Systemic Lupus Erythematous is a chronic inflammatory disease that can damage any part of the body, including the skin, joints, and internal organs. Lupus is an autoimmune disease, which means that the body’s immune system attacks its own tissues and organs. It is common for the symptoms of lupus to come and go – oftentimes for no known reason.
Symptoms of Lupus
Individuals with lupus usually experience signs and symptoms that flare up and then improve or disappear. Symptoms may include:
- Butterfly-shaped rash on the face, covering the cheeks and the bridge of the nose
- Joint pain, stiffness, and swelling
- Skin lesions (typically worsened by sun exposure)
- Sores inside the mouth or nose
- Raynaud’s Phenomenon (fingers and toes that turn white or blue when under stress or exposed to cold)
- Fatigue and fever
- Headache, confusion, memory loss
- Chest pain
- Shortness of breath
- Dry eyes
Causes of Lupus
While the cause of lupus is unknown, it is believed that certain people may have a genetic predisposition toward the disease, which can be activated by environment. Sun exposure and certain medications are believed to be possible triggers. Certain drugs (isoniazid, hydralazine, and procainamide) are also believed to be possible causes of lupus.
Lupus Risk Factors
While lupus can affect anyone, the autoimmune disease is most common in young women, with peak occurrence between women ages 15 and 40. Generally, blacks are affected more than whites. Some evidence indicates that Hispanics, Native Americans, and Asians may also be at an increased risk. It is not uncommon for lupus to occur with other autoimmune conditions, such as hemolytic anemia and thyroiditis.
Testing for & Diagnosing Lupus
Diagnosing lupus can be difficult, as the illness goes through phases of remission and can manifest itself in many areas of the body. The American College of Rheumatology (ACR) uses a standard evaluation process to diagnose lupus. In order to be diagnosed, a patient must meet four of the following 11 criteria:
- Malar rash, a butterfly-shaped rash on the cheeks.
- Discoid rash, a red rash with raised round or oval patches.
- Skin rash caused by sun exposure.
- Mouth or nasal sores that last for several days to more than a month.
- Arthritis in two or more joints for several weeks or more.
- Inflammation around the lungs (pleurisy) or heart (pericarditis), which causes chest pain when breathing deeply.
- Poor kidney function.
- Seizures, strokes, or psychosis.
- Low blood cell counts: anemia, low white blood cells, or low platelets.
- Positive antinuclear antibody (ANA) test. (This sign is present in nearly all patients with lupus.)
- Presence of antibodies that reveal a problem with the immune system.
This standard in diagnosing lupus helps reduce instances of under-diagnosis (common because of the disease’s many possible signs and symptoms) and over-diagnosis (which has become problematic due to physicians diagnosing the disease based on a single blood test, which 5 percent of the healthy population tests positive for).
There is no known cure for systemic lupus erythematous. However, rheumatologists at Hedley Orthopaedic Institute may be able to help patients manage their symptoms, pain, and discomfort with one or more of these therapies:
- Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) can help with swelling, pain, and fever. However, long-term use of NSAIDs like ibuprofen and naproxen is not advised, as these drugs can cause stomach bleeding, ulcers, and kidney damage.
- Antimalarial Drugs, including hydroxychloroquine, are also used in treating lupus. These drugs can relieve common lupus symptoms, such as joint pain, fatigue, rash, and mouth sores.
- Corticosteroids and immunosuppressants offer slightly more aggressive treatment options. These drugs function by inhibiting immune cells that cause some lupus symptoms.
Biologics (commonly used for treating rheumatoid arthritis) are now being used to treat some instances of lupus. These drugs, which target specific parts of the immune system, can reduce inflammation and joint pain. Biologic agents may be administered intravenously or as injections beneath the skin.
Patients with systemic lupus erythematous can be active participants in their treatment. Many clinical trials, which need patients diagnosed with lupus, are ongoing. Furthermore, you can take part in your treatment by having regular screenings for osteoporosis, getting preventative heart care, staying up-to-date with your immunizations, and wearing proper protection when out beneath the Arizona sun.
Schedule Your Appointment With a Rheumatologist
If you’re suffering from joint pain, stiffness, swelling, or other symptoms of lupus you may wish to schedule an appointment with a rheumatologist in Mesa. At Hedley Orthopaedic Institute, your rheumatologist can provide state-of-the-art treatment and therapy, all under the same roof as some of Arizona’s best-known orthopaedic surgeons and sports med physicians. Lupus may be treated most effectively when diagnosed early on. Call to schedule your appointment.