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Lupus Erythematosus Learning Center

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Lupus Erythematosus

What is lupus?

Lupus is a chronic autoimmune disease that causes inflammation throughout your body. An autoimmune disease is a condition in which your body’s own immune system is responsible for the inflammation and breakdown of its own cells. The inflammation seen in lupus can affect various organs and tissues in your body, including your:

  • joints
  • skin
  • heart
  • blood
  • lung
  • brain
  • kidneys

This disease can be severe and potentially life-threatening. It can cause permanent organ damage. However, many people with lupus experience a mild version of it. Currently, there’s no known cure for lupus.

What are the symptoms of lupus?

The symptoms of lupus vary according to the parts of your body affected. Symptoms can disappear suddenly. They can be permanent or flare up occasionally. Although no two cases of lupus are the same, the most common symptoms and signs include:

  • a fever
  • fatigue
  • body aches
  • joint pain
  • rashes, including a butterfly rash on the face
  • skin lesions
  • shortness of breath
  • chronic dry eyes
  • chest pain
  • headaches
  • confusion
  • memory loss

What are the possible causes of lupus?

Doctors and researchers aren’t sure what the exact causes of lupus are. However, most believe that lupus may be caused by the following factors:

Genetics

Although there’s no concrete evidence, most researchers believe heredity plays a role. Having a family history of lupus doesn’t mean you will develop it. However, you may have a slightly higher risk of developing it.

Environment

Environmental triggers for the disease may include:

  • smoking
  • stress
  • toxins
  • silica dust

However, more research needs to be done to draw any definite conclusions.

Exposure to sunlight or ultraviolet (UV) light is the only environmental influence that has been associated with skin inflammation and malar butterfly rash in lupus. UV light exposure has also been associated with inflammation in internal organs in people prone to developing lupus.

Hormones

Some studies suggest that hormones could be responsible. Many doctors and researchers consider abnormal estrogen levels to be a risk factor.

Infections

Some people infected with certain viruses, such as cytomegalovirus, may develop lupus. The association between hepatitis C and lupus is still under investigation. Direct causal links between these illnesses and lupus have never been established. The Epstein-Barr virus has been linked to the development of childhood lupus, but studies haven’t been conclusive.

Medications

In some rare cases, the long-term use of certain medications can trigger lupus. Drug-induced lupus erythematosus (DILE) is a subset of the disease. Several dozen drugs are linked to DILE.

Some of the more common medications linked to DILE include medications used to treat high blood pressure, such as hydralazine, and drugs used to treat irregular heartbeats, including procainamide and quinidine.

DILE is a rare consequence of taking these medications on a long-term basis.

Multiple Factors

Many doctors and researchers believe that a combination of factors causes lupus. For example, someone with a family history of the disease who’s exposed to certain environmental factors may develop it.

What are the types of lupus?

Four types of lupus are commonly diagnosed:

Systemic lupus erythematosus (SLE)

This is the most common type of lupus. When most people refer to lupus, this is the form they mean. SLE can be mild or extremely severe.

Cutaneous lupus

This type of lupus is generally limited to your skin. It may cause rashes and permanent lesions with scarring. The cutaneous form of skin lupus that causes scarring is called discoid lupus.

DILE

DILE is caused by the long-term use of certain prescribed medications. It mimics the symptoms of systemic lupus, but in most cases, major organs aren’t affected.

Neonatal lupus

Neonatal lupus is extremely rare and affects infants born to mothers who have lupus. If your child is born with neonatal lupus, they may have a skin rash, liver problems, and a low blood cell count. These symptoms usually disappear after a few months, with no lasting issues. Rarely, infants with neonatal lupus may have serious heart defects. Lupus can be diagnosed before birth, allowing for proper treatment and optimum health for these babies.

Who is at risk for lupus?

The following groups are at increased risk for being diagnosed with lupus:

  • Lupus primarily affects women.
  • Lupus can affect people of all ages, but it’s routinely diagnosed in people between the ages of 12 to 40.
  • African-Americans, Hispanics, and Asians are diagnosed with lupus more often than other groups.
  • People who use certain medications can be at increased risk of developing DILE. Approximately 38 drugs have been linked to DILE, including procainamide (Pronestyl), hydralazine (Apresoline), and quinidine (Quinaglute).

How is lupus diagnosed?

It can be difficult to diagnose lupus because the signs and symptoms vary. Your doctor will get a detailed medical history and assess your general health to rule out other conditions.

No single test can definitively reveal the condition. A combination of symptoms and tests will help your doctor learn if you’re affected. Some of the tests performed include:

Laboratory tests

Several laboratory tests may be performed. Certain test results can help your doctor determine if you have lupus:

  • Anemia or a low white blood cell count can be signs of lupus. CBC tests determine the number of white blood cells, red blood cells, and platelets in your blood.
  • The erythrocyte sedimentation rate of your blood can be an indicator of several illnesses, such as lupus, cancer, or an infection.
  • The increased protein levels or red blood cells in your urine may indicate lupus.
  • The antinuclear antibody test is a screening test, and a positive result only indicates activity of your immune system that’s linked to other immune diseases and infections too. If you get a positive result, you’ll need more testing to confirm a lupus diagnosis.

Imaging tests

Chest X-rays and echocardiograms are often used to check for abnormal swelling or fluid. These things can indicate damage caused by lupus.

Biopsy

If you have a rash that may be caused by lupus, a skin biopsy can be taken. A special microscopic analysis will be performed to confirm skin lupus.

Your kidney is another critical organ that can be affected by lupus. A kidney biopsy may be needed to look for damage from lupus. This test doesn’t require major surgery. Typically, a local anesthetic is used. Then, your doctor will insert a needle through your skin to your kidneys to take a sample of your kidney tissue for microscopic examination. This procedure can be done under ultrasound guidance.

How is lupus treated?

Treating lupus is generally restricted to treating the symptoms. As your symptoms subside or change, your treatment plan may need regular adjustments.

Medications

The following medications can treat the symptoms of lupus:

  • nonsteroidal anti-inflammatory drugs (NSAIDs)
  • antimalarial medications
  • corticosteroids
  • immunosuppressive drugs

Lifestyle changes

The following lifestyle changes may provide benefits:

  • getting adequate rest
  • exercising regularly
  • wearing sunscreen
  • avoiding prolonged exposure to UV sunlight
  • avoiding smoking
  • eating a balanced diet

Other therapies

Some people have reported relief from using certain alternative therapies along with traditional treatments. Supplements are commonly used, although you should talk with your doctor about any alternative therapies you want to try.

Commonly used supplements include:

  • flax seed
  • fish oil
  • dehydroepiandrosterone
  • vitamin D

Can lupus be prevented?

Since the exact cause of lupus isn’t known, it’s not yet possible to prevent it. More research and studies are needed to learn the cause of the disease. This could lead to effective prevention strategies. Until then, your doctor will probably focus on fighting inflammation, controlling your symptoms, and alleviating any pain associated with lupus.

Content licensed from:

Written by: Bree Normandin and Matthew Solan
Published on Aug 07, 2012
Medically reviewed on Mar 28, 2016 by [Ljava.lang.Object;@290b3530

This feature is for informational purposes only and should not be used to replace the care and information received from your health care provider. Please consult a health care professional with any health concerns you may have.
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