Living With Lupus: Can You Recognize The Signs?
Medically reviewed on Aug 10, 2017 by L. Anderson, PharmD.
What Exactly is Lupus?
Lupus is an autoimmune disease, a condition that occurs when the body mistakes its own tissue as foreign and attacks itself. Lupus can result in an attack on many body systems, including the joints, skin, kidneys, heart, lungs, blood vessels and brain. Lupus, also known scientifically as Systemic Lupus Erythematosus (SLE), often results in symptoms of mouth sores, rash, fatigue, joint pain and swelling, and kidney damage.
The cause of lupus is not fully known, and in severe cases, lupus can be fatal.
Data from 2016 research suggests that in people with lupus, some of the immune system's "B cells" mature the wrong way – so that they promote inflammation instead of fighting it.
Who Gets Lupus?
In the U.S., 300,000 to 1.5 million people are affected by lupus, and roughly 24,000 new people are diagnosed each year. Women get lupus 10 times more frequently than men, and the average age of onset is 15 to 44 years.
Race can play a role, too. While anyone is subject to lupus, African-American women are 3 times more prone than white, non-Hispanic women, and it can be more serious in these women. Hispanic, Asian, and Native American women are more prone to lupus than white women, too.
What Causes Lupus?
Researchers have not pinpointed the exact cause of lupus. Since it occurs so frequently in women of child-bearing age, some scientists believe hormones may be involved.
Genetics may play a role, too, as those who develop lupus may inherit the risk from one or both parents. Lupus then develops when the person is exposed to an autoimmune trigger, like an infection, being pregnant, sunlight exposure, or after surgery.
Lupus can also be triggered by certain types of anti-seizure medications, blood pressure medications and antibiotics, which may be reversible when the medication is stopped.
The Symptoms of Lupus Can Vary
Lupus symptoms can be difficult and flare-up over time. Inflammation and damage to organ systems, especially the kidneys, can be severe. Fatigue, fever and weight loss or weight gain can occur commonly, and the fatigue can be debilitating for a patient, zapping all of their energy. Weight loss may be due to lack of appetite; on the flipside, weight gain may be due to fluid retention and a boosted appetite due to corticosteroid use.
Joint pain and stiffness, primarily the fingers, wrist, and knees, are early signs of lupus. A "butterfly rash", a redness on the nose and cheeks following sunlight exposure, is a telltale sign of lupus. Mouth sores, dry eyes and hair loss can occur, too.
How to Diagnose Lupus: It's Not So Cut and Dry
The diagnosis of lupus is not always straightforward, but great strides are being made. Signs and symptoms can vary from person to person, and one test cannot diagnose lupus. Your signs and symptoms, certain blood and urine tests, and a physical exam by your doctor will help to make the diagnosis. Tests may include:
How to Treat Lupus: Older Stand-Bys
While great advances are being made in lupus, there is no cure yet. Treatments act to limit symptoms, prevent end-organ damage, and lower the risk of recurrence.
Common drugs used to treat lupus include:
Newer Lupus Treatment: Benlysta
Older medicines may work well for lupus but tend to suppress the whole immune system. In 2011, the FDA approved the first lupus treatment since 1955 - Benlysta (belimumab). Benlysta, a monoclonal antibody, targets the B-lymphocyte stimulator (BLyS) protein, and lowers abnormal B cells. Benlysta is given as an intravenous infusion every 4 weeks or as a once-weekly self-injectable subcutaneous (SQ) injection, under the skin.
The most common side effects include nausea, diarrhea, and fever. Patients also commonly experienced infusion reactions, so pre-treatment with an antihistamine may be needed. Benlysta is not for severe kidney problems caused by lupus, or lupus that affects the central nervous system (brain, nerves, and spinal cord). Learn more about Lupus treatment here.
How to Cope With Lupus
Lupus has no cure, but you can learn to control this condition. A more healthy lifestyle can help to control symptoms. First, don't push yourself too hard each day at work or at home, and take a break when needed. To reduce stress, exercise, gather with friends, and relax. Seek out lupus support groups that can be a sounding board for concerns and questions of your lupus. Avoid sunlight, use sunscreens, and wear protective clothing — such as a hat, long-sleeved shirt and long pants — every time you go outside. Finally, educate yourself on lupus to be better prepared for future healthcare decisions.
Finished: Living With Lupus: Can You Recognize The Signs?
- GSK Receives FDA Approval for a New Self-Injectable Formulation of Benlysta (belimumab) for Systemic Lupus Erythematosus. July 21, 2017. Accessed August 10, 2017 at https://www.drugs.com/newdrugs/gsk-receives-fda-approval-new-self-injectable-formulation-benlysta-belimumab-systemic-lupus-4563.html
- Lupus Foundation of America. What is Lupus? Accessed March 6, 2017 at http://www.lupus.org/answers/entry/what-is-lupus.
- Lupus. Mayo Clinic Reference. Drugs.com. Accessed March 6, 2017 at https://www.drugs.com/mcd/lupus.
- Fast Facts About Lupus. National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). November 2014. Accessed March 7, 2017 at http://www.niams.nih.gov/health_info/lupus/lupus_ff.asp
- Up to Date: Patient information: Systemic lupus erythematosus (SLE) (Beyond the Basics). Up To Date. Accessed March 6, 2017 at https://www.uptodate.com/contents/systemic-lupus-erythematosus-sle-beyond-the-basics