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Lupus Erythematosus Learning Center

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Lupus Erythematosus

What is Lupus?

Lupus is an autoimmune disease that causes inflammation throughout the body. An autoimmune disease is a condition where the 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 of the body including the joints, skin, heart, blood, lungs, brain, and kidneys. While this disease can be severe and life threatening with permanent organ damage, many patients experience a mild version of the disease. Currently, there is no known cure for lupus.

What Causes Lupus?

Physicians 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. You just may have a slightly higher risk of lupus.

Environment

Some studies are being done to determine if there are environmental causes for lupus. Environmental triggers for the disease may include smoking, stress, toxins, and silica dust. However, more research needs to be done to draw any definite conclusions.

Exposure to sunlight or ultraviolet light is the single environmental influence that has proven to be associated with the skin inflammation (malar butterfly rash) of lupus. Inflammation in internal organs have also been associated with ultraviolet exposure in individuals prone to develop lupus.

Hormones

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

Infections

Some individuals infected with 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 still aren’t conclusive.

Medications

In some rare cases, long-term use of certain medications can trigger lupus. Drug-induced lupus erythematosus (DILE) is a subset of the disease. There are several dozen drugs linked to drug-induced lupus but some of the more common medications are those used to treat high blood pressure such as hydralazine, anti-seizure drugs such as carbamazepin, and the aniti-infectious drug isoniazide used to treat tuberculosis. after long-term use.. Again, DILE is a rare consequence from taking these medications.

Multiple Factors

For many doctors and researchers, a combination theory of the factors that cause lupus makes the most sense. An individual with a family history of the disease who is exposed to certain environmental factors or drugs may contract lupus.

What are the Types of Lupus?

There are four types of lupus commonly diagnosed.

Systemic Lupus

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

Cutaneous Lupus

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

Drug-Induced Lupus

Drug-induced lupus erythematosus (DILE) is caused by 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. When an affected infant is born, a skin rash, liver problems, and low blood cell count may be present. These symptoms eventually disappear after a few months, with no lasting issues. Rarely, infants with neonatal lupus may have serious heart defects. Lupus can be diagnosed prior to birth, allowing for proper treatment and optimum health for these babies.

Who is at Risk for Lupus?

Factors that can increase the risk of lupus include:

  • Sex: lupus primarily affects women.
  • Age: lupus can affect people of all ages, but it’s routinely diagnosed in people between the ages of 15 to 40.
  • Ethnicity: African Americans, Hispanics, and Asians are diagnosed with lupus more often than other groups.
  • Drugs: using certain medications can result in developing a lupus-like ailment. Approximately 38 drugs have been linked to drug-induced lupus. Three drugs in particular are procainamide (Pronestyl), hydralazine (Apresoline), and quinidine (Quinaglute).

What are the Symptoms of Lupus?

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

  • fever
  • fatigue
  • joint pain
  • rashes
  • skin lesions
  • shortness of breath
  • chronic dry eyes
  • chest pain
  • headaches
  • confusion
  • memory loss

How is Lupus Diagnosed?

It can be difficult to diagnose lupus, as signs and symptoms vary. No single test can definitively reveal the condition. A combination of symptoms and tests will help determine if you are affected. Some of the tests performed include:

Detailed Medical History

Physicians will get a detailed medical history and assess a patient’s general health to rule out other conditions.

Laboratory Tests

Several laboratory tests may be performed, including:

  • Complete blood count (CBC): 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 present in the blood.
  • Erythrocyte sedimentation rate: The sedimentation rate of your blood isn’t indicative of any one disease, but can be an indicator of several illnesses such as lupus, cancer, or infection.
  • Urinalysis: Increased protein levels or red blood cells in the urine may indicate lupus.
  • Antinuclear antibody test (ANA): This is a screening test and a positive result only indicates activity of the immune system and is not specific for lupus.. A positive ANA can be seen in other immune diseases and infections. If a positive test is confirmed, additional testing will be necessary to confirm a lupus diagnosis.

Imaging Tests

Chest X-rays and echocardiograms are often used to check for abnormal swelling or fluid. The presence of either could indicate damage caused by lupus.

Biopsy

A skin biopsy of a rash can be taken and special microscopic analysis performed to confirm skin lupus. The kidney is a critical organ and is affected in about 60% of patients with lupus. Based on certain clinical tests and criteria, a kidney biopsy may be indicated to look for damage from lupus. This test does not require major surgery and typically a local anesthetic is given, a needle is inserted through the skin to the kidney and a sample of kidney tissue is obtained. This procedure can be done under ultrasound guidance. Microscopic examination of this sample will be helpful in determining whether the kidney is involved in this disease.

How is Lupus Treated?

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

Medications

Non-steroidal anti-inflammatory drugs (NSAIDs), antimalarial medications, corticosteroids, and immune suppressive drugs have all proven effective in treating symptoms of lupus.

Lifestyle and Home Remedies

Getting adequate rest, exercising regularly, wearing sunscreen and avoiding prolonged exposure to ultraviolet sunlight, not smoking, and eating a balanced diet have provided benefits for some people affected by lupus.

Other Therapies

Some patients have reported relief using certain alternative therapies along with traditional treatments. Supplements, such as flax seed, fish oil, dehydroepiandrosterone (DHEA), and vitamin D are commonly used. Talk with your doctor about any alternative therapies you wish to try.

Can Lupus be Prevented?

As the exact cause of lupus is not known, it is not yet possible to prevent it. Additional research and studies are needed to determine the cause, which could lead to effective prevention strategy. Until then, most physicians focus on fighting the inflammation, controlling 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 by Brenda B. Spriggs, MD, MPH, FACP

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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