Lupus
The name of this disease means wolf in Latin. It's
named for the red rash many people get across the bridge of the nose and
the cheeks, which resembles the dark markings on the face of a wolf. And
like the wolf, it is a predator.
Lupus targets young women of childbearing age (between 18 and 45), although
men can get the disease as well. The condition is serious and can inflame
and damage joints, skin, kidneys, heart, lungs, and other organs and connective
tissues throughout the body. The severity of lupus varies, but at its worst
it can destroy the kidneys, cause a stroke or heart disease, or even cause
death.
What happens in the body
Lupus is an autoimmune disease, which means that the
immune system, your body's defense against infections, turns on itself and
attacks your own cells. Lupus is an unpredictable disease. The symptoms may
come and go in flares (when it worsens) and remissions (when it quiets down
or even seems to go away). Some people develop all or most of the signs described
below, and some might have just a few.
About 70% of people with lupus have a systemic type, meaning it affects several
body systems. In about half of those with systemic lupus, the disease attacks
the major internal organs. This can be very serious, leading to dialysis or a
kidney transplant. When lupus primarily attacks the skin and joints, the disease
usually has fewer complications.
About 10% of those with lupus have a type that is a skin disease called discoid
lupus or cutaneous lupus. A scaly, disc-shaped rash can cover much or part of the
face, neck, and chest. Scarring may result from discoid lupus, but this type isn't
as dangerous as systemic lupus.
People with lupus may have other forms of autoimmune arthritis as well. Between
10% and 15% have something called secondary Sjögren's syndrome, which causes
dryness in the eyes, mouth, and sometimes the vagina. Some have rheumatoid arthritis,
or a condition called Raynaud's phenomenon. Up to one third may develop
fibromyalgia.
No one knows what causes lupus. It seems to run in families, though it may not be
directly passed on from parent to child. Some experts also believe it is connected
to inherited problems with the immune system that are then triggered by an attack
on the body, such as an infection, stress, allergies, environmental toxins, drugs,
or sun exposure.
Symptoms you may notice
If you have or suspect you have three or more of the
symptoms below, see your doctor.
A butterfly-shaped rash across the bridge of the nose and cheeks (called a malar rash)
A scaly disk-shaped rash on the face, neck, and chest (associated with sun exposure)
Photosensitivity -- severe reactions to sunlight such as serious sunburns or rashes from short exposure
Sores (that may be painless) inside the nose or mouth
Pain, stiffness, or swelling in the joints
Kidney disorders, often connected with swelling in the legs and feet
Nervous system disorders, such as seizures, mood swings, or mental confusion
Anemia, a low white-cell count, or other blood disorders
Signs of immune system problems such as fever, weakness, and weight loss
An inflammation of the lining of the heart, lungs, or other organs (called serositis)
How lupus is diagnosed
Lupus can be hard to diagnose because it can resemble other
diseases, or because you may have complications such as kidney problems that
are misleading.
Your family doctor may suspect lupus after doing an examination and taking a medical
and family history, and will then order laboratory tests. Although no test definitely
shows you have lupus, results can rule out other diseases and confirm a pattern of
symptoms.
Your doctor might order any of these tests
Antinuclear antibody (ANA), a blood test that detects the presence of auto-antibodies that attack your own cells
Blood tests, to check the function of and any damage to the kidneys and liver
Blood tests for anemia, low white-cell count, or other abnormalities
Urinalysis, to check for kidney involvement
Chest X-rays to look for lung and heart problems
Electrocardiogram or echocardiogram tests to check the condition of your heart
Your doctor may also
Check the health of your kidneys with a tissue biopsy
Look for signs of Sjögren's syndrome or Raynaud's phenomenon
Risk factors
Being a woman. Eight in 10 with lupus are female
Being African-American. The rate is three times that of Caucasians.
Being Asian. The rate of lupus is also higher in this population.
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