Lupus

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Lupus

Lupus is derived from the Latin term for "wolf". In English, "lupus" can denote several references, such as:

• Diseases associated with the term include:
  • Lupus erythematosus, the autoimmune disease commonly referred to as systemic lupus erythematosus (SLE).
  • Lupus nephritis, which is inflammation triggered by SLE.
  • Lupus pernio, a manifestation of sarcoidosis.
  • Lupus vulgaris, linked with cutaneous tuberculosis.
• Other uses of the term are:
  • Lupus, an astronomical constellation.
  • Lupus, a comic series by Frederik Peeters.
  • Toshiba Brave Lupus, a semi-professional rugby team based in Japan.

Symptoms of SLE

Butterfly rash

LUPUS-UK-Logo

SLE

Overview of Systemic Lupus Erythematosus (Lupus)

Systemic lupus erythematosus (often abbreviated to lupus) is a complex disorder that can harm various body parts including the joints, skin, kidneys, heart, lungs, blood vessels, and the brain. It's not contagious, and its course varies among individuals. Those with lupus experience cycles of symptomatic periods (known as 'flares') and symptom-free periods ('remission').

What Happens in Lupus?

Lupus arises when the body's immune system, which ordinarily defends against infections, starts attacking its own tissues.

Who Is Affected?

While lupus affects both genders, it's more prevalent in women. It's especially common among African American women compared to Caucasian women and also frequently appears in Hispanic, Asian, and Native American women. Genetics play a role too, as lupus can be hereditary, although the likelihood is low.

Symptoms

Systemic lupus erythematosus presents an array of symptoms, varying in severity from one person to the next. These can include:

• Joint pain or swelling.
• Persistent fever without any apparent cause.
• Fatigue.
• Skin rashes, especially a "butterfly" rash on the face.
• Breathing pain.
• Hair loss.
• Photosensitivity.
• Oral ulcers.
• Color changes in fingers and toes due to cold or stress.
• Swelling in extremities or around the eyes.

Additional manifestations can encompass:

• Anemia.
• Kidney inflammation necessitating medication.
• Neurological symptoms like headaches, dizziness, and even seizures.
• Blood vessel inflammation.
• Abnormalities in blood cell counts.
• Increased clotting tendencies.
• Cardiac complications.

Causes

The exact etiology of SLE remains elusive but is believed to encompass genetic, environmental, hormonal, and possibly certain medicinal factors.

Diagnosis

Diagnosing SLE is challenging and can span months or even years. It entails:

• Comprehensive medical history review.
• A detailed physical examination.
• Laboratory testing, especially looking for specific antibodies.

Treatment

Modern treatments offer a multitude of options for managing lupus. Medications include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs): For pain, fever.
• Antimalarials: For fatigue, joint pain, skin issues.
• Corticosteroids: Potent anti-inflammatory agents.
• Immunosuppressives: For severe cases affecting kidneys or the central nervous system.
• B-lymphocyte stimulator (BlyS)-specific inhibitors: Targeting specific immune cells.

Alternative treatments can also help with symptom relief.

Living With Systemic Lupus Erythematosus (Lupus)

Dealing with a long-lasting disease like systemic lupus erythematosus (lupus) can be hard on the emotions. You might think that your friends, family, and coworkers do not understand how you feel. Sadness and anger are common reactions.

Besides working with your doctor to determine a treatment plan, there are a few things you can do to help you live with lupus:

• Learn to recognize the warning signs of a flare so that you and your doctor might reduce or prevent them. These warning signs include:
  • Increased tiredness.
  • Pain.
  • Rash.
  • Fever.
  • Stomach discomfort.
  • Headache.
  • Dizziness.
• Eat a proper diet, exercise, and learn relaxation techniques to help cope with stress. A healthy lifestyle, as well as quitting smoking, will also reduce your risk for heart disease associated with lupus. Talk to your doctor before starting an exercise program.
• Develop and maintain a good support system of family, friends, medical professionals, community organizations, and support groups.

Pregnancy and Contraception for Women With Lupus

Although pregnancy in women with lupus is considered high risk, most women with mild to moderate lupus can have healthy pregnancies. Regular care and good nutrition during pregnancy are essential. Talk to your doctor if you are pregnant or plan to become pregnant.

Research shows that birth control pills do not increase the risk for severe flares among women with lupus. As a result, doctors are increasingly prescribing oral contraceptives to women with inactive or stable disease.

Outlook (Prognosis)

The outcome for people with SLE has improved in recent years. Many people with SLE have mild symptoms. How well you do depends on how severe the disease is. Most people with SLE will require medicines for a long time. Nearly all will require hydroxychloroquine indefinitely.

Possible Complications

LUPUS NEPHRITIS

Some people with SLE have abnormal immune deposits in the kidney cells. This leads to a condition called lupus nephritis. People with this problem may develop kidney failure. They may need dialysis or a kidney transplant.

A kidney biopsy is done to detect the extent of damage to the kidney and to help guide treatment. If active nephritis is present, treatment with immunosuppressive medicines including high doses of corticosteroids along with either cyclophosphamide or mycophenolate are needed.

OTHER PARTS OF THE BODY

SLE can cause damage in many different parts of the body, including:

• Blood clots in arteries of veins of the legs, lungs, brain, or intestines
• Destruction of red blood cells or chronic anemia.
• Fluid around the heart (pericarditis), or inflammation of the heart (myocarditis or endocarditis)
• Fluid around the lungs and damage to lung tissue
• Pregnancy problems, including miscarriage
• Stroke
• Bowel damage with abdominal pain and obstruction
• Inflammation in the intestines
• Severely low blood platelet count (platelets are needed to stop any bleeding)
• Inflammation of the blood vessels

SLE and Pregnancy

Both SLE and some of the medicines used for SLE can harm an unborn child. Talk to your provider before you become pregnant. If you become pregnant, find a provider who is experienced with lupus and pregnancy.

Lupus nephritis

• Minimal mesangial glomerulonephritis Class I (Minimal mesangial glomerulonephritis Minimal mesangial glomerulonephritis)
• Mesangial proliferative lupus nephritis Class II (Mesangial proliferative lupus nephritis Mesangial proliferative lupus nephritis)
• Focal proliferative nephritis Class III (Focal proliferative nephritis Focal proliferative nephritis)
• Diffuse proliferative nephritis Class IV (Diffuse proliferative nephritis Diffuse proliferative nephritis)
• Membranous glomerulonephritis Class V (Membranous glomerulonephritis Membranous nephritis)
• Glomerulosclerosis Class VI (Glomerulosclerosis Glomerulosclerosis)

Rheumatologic diseases

Arthritis is often used to refer to any disorder that affects the joints. Rheumatic diseases usually affect joints, tendons, ligaments, bones, and muscles. Rheumatologic diseases usually affect joints, tendons, ligaments, bones, and muscles.

Connective Tissue Diseases

Rheumatology and	Connective Tissue Diseases
Ankylosing spondylitis	Arthritis
Arthritis and Rheumatic diseases	Autoimmune diseases
Autoinflammatory diseases	Behçet’s disease
Bursitis	Giant cell arteritis
Gout	Juvenile arthritis
Knee problems	Lupus
Osteoarthritis	Polymyalgia rheumatica
Psoriatic arthritis	Reactive arthritis
Rheumatoid arthritis	Scleroderma
Sjögren’s syndrome	Systemic lupus erythematosus (Lupus)
Tendinitis	Rheumatologic diseases

Lupus Resources
Latest articles Most recent articles Ongoing trials	Wikipedia

Lupus nephritis

• Minimal mesangial glomerulonephritis Class I (Minimal mesangial glomerulonephritis Minimal mesangial glomerulonephritis)
• Mesangial proliferative lupus nephritis Class II (Mesangial proliferative lupus nephritis Mesangial proliferative lupus nephritis)
• Focal proliferative nephritis Class III (Focal proliferative nephritis Focal proliferative nephritis)
• Diffuse proliferative nephritis Class IV (Diffuse proliferative nephritis Diffuse proliferative nephritis)
• Membranous glomerulonephritis Class V (Membranous glomerulonephritis Membranous nephritis)
• Glomerulosclerosis Class VI (Glomerulosclerosis Glomerulosclerosis)