Lupus

What is Lupus

Lupus is an autoimmune disease, a type of self-allergy,
whereby the patient's immune system creates antibodies
which instead of protecting the body from bacteria and viruses
attack the person's own body tissues.
This causes symptoms of extreme fatigue, joint pain, muscle aches,
anemia, general malaise, and can result in the destruction of vital organs.
It is a disease with many manifestations,
and each person's profile or list of symptoms is different.
Lupus can mimic other diseases, such as multiple sclerosis & rheumatoid arthritis
making it difficult to diagnose.

Cause

The cause of lupus is unknown, but there are environmental and genetic factors involved.
While scientists believe there is a genetic predisposition to the disease,
it is known that environmental factors also play a critical role in triggering lupus.
Some factors that may trigger the disease are:
infections,
antibiotics,
ultraviolet light,
extreme stress,
certain drugs,
and hormones.

Although lupus is known to occur within families, there is no known gene or genes which are thought to cause the illness.
Statistics show that only about 5% of the children born to individuals with lupus
will develop the illness.

Lupus is often called a "woman's disease" despite the fact that many men are affected.
Lupus can occur at any age, and in either sex,
although it occurs 10-15 times more frequently among adult females.
People of african, american indian, and asian origin
are thought to develop the disease more frequently than Caucasian women.
The reasons for this ethnic selection are not clear.

Types of Lupus

There are three types of lupus:

discoid, systemic, and drug-induced.
discoid lupus is always limited to the skin.
It is identified by a rash that may appear on the face, neck, and scalp.
and by examining a biopsy of the rash.
Discoid lupus does not generally involve the body's internal organs.
therefore, the ana test, a blood test used to detect systemic lupus,
may be negative in patients with discoid lupus.

In approximately 10 percent of patients,
discoid lupus can evolve into the systemic form of the disease,
which can affect almost any organ or system of the body.
This cannot be predicted or prevented.
Treatment of discoid lupus will not prevent
its progression to the systemic form.
Individuals who progress to the systemic form probably
had systemic lupus at the outset,
with the discoid rash as their main symptom.

Systemic lupus is usually more severe than discoid lupus,
and can affect almost any organ or system of the body.
For some people,only the skin and joints will be involved.
In others, the joints, lungs, kidneys,
blood, or other organs and/or tissues may be affected.
Generally, no two people with systemic lupus
will have identical symptoms.
Systemic lupus may include periods in which few,symptoms are evident ("remission")
and other times when the disease becomes more active ("flare").
Most often when people mention "lupus," they are referring
to the systemic form of the disease.

Drug-induced lupus occurs after the use of certain prescribed drugs.
The symptoms of drug-induced lupus are similar to those of systemic lupus.
The drugs most commonly connected with drug-induced lupus are
Hydralazine (used to treat high blood pressure or hypertension) and
Procainamide (used to treat irregular heart rhythms).
The symptoms usually fade when the medications are discontinued.

Symptoms

Although lupus can affect any part of the body,
most people experience symptoms in only a few organs.
Following are the most common symptoms of people with lupus.

Treatment

For the vast majority of people with lupus,
effective treatment can minimize symptoms,reduce inflammation,
and maintain normal bodily functions.
Preventive measures can reduce the risk of flares.
For photosensitive patients,avoidance of sun exposure
and/or the regular application of sun screens
will usually prevent rashes.
Regular exercise helps prevent muscle weakness and fatigue.
Immunization protects against specific infections.
Support groups, counseling, talking to family members
friends, and physicians can help alleviate the effects of stress.
Needless to say, negative habits are hazardous to people with lupus.
These include smoking, excessive consumption of alcohol,
too much or too little of prescribed medication, or postponing regular medical checkups.

Treatment is based on the specific needs and symptoms of each person.
Because the characteristics and course of lupus may vary significantly among people,
it is important to emphasize that a thorough medical evaluation and ongoing medical
supervision are essential to ensure proper diagnosis and treatment.

Medications are often prescribed for people with lupus,
depending on which organs are involved, and the severity of involvement.
Effective patient-physician discussions regarding the selection of medication,
its possible side effects, and any changes in doses are vital.

Commonly prescribed medications include

Non-steroidal anti-inflammatory drugs (NSAIDs):
Acetylsalicylic acid (e.g., aspirin),
Ibuprofen, naproxen,indocin, relafen, tolmetin
and a large number of others.
These drugs are usually recommended for muscle and joint pain, and arthritis.
Aspirin and NSAIDs may cause stomach upsets for some people.
This effect can be minimized by taking them with meals, milk, antacids, or
prostaglandins such as cytotec.
Newer NSAIDs contain a prostaglandin in the same capsule (arthrotec).
The other NSAIDs work in the same way as aspirin, but may be more potent,
and patients often require fewer pills per day to have the same effect as aspirin.
Many NSAIDs are now available in "over the counter" forms.
Patients should be cautious about taking too much aspirin or nsaid since too many
of these can reduce the blood flow to the kidney and cause problems.

Acetaminophen: acetaminophen

Is a mild analgesic that can often be used for pain
. It has the advantage of less stomach irritation than aspirin,
but it is not nearly as effective at suppressing inflammation as aspirin.

Corticosteroids:

corticosteroids (steroids) are hormones that have
anti-inflammatory and immunoregulatory properties.
They are normally produced in small quantities by the adrenal gland.
This hormone controls a variety of metabolic functions in the body.
Synthetically produced corticosteroids are used to reduce
inflammation and suppress activity of the immune system.
the most commonly prescribed drug of this type is prednisone.

Because steroids have a variety of side effects,
the dose has to be regulated to maximize the beneficial anti-immune/anti-inflammatory effects
and minimize the negative side effects.
side effects occur more frequently when steroids are taken
over long periods of time at high doses
taken daily for periods of more than one month.
Such side effects include weight gain, a round face, acne, easy bruising,
osteoporosis, high blood pressure, cataracts,onset of diabetes,
increased risk of infection, stomach ulcers, hyperactivity, and
an increase of appetite.

Antimalarials:

Chloroquine or Hydroxychloroquine

commonly used in the treatment of malaria, may also be very useful
in some individuals with lupus.
hey are most often prescribed for skin and joint symptoms of lupus.
It may take months before these drugs demonstrate a beneficial effect.
Side effects are rare, and consist of occasional diarrhea or rashes.
Some antimalarial drugs, such as quinine and chloroquine, can affect the eyes.
Therefore, it is important to see an eye doctor (ophthalmologist) regularly.
The manufacturer suggests an eye exam before starting the drug and one exam every six months thereafter.
However, your physician might suggest a yearly exam is sufficient.

Immunomodulating Drugs:

Azathioprine and Cyclophosphamide
are in a group of agents known as cytotoxic or immunosuppressive drugs.
These drugs act in a similar manner to the corticosteroid drugs
in that they suppress inflammation and tend to suppress the immune system.
The side effects of these drugs include anemia, low white blood cell count,
and increased risk of infection.
Their use may also predispose an individual to developing cancer later in life.

Other Agents

Methotrexate and Cyclosporin
are used to control the symptoms of lupus.
Both are immunomodulating drugs which have their own side effects.
These drugs are still in the investigational phase for lupus.
Some of these agents are used in conjunction with apheresis, a blood filtering treatment.
Apheresis has been tried by itself
in an effect to remove specific antibodies from the blood
but the results have not been promising.

For Further Information
Please Got To

Lupus Fondation of America