Lupus

Some Facts and Figures

There are three main types of this chronic inflammatory disease - systemic lupus erythematosus (SLE), discoid lupus erythematosus and drug induced lupus.  More women are affected than men.  The most common and serious form of Lupus is SLE, causing swollen painful joints, kidney damage, skin rash and fatigue.  There have been reported cases that a mother can pass the antibodies to the baby during childbirth even though she may not show any signs of lupus herself (this is very rare).

The disease can affect all ages but most commonly begins between the age of 20 to 45 years. It is also more frequent in African-Americans and people of Chinese and Japanese descent

Diagnosis and treatment of lupus have improved in recent years and with ongoing care and treatment most sufferers can lead normal active lives. 

What is Lupus?

Lupus is an auto-immune disease resulting in chronic inflammation.  Auto-immune diseases occur when the immune system attacks the body's tissues. 

The disease targets joints, tissue, organs and blood cells as a result of the immune system attacking the body. When only the skin is affected this is known as discoid lupus; systemic lupus erythematosus (SLE) involves internal organs.  The immune system is designed to fight infections, however in lupus, patients produce abnormal antibodies in the blood that attack their own bodies instead of infections.

What causes Lupus?

Considerable research has been carried out to determine the causes of Lupus ranging from inherited genes, viruses, ultraviolet light, poor nutrition and digestion and the possibility of certain medications.  A number of drugs have been identified that may trigger SLE, including hydralazine used for high blood pressure, isoniazide used in the treatment of tuberculosis, procainamide and quinidine used for abnormal heart rhythm, phenytoin used for epilepsy and d-penicillamine used in the treatment of rheumatoid arthritis).  However less than 5% of SLE patients account for cases of drug-induced SLE.  This usually is resolved by discontinuing the medication involved.

There is thought to be a hormonal relationship with SLE, as some women experience a worsening of symptoms prior to menstruation.  The fact that more women suffer with this disease could indicate that female hormones play an important role in SLE.  This is still being actively researched by scientists.

What are the symptoms of Lupus?

Only a skin rash occurs in Discoid Lupus, usually found on the face and scalp.  The rash is normally red, have raised borders, is painless and does not itch.  Scarring can occur and can result in permanent hair loss.

The arthritic symptoms of SLE are often very similar to Rheumatoid Arthritis.  The small joints of the feet, wrists and hands become painful, swollen and stiff and can also become deformed.

SLE on the other hand presents different combinations of symptoms and the organs affected.  Patients suffering with SLE complain of extreme fatigue, muscular aches, mouth ulcers (also nose ulcers), loss of appetite, fever and facial rash.  They can also have an increased sensitivity to sunlight and suffer with poor circulation to fingers and toes associated with Raynaud's phenomenon.  Tests can confirm if inflammation of the lining surrounding the lung and heart is evident.

The red facial rash is quite characteristic of about 50% of people with SLE, the rash appears over the bridge of the nose and looks very much like a butterfly (hence it is often referred to as the "butterfly rash").

The blood clotting factors and white blood cells can be decreased in SLE patients, increasing the risk of bleeding and infection.  In addition, serious organ involvement can occur in the kidney, brain and liver.

What is the treatment for Lupus?

As there is no cure for SLE at this time, the treatment is aimed at relieving symptoms and protecting organs, by decreasing the level of auto-immune activity in the body.  Treatment is given depending on the severity of the disease; mild symptoms may not need ongoing treatment but courses of anti-inflammatory drugs intermittently.  For patients with more serious symptoms involving internal organs, could be prescribed high doses of corticosteroids together with other medication to suppress the immune system.

To avoid fatigue, SLE patients require more quality sleep during the active stages of the disease.  A carefully prescribed exercise regime is important to maintain muscle tone and joint movement.  Depression is often experienced by SLE patients and care must be taken to address this problem.

Non steroidal anti-inflammatory medication is often helpful in reducing inflammation and pain in joints, muscle and tissue, however corticosteroids are usually prescribed when the disease is active to help with reducing inflammation and also when internal organs are involved.  In addition, anti malarial drugs (eg. Plaquenil) have been found to be effective in patients experiencing fatigue, joint and skin disease.

Ongoing research is leading to a better understanding of the disease and its treatment, as well as the role the immune system plays in causing disease.

What can you do to help yourself?

Maintaining good health is quite often difficult for Lupus sufferers.  However, a number of things can assist, such as - 

Healthy Balanced Diet 

This is important for everyone.  A healthy diet and being aware of any foods you may find aggravate your symptoms, will help you maintain an ideal weight and ensure your body is getting the nutrition it needs.  You should avoid, or at least limit alcohol, as this can have an effect on your liver and heart as well as adversely affecting medication.  It is also very advisable that you do not smoke as this can also affect heart and blood vessels.

Rest, Sleep and Relax  

When the disease is active, it is essential to rest as much as possible.  In addition, you will find you need more sleep - good quality sleep.  Some experts recommend eight to ten hours as being a good rule of thumb.  This time can be spread out with naps and rests during the day and sleep at night.  (This differs slightly from recommendations for Fibromyalgia patients, in that it is better that they do not rest during the day to ensure a better sleep at night.)

It is important to relax and reduce stress and anxiety.  Stress triggers changes in biochemistry that suppress white blood cell activity, it also depletes the body of nutrients. 

Immunization

As some live vaccines such as intranasal flu can affect lupus sufferers, it is advisable to check with your doctor prior to having any vaccination.

Alternative Treatments

There are many herbal medications said to improve the immune system and assist with inflammation.  To find out more you should consult with a qualified health professional and also discuss any non-prescription medications with your doctor.