The immune system is designed to help protect against foreign bodies (toxins, pathogens) in the human body. All of this takes place through a complex set of biological processes, which combine to form a safety net for the body as it looks to stay healthy.
When things aren’t right with the immune system, an “autoimmune disorder” can often be the cause of this issue.
One of those autoimmune disorders comes in the form of Systemic Lupus Erythematosus or lupus.
Here is more on what lupus entails.
What Is Lupus?
Systemic Lupus Erythematosus or lupus is an autoimmune disorder where the system becomes hyperactive. It starts creating antibodies in a bid to fight against its cells. This means the immune system remains active even when it is not required.
For example, the immune responses will start to promote inflammation in various cells. These cells are going to have a profound impact on the health of one’s tissues such as muscles, joints, skin, and various other aspects.
No part of the body can stay away from the impact of lupus once it kicks in. This can include parts such as the brain, heart, gastrointestinal tract, and kidneys. Each patient will have a unique experience with lupus, and it is important to keep tabs on things at all times.
There are three types of lupus a person will hear about, and these include:
1) Drug-induced Lupus (DILE)
The first form of lupus would be drug-induced lupus or DILE. This occurs when certain drugs are administered, and a person is vulnerable from a medical perspective. These can include drugs such as anti-TNF drugs, phenytoin, hydralazine, minocycline, and procainamide.
Patients who are deemed vulnerable will see these drugs create significant issues in their body over the long haul.
Various lupus-like symptoms can start to form as the body starts to feel the impact of these drugs.
2) Discoid Lupus (DLE)
This form of lupus remains focus on the skin and internal organs. It doesn’t spread throughout the rest of the system. Research has shown patients who are diagnosed with discoid lupus can see a flare-up where the rest of their body is impacted 95% of the time.
This is called a generalized flare, and it can affect the kidneys, joints, and more.
This is why it is important to get treatment as scarring is a real concern with this form of lupus.
3) Systemic Lupus Erythematosus
This is the generalized form of lupus and is the most common type.
A patient with Systemic Lupus Erythematosus will display all of the key symptoms associated with the medical condition, and it will start to spread quickly. It will not be reserved for one part of the body, and those antibodies will start to have an impact on various major organs and tissues.
It is pertinent to receive treatment for this form of lupus as it can start to have a telling effect on one’s life.
Who Gets Lupus?
Let’s move onto the next part of lupus.
Who does it impact? Are there particular people who are prone to dealing with lupus or is it a universal autoimmune disorder?
In general, lupus is going to have a widespread impact and can be seen in both men or women. However, based on medical research and the incoming data over decades of medical work, it is apparent women are more prone to lupus than men. The ratio is set at 9:1 meaning there are nine women diagnosed with lupus vs. one man.
What is the reason for this discrepancy? The reason is often associated with childbearing. Most cases of lupus are seen in women who are pregnant or were pregnant recently.
It is important to remember while women are prone to this disorder, it is also seen in children and cannot be disregarded. The same applies to women who are dealing with post-menopause years. Medical professionals will sift through the symptoms to diagnose a patient regardless of their age or gender.
As for racial demographics and lupus, it is often associated with Eastern, Asian, and Afro-Caribbean races than any other.
Causes of Lupus
Medical research has been done on lupus, and most studies are unable to decipher what causes this autoimmune disorder. There isn’t one particular reason for what causes it, and that is why continuous work is done to gain a better understanding for those who are fighting against it.
However, two areas have been pinpointed as being reasons. These are genetic and environmental causes.
Some patients are seen to have a genetic disposition for this condition and were going to have it act up at one stage or another. Many children who face this disorder are often cited under this reason as they saw the “flare up” early on in their lives.
The specific genetic reasons have not been pinpointed by it is something that is noted by medical professionals.
The next cause that is listed would be environmental reasons. However, the specific environmental reasons for why lupus occurs in some and not in others are still being researched to this day. The reason for this has more to do with why specific races around the world are more prone to this condition than others.
The same applies to childbearing women compared to other women and men.
These environmental factors can add up over time and be the reason patients deal with lupus in their body and have to fight it off over time. Some patients are regarded as having a combination of genetic and environmental reasons for why their lupus kicked in.
It is also important to note, this is not an infectious disease and cannot be spread from one person to another after a diagnosis has been made.
Symptoms of Lupus
Before listing the main symptoms of lupus, it is best to realize this is a variable condition and not one that is going to have an established set of symptoms one can look out for. This is why having it diagnosed by a specialist is key for one’s health and wellness.
For those who are intrigued by the disorder and want to know more about the key symptoms most patients deal with, here are a few that do come up.
1) Muscle Pain
This is a common complaint where patients will start to notice their muscles are not as strong as they used to be. This can be something as simple as lifting a remote control can be harder to do than before. The muscle starts to give out quickly, and the same applies to when force is being put on one’s legs to walk from place to place.
If left untreated, the muscle pain will worsen if it has set in.
2) Joint Pain
The body has numerous joints, and each one is vulnerable when dealing with antibodies that spread throughout the body. When this takes place, the joints start to become rigid and not as forgiving when a person moves from place to place. This comes back to the idea of walking and feeling pain in one’s ankles and knees.
This is one example of many when it comes to how joint pain can feel with lupus.
3) Flu-Like Symptoms
Lupus will also start to establish flu-like symptoms in some where they feel sluggish and tired. They will start to notice headaches set in and some can start to complain about feeling nauseous.
These symptoms are hard to pinpoint but can start to come about early on when dealing with lupus.
Even if a patient sleeps 10-12 hours a day, they will wake up feeling like they haven’t slept all night.
This can be a distressing situation for those who have to go about their daily lives, and the fatigue can start to get in the way of things. This fatigue is set throughout one’s body and is discomforting, to say the least.
5) Chest Wall Pain
Another term for this is “pleurisy” where the chest wall starts to feel painful. It tends to be a stabbing pain that is present in a particular part of the chest. For some, it might not be as severe, but it will remain present as the lupus kicks in.
6) Brain Inflammation
This can happen in some cases where lupus leads to antibodies heading towards the brain.
This is when the brain starts to swell up and can lead to a dangerous situation for the patient who has brain inflammation.
7) Kidney Disease
Just like the brain, a patient might have to deal with kidney disease as the antibodies start to go out of control. The kidneys won’t function as they used to while this occurs.
8) Swelling in Limbs
The final symptom that is often seen with patients who have lupus would come in the form of swelling in their limbs. This can be related back to the idea of joint or muscle pain. As the condition worsens, the inflammation is going to become apparent, and that is when the swelling kicks into high gear.
How is lupus diagnosed when a patient comes in complaining of certain symptoms they might be having at the time?
A doctor is going to have the following tests run to complete their diagnosis.
1) Blood Test
The initial examination is going to look at running a few types of blood tests. The doctor is going to order Positive anti-nuclear antibody, Full Blood Count (FBC), Raised double-stranded DNA (dsDNA), Complement (C3 and C4), C-reactive protein (CRP), Erythrocyte Sedimentation Rate (ESR), and Extractable Nuclear Antigens (ENA).
There are other tests that one might also see being administered by the doctor based on the symptoms being displayed. They will want to rule out other conditions that can mimic lupus.
2) Urine Test
The doctor will also look to assess one’s urine.
This might be done in the clinic where a regular dipstick test is done to see what is going on with the body. The goal is to determine the urine albumin-creatinine ratio as that can tell a lot about how the kidneys are doing at the moment of diagnosis.
3) Skin Biopsy (If Necessary)
The final test will be a skin biopsy, but this doesn’t have to be set up as long as the other tests reveal everything the doctor is searching for.
If organs are involved or the doctor feels they might be, other tests such as an EKG, kidney biopsy, and abdominal CT scan can also be set up.
To treat lupus, the specialist or rheumatologist might assess what the patient is going through. Various professionals can be involved in helping a patient with lupus because of the varying symptoms and how they start to appear over time.
Steroids are reserved for serious manifestations of lupus where the kidneys and other organs are involved. This is an aggressive treatment that is often left for later.
2) Anti-Inflammatory Agents
These are used to help treat mild symptoms such as headaches, muscle pain, joint pain, and pleurisy in patients. It is important to note non-steroidal variants are not prescribed as they can damage the kidneys.
This is regarded as a “first-line” treatment for lupus and malaria.
It can help with controlling skin-related symptoms, pleurisy, and joint pain. It will often be prescribed over multiple months to help suppress these symptoms.
4) Immunosuppressive Drugs
These are used as a second-line drug and come after anti-inflammatory agents, or hydroxychloroquine doesn’t work out.
Examples of these would include mycophenolate mofetil or myfortic.
It is important for a specialist to monitor intake to ensure the immune system isn’t being pressured.
5) Biological Agents
These are used to help tackle the creation of antibodies. Biological agents include belimumab or Rituximab.
6) Other Treatments
Patients are required to remain aware of their symptoms and highlight changes for quick action instead of letting things linger. It is also important to minimize stress and stay on top of symptoms at all times. If this doesn’t take place, it might heighten the symptoms of lupus.
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