Everything You Need to Know About Lupus

Lupus is a chronic autoimmune disease that can cause inflammation throughout the body. However, it is often a localised disease, so it is not always systemic. An autoimmune disease is one in which your own immune system is responsible for inflaming and breaking down your own cells. Many people with lupus have a mild form of lupus, but without appropriate medical care it can become very serious. There is currently no known cure, so the focus of care is on easing symptoms and reducing inflammation.

What Is Lupus?

Lupus is a health condition classed as an autoimmune disease, in which the body's immune system attacks its own tissues. The immune system normally fights foreign substances, but in people with lupus it mistakenly attacks its own cells and tissues.

What Are the Types of Lupus?

Healthcare professionals generally describe four types:

Systemic lupus erythematosus (SLE)

Systemic lupus erythematosus is the most common type of lupus.

Cutaneous (Skin) Lupus

This type is usually limited to your skin. It can cause rashes and scarring, long-lasting lesions. It can also cause skin discolouration, scarring and hair loss.

Neonatal Lupus

This condition is extremely rare and affects babies whose mothers have certain autoimmune antibodies. These autoimmune antibodies are passed from the mother to the foetus through the placenta.

Drug-Induced Lupus

Some prescription medicines can lead to drug-induced lupus (DIL). Several types of medicine have been linked with it, including certain antimicrobials, anticonvulsants, heart-rhythm medicines, blood pressure medicines and some biologic medicines. Never stop or change a prescribed medicine without talking to your doctor.

What Causes Lupus?

Healthcare professionals do not know exactly what causes lupus, but they think it may be a combination of several underlying factors. These factors include:

• Environment: smoking, stress and exposure to toxins such as silica dust.
• Genetics: more than 50 genes have been identified in association with lupus. Having a family history of lupus may also put you at higher risk of developing it.
• Hormones: some research suggests that raised levels of the hormone oestrogen may contribute to lupus.
• Medicines: long-term use of certain medicines has been linked with a form of lupus known as drug-induced lupus erythematosus (DIL).

What Are the Risk Factors for Lupus?

Some groups have a higher risk of developing lupus. The risk factors include:

• Sex: women are more likely than men to develop lupus, but the disease can appear more severe in men.
• Age: it can occur at any age, but it is most often diagnosed in people between 15 and 44.
• Race or ethnic background
• Family history: having a family history of lupus means your risk of developing the condition is higher.

What Are the Symptoms of Lupus?

The symptoms of lupus depend on which parts of your body are affected. The inflammation seen in lupus can affect various organs (the heart, kidneys, lungs and brain) and tissues (blood, joints and skin) in your body.

Symptoms look different in everyone. They can be persistent, or they can come and go suddenly, with occasional flares.

No two cases of lupus are the same, but the most common symptoms and signs include:

• High temperature (fever)
• Tiredness
• Body aches
• Joint pain
• Rashes, including a butterfly-shaped rash on the face
• Skin lesions
• Shortness of breath
• Chronic dry eyes
• Sjogren's syndrome, which causes a dry mouth
• Pericarditis and pleurisy, which can cause chest pain
• Headaches
• Confusion
• Memory loss

Early Signs

The symptoms of lupus typically begin in early adulthood, in the 30s. Some of the early signs are tiredness, fever, a rash, swollen joints, a dry mouth or dry eyes, hair loss, and problems with the lungs, kidneys, thyroid or gastrointestinal system.

Lupus Care

There is currently no cure for lupus, but there are medicines that doctors can use to manage symptoms. Your treatment plan is set by your doctor and may change depending on how your symptoms are. As well as medical care, your healthcare professional may suggest lifestyle changes that help you manage your symptoms. These include:

• Avoiding too much exposure to ultraviolet (UV) light.
• Eating a healthy diet.
• Asking your doctor whether any supplements, such as vitamin D, calcium or fish oil, are suitable for you. Only take supplements on your doctor's advice.
• Exercising regularly.
• Stopping smoking, if you smoke.

Medical Treatment

Your doctor may use medicines from groups such as the following to manage lupus:

• Non-steroidal anti-inflammatory medicines (NSAIDs): these can reduce swelling and pain.
• Antimalarial medicines: these can ease lupus symptoms such as rash, joint pain and tiredness, and may also help to reduce lupus flares.
• Corticosteroids: these help calm your immune system and can reduce pain and swelling.
• Immunosuppressive medicines: these work to suppress your immune system. Because they are very strong and can lower your body's defences against infection, they are used only when the disease is severe or affects many organs.
• Biologics: biologics are medicines of biological origin that are used in the care of lupus in some people.

Which medicines are right for you, and at what dose, is a decision for your doctor.

This article is for general information only; please consult your doctor and dietitian about your own situation.