LUPUS

Lupus, otherwise known as systemic lupus erythematosus (SLE), is a chronic, autoimmune disease that can damage any part of the body.  It involves the inflammation of many body systems, including your joints, skin, kidneys, blood cells, brain, heart and lungs.  SLE is characterized by the unusual production of antibodies in the body.

The most distinctive symptom of lupus is the butterfly rash, a facial rash that resembles the wings of the butterfly.

The cause of lupus is unknown, but sunlight, infections and medications may trigger lupus. Complications can arise from lupus, it may involve the:

  • It can cause kidney failure that manifest as generalized itching, chest pain, nausea, vomiting, and leg swelling.
  • Brain and central nervous system. A patient may experience headaches, dizziness, behavior changes, hallucinations, and even strokes or seizures.
  • Blood and blood vessels. Problems such as anemia and increased risk of bleeding or blood clotting.
  • Lupus can cause the inflammation of the lining of the lungs, known as pleurisy.
  • Lupus can cause inflammation of the heart muscle, arteries, or heart membrane (pericarditis).

Lupus symptoms are not all alike.  Symptoms depend on the body system affected by the disease.  Lupus improves at times, and worsens at others. Symptoms of lupus may include:

  • Profound fatigue
  • Low-grade fever
  • Severe joint pain and muscle aches
  • Skin rash on the face or body
  • Extreme sun sensitivity
  • Weight loss
  • Mental confusion and seizures
  • Chest pain on taking a deep breath
  • Nose, mouth, or throat sores
  • Enlarged lymph nodes
  • Poor circulation in fingers and toes
  • Bald patches and hair loss

Lupus can be deadly. Treatment is much more successful if begun early and followed faithfully.

DIAGNOSIS

Diagnosing lupus is difficult because signs and symptoms vary considerably from person to person. The combination of blood and urine tests, signs and symptoms, and physical examination findings leads to the diagnosis.

Laboratory tests

Blood and urine tests may include:

  • Complete blood count. Results may indicate you have anemia, which commonly occurs in lupus. A low white blood cell or platelet count may occur in lupus as well.
  • Erythrocyte sedimentation rate. The sedimentation rate isn’t specific for any one disease. It may be elevated if you have lupus, another inflammatory condition, cancer or an infection.
  • Kidney and liver assessment. Blood tests can assess how well your kidneys and liver are functioning. Lupus can affect these organs.
  • Urinalysis. An examination of a sample of your urine may show an increased protein level or red blood cells in the urine, which may occur if lupus has affected your kidneys.
  • Antinuclear antibody (ANA) test. A positive test for the presence of these antibodies — produced by your immune system — indicates a stimulated immune system. While most people with lupus have a positive ANA test, most people with a positive ANA do not have lupus. If you test positive for ANA, your doctor may advise more-specific antibody testing.

Imaging tests

If your doctor suspects that lupus is affecting your lungs or heart, he or she may suggest:

  • Chest X-ray. An image of your chest may reveal abnormal shadows that suggest fluid or inflammation in your lungs.
  • Echocardiogram. This test uses sound waves to produce real-time images of your beating heart. It can check for problems with your valves and other portions of your heart.

Biopsy

Lupus can harm your kidneys in many different ways, and treatments can vary, depending on the type of damage that occurs. In some cases, it’s necessary to test a small sample of kidney tissue to determine what the best treatment might be. The sample can be obtained with a needle or through a small incision.

 

RECOMMENDED MEDICATIONS

Medicines can’t cure lupus, but they can control many symptoms and often can prevent or slow organ damage.

Medicine treatment for lupus often involves reaching a balance between preventing organ damage, having an acceptable quality of life, and minimizing side effects.

Medicine choices

If you have mild disease or symptoms that affect your quality of life but you don’t have organ-threatening problems, your doctor may prescribe:

  • Acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs), sometimes in combination with antimalarial drugs. Acetaminophen and NSAIDS are often enough to reduce symptoms.
  • Antimalarial drugs such as hydroxychloroquine (Plaquenil).
  • Low-dose corticosteroids and/or corticosteroid creams or ointments.

If you have more severe disease, your doctor may prescribe:

  • Corticosteroids, such as prednisone.
  • Immunosuppressive medicines, such as azathioprine, belimumab, cyclophosphamide, methotrexate, or mycophenolate mofetil.

If you have had blood clots in a vein or artery (venous or arterial thrombosis), or have antiphospholipid antibody syndrome, which increases your risk for blood clots, your doctor may prescribe a blood thinner (anticoagulant). This is especially important if you already have blood clots. Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) that is sometimes used to slow blood clotting in antiphospholipid antibody syndrome.

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