to experience a flare-up during their
pregnancy. They are also at greater risk of pre-term birth and other complications
while they are pregnant, including diabetes, kidney problems and high blood
pressure. Women with lupus have an increased risk of infection from the intrauterine
device (IUD) and may have a low tolerance for birth control pills.
   Lupus can result in permanent tissue and organ damage because
the early warning signs and symptoms are so often overlooked or misdiagnosed.
Early diagnosis and treatment is critical because it can cut the time needed
to take higher doses of medications which can cause serious side effects.
   People with lupus can reduce the length and severity of their
flares by learning to recognize the warning signs and getting adequate amounts
of rest, staying out of the sun, getting exercise, eating well and limiting
stress. Staying away from alcohol and cigarettes also help.
   With the right care, better methods of therapy, increased
awareness and early intervention, 80 to 90 percent of people today with non-organ-threatening
lupus can look forward to a normal life span.
   To find out more about lupus, visit the Lupus Foundation of
America at www.lupus.org or the Alliance for Lupus Research at www.lupusresearch.org.
To find a Princeton Healthcare System rheumatologist, visit www.princetonhcs.org
or call (888) 742-7496.