Lupus (systemic lupus erythematosus) is a chronic disease that causes inflammation. It can affect the skin, joints, kidneys, lungs, nervous system and other organs. Patients experience fatigue, rashes, painful/swollen joints and fever. Lupus can be difficult to diagnose and can range from mild to serious. It affects significantly more women than men, often starting in the teens and twenties. Although lupus cannot be cured, medications can relieve symptoms and prevent damage to organs.
Lupus is a complicated disease with many symptoms also associated with other conditions. Examples are fever, fatigue, weight loss, blood clots, spotty hair loss, heartburn, stomach pain and poor circulation in the toes and fingers.
A doctor’s finding of at least four of the following conditions, with no other reason for them, may lead to a diagnosis of lupus:
- Rashes (butterfly-shaped over the cheeks, red rash with raised patches, rash on sun-exposed skin)
- Mouth sores lasting from a few days to more than a month
- Joint tenderness and swelling
- Swelling of the tissue lining the lungs or heart, which can cause chest pain during deep breaths
- Blood or protein in the urine
- Seizures, strokes or other neurologic problems
- Abnormal blood tests including anemia and positive ANA (antibody)
The most common risk factors include:
- Being a woman
- Being African-American, Hispanic, Asian or Native-American
- Being between the ages of 15 and 40, the most common age of diagnosis
While there is no way to prevent lupus, people who do not smoke appear less likely to develop it:
- Stop smoking if you smoke cigarettes, cigars or a pipe.
- Avoid secondhand smoke, pollution, dust and other airborne contaminants.
Diagnosing lupus is challenging because symptoms of the disease vary considerably from case to case. And some signs of the disease mimic symptoms of other disorders. There is no single test for lupus. Your WellStar physician will review the results of a physical examination and of blood and urine tests to arrive at a diagnosis.
Tools and Tests
Diagnostic blood and urine tests include:
- Complete blood count to measure the number of red blood cells, white blood cells and platelets
- Erythrocyte sedimentation rate. This blood test assesses the rate at which red blood cells settle. An above-average rate suggests a systemic condition such as lupus
- Blood tests to determine the health of the kidneys and liver as lupus can impact these organs
- Urinalysis to look for an increase in protein level or red blood cells that can be signs of lupus
- Antinuclear antibody (ANA) test to look for the presence of antibodies suggesting a stimulated immune system.
- Echocardiogram and chest X-ray if your doctor believes lupus may have affected other heart and lungs.
- Kidney biopsy to determine if lupus has harmed the kidneys
WellStar offers a variety of treatment options depending on signs and symptoms. The combination of medications can change as indicators flare and subside. These include:
- Conservative treatment for muscle or joint pain, fatigue and rashes with over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like Motrin, Advil and Aleve
- Antimalarial drugs to help relieve the fatigue, rashes, joint pain and mouth sores associated with lupus
- More aggressive treatment for patients with serious problems involving the kidneys, lungs, heart or central nervous system. Options are high-dose corticosteroids such as prednisone, and various drugs that suppress the immune system
- A biologic drug known as belimumab (Benlysta) approved for treatment of lupus in 2011
- Biologics approved for treatment of other rheumatic diseases
All treatments have risks and benefits. Your rheumatologist will asses these during regular visits and will discuss them with you. A particular drug may be stopped during a period of remission due to possible side effects.
Discuss alternative treatments with your doctor rather than starting them on your own. It’s important to understand the risks and benefits of supplements and dietary changes.
Lupus can cause health problems later in life, such as clogging of the arteries (atherosclerosis), especially in younger women. That means a higher risk of heart attack, heart failure and stroke. That’s why it’s important for people with lupus to reduce risk factors for heart disease like smoking, high blood pressure and high cholesterol.
A healthy lifestyle can help lower heart and lung risks, prevent flares and improve the outcome when one occurs. Taking the following steps can make a difference:
- Get enough rest including naps during the day as needed.
- Avoid sun exposure because ultraviolet rays can trigger a flare. Wear protective clothing and use sunscreen with an SPF of at least 55 whenever you go out.
- Exercise regularly to recover from a flare, reduce the risk of heart attack, help battle depression and improve overall wellbeing.
- Don’t smoke, as smoking increases your risk of cardiovascular disease and can worsen the effects of lupus on the heart and blood vessels.
- Eat a healthy diet that includes plenty of fruits, vegetables and whole grains.
WellStar offers smoking cessation programs that educate people about smoking risks, encourage behavior modification to help minimize smoking urges and offer numerous coping strategies. Several different methods for changing smoking behavior are explored so that individuals learn approaches that work best for them.