Is Lupus Still A Threat?

An older woman walking in a park(BlackDoctor.org) — Lupus erythmatosus is a chronic autoimmune disorder of the connective tissue of the body, in which inflammation occurs in various systems and organs including the skin, blood cells, joints, heart, lungs and kidneys.

In autoimmune diseases, the immune system loses its ability to recognize the body’s own tissues and cells as belonging to the body. Thus, the immune system, which normally protects the body from outside invaders like bacteria or viruses, begins to attack the body’s own tissues and organs as if they were foreign substances in need of destruction.

Although there are several forms of lupus, the most common form is known as Systemic Lupus Erythmatosus (SLE). SLE effects women nine times more often than men, and usually strikes between the ages of 15 and 50, and is more common in women of non-European heritage.

There is no known cure for lupus, although immune-suppressants and other drugs can be used to control its symptoms and decrease the frequency and severity of “flares”, wherein symptoms are periodically exacerbated. Individuals living with lupus can also periodically have symptom-free periods of remission.

Lupus may be caused by inherited genetic traits, but may also be caused by environmental factors. The use of certain medications can also cause drug-induced lupus.

Symptoms and Complications of Lupus

The symptoms of lupus vary depending on which system or organ of the body is being affected. Unfortunately, lupus is often misdiagnosed since it can imitate other illnesses and disease processes, so those people who have lupus may spend years seeking an accurate diagnosis.

Some common complaints are chronic fatigue, joint pain, myalgias (muscle pain), and fever. Some patients also experience changes in their cognitive abilities over time.

Dermatological: The skin is the largest organ of elimination in the human body, and more than 30% of individuals living with lupus experience dermatological symptoms which manifest as red, scaly patches on various parts of the body, as well as alopecia (hair loss), and ulcers of the mouth, vagina and nose. Many individuals with lupus will demonstrate the classic “malar rash”, which is a butterfly-shaped rash over the bridge of the nose and cheeks, a symptom which can be seen in other diseases but which occurs in more than 40% of lupus sufferers.

Cardiovascular system: Lupus can commonly affect the heart, blood cells and blood vessels. In terms of the heart, lupus can cause pericarditis (inflammation of the sac around the heart), leading to symptoms of shortness of breath and chest pain. Lupus can also cause inflammation of the heart muscle itself (myocarditis), endocarditis (inflammation of the inner walls of the heart), as well as coronary artery disease. Symptoms can range from mild shortness of breath to heart lesions and complications from congestive heart failure and chest pain.

In terms of blood vessels and blood cells, lupus can cause the development of anemia, white blood cell disorders, and increased clotting (thrombosis) which could lead to a clot breaking loose (embolism) and traveling to the brain and causing a stroke. Anemia, of course, can cause symptoms of fatigue and loss of energy, and white blood cell disorders can lead to higher risk of infection.

Vasculitis (inflammation of blood vessels) in patients with lupus can lead to broken blood vessels, seizures, strokes, and other symptoms depending on which organ or tissue is affected.

Lungs: Lupus can impact the lungs by causing pleuritis (inflammation of the lining of the lung), pneuminitis (inflammation of the lung tissue itself), and other complications that can lead to shortness of breath, dry cough, decreased lung capacity, and pulmonary emboli (clots).

Eyes: Lupus can cause a variety of conditions of the eye, including dry eyes, lesions of the eyelids, scleritis (inflammation of the eye lining), lesions of the retina, and nerve damage.
Muscular system: In people living with lupus, musculoskeletal complications and symptoms can include myalgias (muscle pain), lupus arthritis, tendonitis, bursitis, carpal tunnel syndrome, osteoporosis, and bone necrosis (breakdown).

Kidneys: Lupus nephritis is caused by inflammation of the renal (kidney) tissue, and can lead to water retention, weight gain, end stage renal disease, kidney failure and other symptoms and complications.

Other complications of lupus can involve antibody disorders, chronic headaches, mood disorders, anxiety, seizures, elevated intracranial pressure, and a plethora of other conditions and symptoms that can range from mildly troublesome to life-threatening in nature.

Treatment

Although there is no known cure for lupus, the disease can be treated in order to decrease the frequency and severity of symptoms and lupus “flares”.  Immunosuppressive drugs can slow down the autoimmune response underlying the condition, and corticosteroids can be prescribed to decrease inflammation. Pain relief is very important in the management of lupus, and over-the-counter analgesics and prescription pain-killers like anti-inflammatories and narcotics are also frequently employed.

Sunlight has been shown to cause exacerbations of lupus, so the avoidance of the sun is an important lifestyle change that those with lupus must undertake. Exposure to mercury, pesticides and silica can also cause symptoms, so avoidance of such exposures is also crucial.

In advanced renal disease from complications of lupus, kidney transplantation is a potentially life-saving intervention that can prolong life and improve quality of life.

While mainstream medicine offers many medications and treatments to combat symptoms and complications, the use of acupuncture, herbal medicine and other alternative treatments can also be employed to decrease symptoms and improve overall quality of life.

Prognosis

Lupus cannot be prevented, but quality of life can indeed be improved with medications and lifestyle changes once a positive diagnosis is made. Although mortality from lupus was quite high during the first half of the 20th century, it appears that greater than 90% of those diagnosed with the disease can live more than ten years, often with long periods of symptom-free remission. While the disease is more common in women than men, the general prognosis is worse for men and children.

Conclusion

Lupus is indeed a complicated and difficult disease without a cure, but with good medical management, proper use of medications and positive lifestyle changes, individuals living with lupus can have long periods of symptom-free remission.
For more information, please visit The Lupus Foundation of America’s website at http://www.lupus.org.

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