Lupus (Systemic Lupus Erythematosus) is a chronic autoimmune disorder that occurs when the body’s immune system attacks its own tissues and organs. Inflammation caused by lupus can affect many different body systems, including the joints, skin, kidneys, blood cells, brain, heart, lungs, intestines and blood vessels.
Under normal circumstances, the body’s immune system protects the body against “foreign” invaders like viruses, bacteria and parasites. In lupus, the immune system malfunctions and produces antibodies and cells which attack its own organs – hence lupus is known as an “autoimmune” disease. The reason why this happens is unknown, but are believed to be linked to environment (exposure to sunlight, stress or infection), genetic and hormonal factors.
Lupus occurs more frequently in women than in men. Asians and Afro-Americans are more prone to develop lupus than Caucasians and the disorder is more severe in these ethnic groups.
Four types of Lupus exist:
The outlook for people with lupus was once grim, but diagnosis and treatment of the disorder has improved tremendously in recent years. With early diagnosis and treatment, most people with lupus can lead normal, active lives.
No two cases of lupus are exactly alike. Signs and symptoms may come on suddenly or develop slowly, may be mild or severe and may be temporary or last for a long period of time.
Most people with lupus experience episodes called flares, or worsening signs and symptoms that eventually improve or even disappear completely for a period of time with treatment. The course of the disorder is unpredictable, hence long-term treatment and follow-up is essential.
The signs and symptoms of lupus will depend on which body systems are affected by the disorder.
In general, signs and symptoms of lupus include the following:
Lifestyle changes are needed to reduce the incidence of relapses:
Under normal circumstances, the body’s immune system protects the body against “foreign” invaders like viruses, bacteria and parasites. In lupus, the immune system malfunctions and produces antibodies and cells which attack its own organs – hence lupus is known as an “autoimmune” disease. The reason why this happens is unknown, but are believed to be linked to environment (exposure to sunlight, stress or infection), genetic and hormonal factors.
Diagnosing lupus is difficult because the disease varies considerably from person to person and the signs and symptoms come and go unpredictably and overlap with many other diseases. Therefore, doctors may not initially consider lupus until the signs and symptoms become more definite. Your doctor will take a detailed medical history and conduct a physical examination on you.
Even then, diagnosis can often be challenging and a number of laboratory tests are necessary to confirm the diagnosis. These tests include the following:
Specialised clinics may result in better outcomes. Treatment of lupus depends on the signs and symptoms and which organs are involved.
Determining what medications to use requires a careful discussion of the benefits and risks with a rheumatologist. For adequate control of lupus, a rheumatologist may recommend more powerful drugs in higher doses initially but as the disease flare subsides, the dosage can usually be tapered off slowly and carefully. More aggressive lupus usually requires more powerful and long term drugs.
In general, when first diagnosed with lupus, your doctor may recommend the following medications:
Surgery may present some particular challenges in people who have lupus, so proper preparation is important. Although we may not be able to adequately prepare for emergency surgeries, there are many things that can be done for elective surgeries to increase the possibility of a safe outcome.
Keep all your doctors in the loop. It is very important that the surgeon and the rheumatologist communicate with each other prior to the surgery. If this does not happen, it is recommended that patients initiate this communication by asking the surgeon to contact the rheumatologist, and vice versa.
This is important as surgery may induce a lupus flare or may cause complications if surgery is performed while having a flare. Therefore, it is important to know the status of your lupus before having a procedure. In addition, some medications need to be stopped, increased or decreased prior to surgery. For instance, blood thinners will need to be stopped prior to surgery and restarted later on. Your rheumatologist and other doctors can provide specific recommendations.
Your rheumatologist will review you post-surgery to make sure your wound has healed and recommends your treatment appropriately.
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