Lupus Erythematous - Causes, Symptoms, Prevention and Treatment
Health Education

Understanding Lupus Erythematous

Dr.Shrikant Wagh profile Authored by Dr.Shrikant Wagh on 23 May 2014 - 11:45.

The disease 'Lupus' refers to inflammation of various organs, including bone joints, kidney, skin, heart, lungs and brain; which is caused due to an attack of immune cells on one's own body cells (autoimmune).

Types of Lupus:

Lupus is broadly categorized as follows:

  • Systemic Lupus (involves various connective tissues)
  • Discoid Lupus (involves skin and scalp)
  • Drug-induced Lupus(caused due to excessive use of certain drugs)
  • Neonatal Lupus (system lupus in infants)

The root cause of lupus is an attack of immune cells on one’s own healthy cells. Lupus may run in families or can be triggered by some environmental factors or sometimes due to both these reasons. It has been observed that people get the symptoms on exposure to any known triggers like:

  • Direct exposure to sun for long period: Sunlight sensitizes immune response in people with low immunity and may cause skin lesions.
  • Excess use of certain medications: This mainly includes drugs prescribed for the treatment of seizure, hypertension, some antibiotics and silica/ mercury.

The symptoms of lupus may vary from person to person. Symptoms may be displayed on and off and may be mild to severe. Appearance of typically mild symptom/s is called “flare”, which may completely go away for a while.  In some patients, symptoms may go away, however, in the rest of the patients symptoms may persist permanently.

The most prominent symptoms of lupus are:

  • Raised body temperature (fever)
  • Fatigue
  • Weight loss
  • Hair loss
  • Pain in joints
  • Stiffness
  • Swelling in the joints
  • Rash on face covering cheeks and half of nose (like butterfly shape).
  • Lesions on the skin that often becomes severe upon exposure to sun.
  • Discoloration of toes and fingers (white or blue) on exposure to cold conditions.

Some serious implications:

  • Difficulty in breathing
  • Pain in the chest
  • Eye problems like dry eyes
  • Severe headache
  • Problem in remembering (memory loss)
  • Confusion
  • May harm to lungs and nervous system causing severe complications

Physical examinations: The doctor will check for typical signs and symptoms of the lupus.

Blood tests: include the following:

  • Complete blood count (WBCs, RBCs, Platelets, Hemoglobin, proteins etc), Erythrocyte sedimentation rate.
  • Erythrocyte sedimentation rate: faster sedimentation of red blood cells (RBCs) indicates the lupus.
  • Blood examinations to check for liver and kidney functions

Urine tests: Helps to check for elevated levels of RBCs or proteins in the urine indicative of lupus.

Antinuclear antibody (ANA) test: Positive test refers to the triggered immune response. However, not every candidate with a positive ANA test has lupus.

Imaging tests: To rule out the inflammation, the doctor may perform several imaging tests like chest x-ray and echocardiogram.

Biopsy: A sample of a suspected organ like a damaged kidney, lymph node etc is taken out and examined to confirm the abnormality.

Following factors may increase the risk of developing Lupus:

  • Being female (females have 10 folds increased risk as compared to men)
  • Age between 15 to 40 years (though it may affect people of any age)
  • Being a native of  African Americans, Hispanics and Asians

It is quite difficult to diagnose lupus, as its several symptoms resemble many other ailments. However, butterfly shaped rash on the face is a typical sign, but unfortunately it is not displayed by all the lupus patients.Hence, the diagnosis of lupus may require multiple examinations including physical examination, blood tests, urine analysis, imaging tests and biopsy.

Complications:

Lupus may lead to several complications. Some common complications are listed below:

  • Kidney damage or failure
  • Severe headaches
  • Mental illnesses like memory loss, difficulty in speech organization etc.
  • Anemia
  • Other blood related problems including excessive bleeding or blood clotting
  • Difficulty in breathing due to inflammation of the lungs
  • Cardiovascular diseases including myocardial infarction, hypertension and heart attack
  • Infections including respiratory and urinary tract infections
  • Cancer
  • Miscarriage or preterm birth 

 

Management Approach :

The ideal treatment of lupus involves drugs and medications, lifestyle modifications and supportive alternative therapies. According to the presented symptoms and other health conditions, the doctor may choose suitable treatment options or a  combination of treatments:

Drugs and medications: Doctor may prescribe any of the following medications, according to the patient’s condition:

  • Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
  • Medications used in malaria
  • Corticosteroid drugs
  • Drugs suppressing the immune system

Lifestyle modifications:

Several lifestyle modifications may help to prevent severe symptoms or flares and helps to cope up with the condition. Recommended modifications are:

  • Sufficient rest
  • Avoid direct exposure to sun rays by wearing clothes covering hands and using sunscreen lotion.
  • Regular exercise (as recommended by the experts)
  • Limit smoking or avoid completely
  • Healthy diet including whole grains, fruits and vegetables

Alternative medicine:

In complicated cases, alternative therapy in combination with regular treatment may provide additional benefits:

Recommended alternative treatment for lupus includes:

  • Hormone supplements  like Dehydroepiandrosterone (DHEA) to reduce the symptoms
  • Consuming flaxseed which helps to reduce the inflammation and may help to improve kidney functioning.
  • Including fish oil in daily diet
  • Vitamin D supplementation

Lupus cannot be prevented or treated completely but the severity of the symptoms can be reduced by implementing the above recommended lifestyle interventions. 

*Disclaimer This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.