Brief Introduction To Lupus

Systemic Lupus Erythematosus (SLE), commonly known as Lupus, is a group of complex hard-to-diagnose autoimmune disorders with 1.5 million cases reported each year in America. It covers a wide variety of related diseases. This article focuses on SLE which is known to the common man as Lupus (Lt. wolf due to the rash that resembles wolf bite).

Lupus is a chronic, inflammatory disease that presents in a kaleidoscopic manner, with periods of extreme sickness alternating with milder times. This fluctuating nature of Lupus makes it hard to identify. And thus, patients suffer unnecessarily and agonizingly for years and years. The illness is more common among women of child-bearing age due to the presence of female sex hormones. Even more tricky is the fact that its cause is unknown and not well-defined.

Causes

The causes of Lupus are not clearly outlined as with some other disorders like polio or thalassemia. One may have the disease as a result of genetic and environmental factors. Vitamin D Deficiency is also a notable causal agency. Smoking may also be a causative agent.

Genetics:

The disease is inheritable and commoner in families of certain ethnicities and gene linkages. A specific gene for Lupus has not been identified but some of the genes responsible are HLA Class I and Class II, BANK1, STAT4, and BLK. The etiology of this disease suggests that it runs in families and a has a heritability rate of >66%. Among identical twins, there is a 24% chance of susceptibility for one if the other has already been diagnosed.

Environment:

The fact that Lupus is more common among people of certain social and geographic backgrounds hints at the role of the atmosphere in its development.

Drug Side Effects:

Drug-induced Lupus is a curable condition that occurs in patients with other chronic, long-term diseases. The drugs that increase the risk are hydralazine, procainamide, quinidine, and phenytoin.

Photosensitivity:

Some people are hypersensitive to sources of UV light like the Sun, halogen lights, discharge lamps, and lasers. This condition is called photosensitivity. It reportedly causes many symptoms associated with SLE like joint pain, fatigue, fever, and rashes.

Mechanism

Our immune system fights against foreign organisms, microbes and germs. It is the defense system of the body. In Lupus, this security service receives flawed intelligence and starts producing autoantibodies (think Army personnel) against the body’s own tissues. The situation is aggravated by the multiple numbers of organs that face the wrath of a crazy immune system. It involves the production of antinuclear antibodies which inflame the organs and cripple the joints. The appearance of symptoms appears in two phases designated as Flares and Remission. A flare is that length of time for which the disease is in full swing and the symptoms are clearly visible. By remission, we mean the interval in between in which the disease is intermediate and tolerable.

Signs And Symptoms

Lupus presents in a changing and relapsing manner. The symptoms may be intense for a few days or weeks and then completely disappear, only to return a few months later.

This moody nature of the Wolf makes it hard to tame. It baffles the most sharp-witted of clinicians and adds to the patient’s misery. However, the clear indicators of Lupus are:

Physical Indicators

Rashes often referred to as a Malar or Butterfly rash which appears on the face and Sun-exposed regions

Mucous membrane ulcers in the mouth or nose

Arthritis which is swelling or inflammation of the small joints of the hands, feet, knees, and wrists

Weight loss

Exhaustion and fatigue

Formation of subcutaneous nodules

Fever

Hair thinning and loss

Physiologic Indicators

Chest pain

Swollen lymph nodes (lymphadenopathy)

Anemia

Involvement of the CNS, characterized by clouded thoughts and slower motor functions

Tests And Treatment

SLE is termed The Great Imitator because it mimics the symptoms of other autoimmune disorders, hence confusing the physician. The American College of Rheumatology (ACR) has devised a scheme of eleven criteria, out of which the patient must qualify four.

Some tests for its diagnosis are:

Urinalysis with microscopy

Blood tests

Chest Xray

ANA Panel

Skin biopsy

Coombs test direct

ESR

ANA test

CBC with differential

Important Drugs

Lupus can’t be cured but eased. Treatment with Chemotherapy is underway and promising.

Some drugs prescribed by the doctors include:

Immunosuppressants

Corticosteroids for skin rashes (creams)

Blood thinners for anemia, blood disorders e.t.c

NSAIDs for joint swelling

Hydroxychloroquine

Methotrexate

Prednisone

Belimumab

Life With Lupus:

Living with Lupus can be challenging and tedious. The patient may feel depressed, angry and socially isolated. The fatigue and weakness induced by Lupus can deteriorate physical health. It may cause emotional instability and spiritual vulnerability.

If you have been diagnosed with Lupus or are a caregiver for a patient, fret not!

With a little care and devotion, you can survive this malady and live with grace.

Some tips and tricks to live better with Lupus are:

Manage A Support System:

Have a large variety of lifelines which may include relatives, family members, coworkers, friends and trustworthy acquaintances. Share your hopes and fears with them. Try to be as open as possible. Demand their attention and time directly. Keep yourself occupied in household chores and leisure activities.

Eat Healthy:

As a patient of Lupus, you are at a risk of further infections, heart attack, and Stroke. So watch what you eat. It is better to have a nutritionist devise your daily meals. Don’t take Alfalfa (it intensifies the symptoms) and watch your alcohol intake. Smoking can also have adverse effects on your condition.

Coping With The Sun:

Sunlight is known to worsen skin blistering and rash. So don’t go unprepared in the Sun.

Wear Sun-protective clothing and sunglasses. Use a good sun-block. A sun protector of wide spectrum (SPF 30 at least) is recommended.

Hit The Gym:

Strenuous and hard exercises will only add to the pain and soreness. But milder workouts and yoga poses can help ease the pain. Low-impact exercises and restorative yoga (Hatha, Iyengar) can strengthen muscles and prevent osteoporosis.

Get All The Zs You Need:

Sleep is crucial to mental wellness and soundness. It freshens the mind and recharges your batteries. So try to get all the sleep you need.

Keep That Smile On:

Dealing with Lupus can be excruciating and depressing. But don’t give up, there is no disease that can cripple love or corrode faith or shatter true hope. Plus, with the new research and chemotherapeutic trials, there is light at the end of the tunnel.

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