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What is lupus?

Lupus is a chronic disease characterized by inflammation in one or more parts of the body.

In lupus, the immune system which is designed to protect the body against infection creates antibodies that attack the body’s own tissues and organs. Therefore, it is called an auto-immune disease. It can affect any tissue and organ “head to toe” in the body.

Types of lupus

Although lupus is used as a general term, there are four main types of lupus. These are:

Systemic lupus erythematosus (SLE)

This form of lupus is probably what most people mean when they refer to lupus. SLE can cause inflammation and damage in multiple organs and body systems, including the kidneys, brain and central nervous system, blood and blood vessels, skin, lungs, heart and joints. This type is the most frequent form of lupus.

Discoid lupus (DLE)

It affects the skin and can leave residual scarring. It is also referred to as cutaneous lupus.

Drug induced lupus (DILE)

This can be triggered by certain prescription medications such as beta blockers, which are commonly used to treat heart disease and hypertension.

Neonatal lupus (NLE)

This is a rare type of lupus that can affect newborn babies, whose mothers carry a specific type of lupus related antibody. It is caused by the antibodies from the mother acting upon the baby in the womb.

At birth the baby may have a skin rash, liver problems, or a low blood cell count. However, these symptoms usually disappear after several months with no lasting effects. In some very rare cases, neonatal lupus can cause a serious heart problem.

Symptoms of lupus

The symptoms of lupus differ from one person to another. Some people have just a few symptoms, while others have many.

In addition, there are many different symptoms of lupus because the disease can affect any part of the body.

Some of the more common symptoms include:

  • Fatigue
  • Fever
  • Joint pain, stiffness and swelling
  • Butterfly-shaped rash on the face that covers the cheeks and bridge of the nose or rashes elsewhere on the body
  • Skin lesions that appear or worsen with sun exposure (photosensitivity)
  • Fingers and toes that turn white or blue when exposed to cold or during stressful periods (Raynaud's phenomenon)
  • Shortness of breath
  • Chest pain
  • Dry eyes
  • Headaches, confusion and memory loss

This is far from a complete list of symptoms, and the diagnosis of lupus must be made by a doctor.

What causes lupus?

Lupus occurs when your immune system attacks healthy tissue in your body (autoimmune disease). It's likely that lupus results from a combination of your genetics and your environment.

It appears that people with an inherited predisposition for lupus may develop the disease when they come into contact with something in the environment that can trigger lupus. The cause of lupus in most cases, however, is unknown.

Some potential triggers include:

  • Sunlight. Exposure to the sun may bring on lupus skin lesions or trigger an internal response in susceptible people.
  • Infections. Having an infection can initiate lupus or cause a relapse in some people.
  • Medications. Lupus can be triggered by certain types of medications and antibiotics. People who have druginduced lupus usually get better when they stop taking the medication. Rarely, symptoms may persist even after the drug is stopped.

Can my lupus be controlled?

Often, a person’s flares follow a clear pattern, with the same combination of symptoms every time.

An informed patient can watch for warning signs and alert the doctor early on. While false alarms happen, catching a flare in its early stages can make treatment easier and more effective. With this as a basis, a good working relationship with the doctor is crucial for the success of treatment .

It is necessary to check laboratory values (incl. complete blood count, inflammation parameters, kidney function, urine) regularly.

What are the treatment options?

While there is no cure yet, with treatment most people with lupus can look forward to a normal life expectancy. The treatment plan will depend in part on the type and severity of symptoms.

There are many medications that can control symptoms, from a mild antiinflammatory to some very potent steroids or other drugs that suppress the immune-system. Generally, a doctor will prescribe the least powerful one, over the shortest time, that can do the job.

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