Sytemic Lupus Erythematosus

What is Lupus?
Lupus refers to several forms of an immunologic disease that affects the joints, skin, muscles, kidneys, and other parts of the body.  The term lupus usually refers to the form known as systemic lupus erythematosus or SLE.  It is a chronic and inflammatory disease that can potentially be fatal.  Lupus can either be classified as an autoimmune or a rheumatic disease.  Changes in symptoms are called flares and remissions.  Flares are periods when lupus becomes more active with increased symptoms, and remissions are periods when few or no symptoms of lupus are present.



What Causes Lupus?
The specific cause of lupus is unknown.  It is considered to be a multifactorial condition with both genetic and environmental factors involved.  In a multifactorial condition, a combination of genes from both parents, in addition to unknown environmental factors, produce the trait, condition, or disease.  It is known that a group of genes on chromosome 6 that code for the human leukocyte antigens play a major role in a person's susceptibility or resistance to the disease.  The specific HLA antigens associated with lupus are DR2 and DR3.  When the immune system does not function properly, it loses its ability to distinguish between its own body cells and foreign cells.  Antinuclear antibodies are autoantibodies (antibodies that fight the body's own cells) that are produced in people with lupus.





Who Gets Lupus?
Studies suggest that some people may inherit the tendency to get lupus, and new research suggests that new cases of lupus appear to be more common in families in which one member already has the disease.  However, there is no evidence that supports that lupus is directly passed from parent to child.  Females in their childbearing years (18-45) are eight to ten times more likely to acquire lupus than men, and children and the elderly can also acquire the disease.  African Americans, Asians, and Latinos are more likely to get lupus than Caucasians. 




What are the Symptoms?
Lupus is unpredictable, and no two people have exactly the same symptoms of the disease.  There are 11 symptoms that help doctors tell the difference between people who have lupus and people who have other connective tissue diseases.  If a person has 4 or more of the 11 symptoms, it is likely that the person has lupus.

Other symptoms of lupus include fatigue, fever, nausea, vomiting, diarrhea, swollen glands, lack of appetite, sensitivity to cold (Raynaud's phenomenon), weight loss, and hair loss.




How is Lupus Diagnosed?
Lupus is difficult to diagnose because there is no single set of symptoms to determine if a person has the disease.  There is no single test that can diagnose lupus.  Some tests used to diagnose lupus include urinalysis to detect kidney problems, a compliment test to measure the amount of complementary proteins in the blood, and an ANA test to detect antinuclear antibodies in the blood.  Additionally, X-rays may be ordered to check for lung and heart problems.



How is it Treated?
There is no cure for lupus.  Treatment options include:

1. 1. Non-steroidal anti-inflammatory drugs (NSAIDs)- control
   
2. joint pain and thin the blood
   
3. 2. Hydroxychloroquine
4. 3. Quinacrine
5. 4. Corticosteriods- control inflammation
6. 5. Immunosuppressants
7. 6. Balancing rest with exercise
8. 7. Avoiding sunlight- prevents development of a rash
9. 8. Stress reduction

It should be noted that children with lupus should not receive immunizations with live viruses including chickenpox, MMR (measles, mumps, rubella), and oral polio vaccines.  Additionally, a subset of patients with lupus experience antiphospholipid syndrome which is associated with blood clots.  Therefore, it is important for these lupus patients to take a blood thinner daily.


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