Lupus is an autoimmune disease that is considered systemic, meaning that it can affect a wide variety of your body, but especially your own tissue and organs. This means, that your own body’s Immune System acts itself.

This condition causes an increase in Inflammation. When inflammation goes unchecked or abnormally, serious medical results can occur. Lupus inflammation can affect: Joints, Skin, Kidney, Blood, BrainHeart, Lungs, Liver, and more.

The exact cause is unknown, but many believe that there is a genetic tendency that increases your chanced of developing Lupus. Other causes may include: Infections, Certain Drug reactions, or sunlight.

There is no “cure” for Lupus and treatment is directed at management and decreasing inflammation. The patient may have periods of remission (little to no symptoms) and flare ups (Symptoms dramatically worsen). Often treatment is to prevent or reduce flare ups.

Different Types

1.)  Systemic Lupus Erythematosus (SLE): Is the most common type and symptoms are usually Mild to Severe

2.)  Discoid Lupus: Often a Red Rash that doesn’t go away

3.)  Subacute Cutaneous Lupus: Often have sores are after being out in the sun

4.)  Drug-Induced Lupus: Symptoms will usually go away when you stop taking the medications

5.)  Neonatal Lupus: This Rarely seen and is believed to be caused by antibodies from the mother

Symptoms:

–  Fatigue
–  Facial rash
–  Body rash
–  Joints Pains
–  Joint Stiffness
–  Joint Swelling
–  Fevers
–  Skin lesion (Often worsen with Sun Exposure)
–  Turning white of fingers, toes and parts of hands or feet. Known as Raynaud’s phenomenon
–  Dry eyes
–  Headaches
–  Shortness of breath
–  Chest pain
–  Others

Causes:

1.)  Genetics
2.)  Sun Exposure – this often triggers skin reactions and increased symptoms
3.)  Infection – Can initiate symptoms or trigger them
4.)  Medications: Some blood pressure medications, antibiotics, anti-seizure medications have worsened or triggered symptoms

Risk Factors

1.)  Sex – Women have a higher incidence then men
2.)  Age – Most often seen in ages 15-45 (Can be seen in all ages)
3.)  Race – More common in African-Americans, Hispanics and Asian-Americans

Complications

Kidney
–  Serious Kidney damage can occur including kidney failure
–  Kidney failure is one of the leading causes of death among people with lupus

Brain
–  If the Brain is affected, additional symptoms may be seen
–  Including: Dizziness, behavior changes, vision changes, strokes, Seizures
–  Memory and Ability to express oneself may be affected as well.

Lungs
–  Lungs are often affected
–  Inflammation of the cavity and lining – Pleurisy
–  Breathing can be painful.
–  Bleeding into lungs and pneumonia are seen somewhat less often.

Heart
–  The muscles of the heart can be affected
–  Inflammation of muscle, arteries, or membrane (Pericarditis) can be seen.
–  Risk for Coronary Heart Disease and Myocardial Infarction or Heart Attack increases

Blood
–  Blood problems such as Anemia, increased risk of bleeding, and blood clotting can be seen
–  There could also be Vasculitis – or inflammation of blood vessels.

Infection
–  Increase risk for infections due to condition
–  The medications used can also increase risks

Bone Changes
–  Death of the bone can be seen due to inflammation process
–  This can also decrease the ability of the body to fix broken bones
–  Time for healing may increase
–  Bone collapse can be seen

Pregnancy Complications
–  There is an increased risk of Miscarriage
–  Complications of Pregnancy may be seen including – high blood pressure or Hypertension, Pre-Eclampsia, preterm birth, etc

Cancer
–  Certain cancers seem to have an increased risk with those with Lupus
–  This is rarely seen

Diagnosis

1.)  Blood testing
–  CBC
–  ESR (Erythrocyte sedimentation rate)
–  Kidney testing
–  Liver function testing
–  Urinalysis
–  Antinuclear antibody test (ANA)

2.)   X-ray

3.)   Echocardiogram

4.)  Biopsy
–  Kidney often is tested
–  Skin can also be tested

Antinuclear Antibody Test (ANA)

–  A blood test checking for Antibodies
–  Antibodies are produced by immune system
–  If immune system is overactive – ANA level may be increased
–  Most people with Lupus will have a positive ANA test
–  A positive ANA is not specific to Lupus and most people with a positive ANA do not have Lupus.
–  Therefore, other conditions can also cause a positive ANA test

Treatment

Medications

NSAIDS
–  IBU, Naproxen, Naroxen (Aleve), others
–  Goal to reduce inflammation, swelling, etc

Antimalarial Drugs
–  Hydroxychloroquine (Plaquenil)
–  Can help control Inflammation and decrease flare ups
–  Regular eye exams are important when taking Plaquenil

Immunosuppressants
–  Azathioprine (Imuran), Mycophenolate (Cellcept), Methotrexate are all options
–  Suppresses immune system and should be used for serious cases

Corticosterioids
–  Prednisone, Methylprednisolone (Medrol)
–  Can be used to control serious disease of kidney and brain
–  There are some side effects with long term use of steroids.

Biologics
–  Beliumab (Benlysta)
–  Given through an IV and can be given to reduce symptoms

Others
–  Rituximab (Rituxan)
–  Given for those resistant cases of Lupus

Management

–  Take sun precautions – sunscreen, avoidance, etc.
–  Exercise
–  Eat Healthy
–  Avoid Smoking
–  See your Doctor often
–  Consider Vitamin D, and Calcium

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