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Lupus is a chronic inflammatory disease marked by its effect on various parts of the body, including the joints, skin, blood, and kidneys. It is a condition in which the body's immune system attacks its own cells and tissues, resulting in pain, inflammation, and often damage to organs. For many people, the disease is mild and affects only a few organs. For others, however, the disease can be severe and even life threatening.
Lupus involves the immune system. The immune system makes antibodies that work to protect the body against foreign substances like viruses and bacteria. Such foreign bodies are called antigens.
When a person has lupus, his or her body is unable to determine the difference between antigens and the individual's cells and body tissues. As such, the immune system creates antibodies against the individual's own tissues. These antibodies are called autoantibodies.
When a person has lupus, autoantibodies react with cells and tissues to form immune complexes. These immune complexes become concentrated in the body. It is this concentration or build-up within body tissues that causes pain, inflammation, and damage.
There are four types of lupus. The first type, discoid lupus, affects the skin. It is characterized by a rash that may appear on the face, neck, or scalp. Individuals with this condition may also experience mouth or nose ulcers, as well as photosensitivity. Discoid lupus is diagnosed by performing a biopsy on the rash.
Systemic lupus is usually more severe than the discoid type, affecting nearly any organ or system of the body. For example, the disease can affect the skin, blood, nervous system, kidneys, heart, joints, and lungs. Some individuals with the disease have only one or two organs or tissues affected, while others may have many affected organs, systems, or tissues.
Systemic lupus may include periods of remission as well as periods of activity. Periods of activity are often referred to as flares. There is no single diagnostic test for the systemic form of the disease. A careful review of the patient's medical history is used, along with the results of various tests, to diagnose the condition.
Drug-induced lupus is caused by the use of certain drugs. It is characterized by symptoms similar to those caused by the systemic form of the disease. Hydralazine and procainamide are the two drugs most frequently connected with the disorder. Only a very small number of people taking these drugs develop the condition and the symptoms generally disappear upon discontinuing the medication.
The last type of lupus, neonatal lupus, occurs quite infrequently. Neonatal lupus affects newborns born to women who have systemic lupus. Their symptoms include heart defects, skin problems or problems with the liver.
Depending on the type of lupus, a wide range of symptoms may be experienced, from rashes, hair loss, and achy, swollen joints to fever, anemia, and abnormal blood clotting. Though the disease can affect many parts of the body, individuals usually experience symptoms in only a few organs. There is no known cure for lupus. However, medication and preventative-care treatments can help to minimize symptoms.
As with other autoimmune diseases, people with lupus share some type of common genetic link. An identical twin of a person with lupus has a threefold to tenfold greater risk of getting lupus than a nonidentical twin. Moreover, first-degree relatives (mother, father, brother, sister) of people with lupus have an eightfold to ninefold increased risk of having lupus compared with the general public.
Although an identical twin is much more likely to have lupus if her identical sibling has lupus, the likelihood of developing the disease in the unaffected twin is not 100%. Despite the nearly identical genetic makeup of identical twins, the probability of the unaffected twin developing the disease if the other twin has it is around 30%-50% or less. This implies that environmental factors may help determine whether or not the disease develops in a person. Outside of random occurrences of lupus, certain drugs, toxins, and diets have been linked in its development. Sun exposure (ultraviolet light) is a known environmental agent that can worsen rashes of patients with lupus and sometimes trigger a flare of the entire disease.
In the past, the drugs most frequently responsible for drug-induced lupus are procainamide (Procanbid), hydralazine (Apresoline), minocycline (Minocin), phenytoin (Dilantin), and isoniazid (Laniazid). However, newer medications have been associated with drug-induced lupus, such as the new biological agents (etanercept [Enbrel], infliximab [Remicade], and adalimumab [Humira]) used to treat rheumatoid arthritis. Generally, lupus that is caused by a drug exposure goes away once the drug is stopped.
Many women with lupus note that symptoms may be worse after ovulation and better at the beginning of the menstrual period. Pregnancy does not appear to worsen the long-term outcome of patients with lupus. On the other hand, active lupus tends to increase the risk of miscarriage and preterm birth. Babies of lupus mothers with the SSA antibody (anti-Ro antibody) can develop heart electrical abnormalities and a temporary skin rash (lupus neonatorum). Pregnant mothers with lupus are monitored closely by obstetricians.
There are many signs and symptoms of lupus that you should be aware of in order to be able to judge whether or not you are suffering from this disease. Be aware that it can sometimes be difficult to get a proper diagnosis of lupus because:
There are so many different symptoms
The symptoms can be like those of other illnesses and diseases
The symptoms are different in each individual. No two lupus cases are just alike!
So just what are these signs and symptoms?
One of the most notable symptoms of lupus is pain. You can have a hot, burning pain in any part of your body from your head all the way down to your toes. It can affect your feet and render you unable to walk, your hands and fingers, making it impossible to grip or hold anything in/with them, or your knees, hips, shoulders, elbows, jaw… any joint in the body can be affected. This pain can move from one place to another and can cause swelling and redness.
Muscle weakness in the knees and hips as well as any of the muscles that are in the area in between the elbow and the neck, most notably the upper arms and shoulders. Your hands and feet, wrists and ankles can also be affected by muscle weakness due to damage to the nerves in these areas caused by inflammatory pain.
Lupus can cause you to have a fever that comes and goes much as your pain does, or hangs around as a low-grade annoyance.
Loss of appetite affects about half of all lupus sufferers. This is often one of the very first symptoms that people notice.
Fatigue and very little energy is also a hallmark of lupus, and one of the most common symptoms, too. People have described this fatigue as feeling as if they always have the flu.
Rashes on the skin are common in someone with lupus. One rash is known as a “butterfly” rash, as it lies across the cheeks and nose almost in the shape of a butterfly. Another type of rash will pop up not only on the face, but in the scalp, the ears, on the arms or the chest. The rash can be faint or extensive, and can also cause you to lose the hair on your scalp. More than ninety percent of all people with lupus are bothered with skin rashes.
Mucosal Ulcers or sores in the mouth or inside the nose can develop in lupus patients. These sores do not hurt.
Sunlight sensitivity is common, and can make the lupus rashes seem worse.
Skin color changes, especially in the fingers when your hands get cold. The fingers take on a paler or a purplish color.
Chest pain when drawing in your breath is another lupus symptom.
Fuzzy thinking, memory problems, and depression can also be signs of lupus.
Lupus as a disease has been called the “Great Imitator” for its ability to mimic many other different diseases. Only a health practitioner can tell you for sure if you have lupus.