Lupus is a chronic non-communicable disease. It is an autoimmune disease i.e. the antibodies affected patients reacts against the body cells rather than the foreign antigens. The defense mechanism affects body itself because of the overabundance of antibodies in the bloodstream. As a result, inflammation and damage in the joints and other organs is caused that shows some common lupus symptoms.
Most of the sufferers of the disease are female, 90%, mainly between the age of 15-55.Since the onset of this disease is usually in the most productive period of life, this might hamper the career and development of the individual.
Types of Lupus
- Discoid and subcutaneous lupus: This is the type in which only the skin is affected. Very few of such cases might develop later into systemic lupus (affecting multisystem).
- Drug-induced lupus (Rare): Some drugs like penicillin, minocycline etc have been associated with lupus.The symptoms disappear after the medications are stopped.
- Systemic Lupus Erythematosus: This is the type of lupus which affects the multisystem. Symptoms are seen in various body parts including vital organs like heart, lungs, kidney, liver, and brain. This is the most frequently occurring form of lupus and is more serious comparatively.
- Neonatal lupus: Rarely, a newborn of a mother may have neonatal lupus. Newborn show the symptoms like skin rashes, anemia, or liver problems. Symptoms are usually temporary and don’t cause any long-term damage. Some neonatal lupus affected babies might be born with a serious defect in the heart.
People who have the family history of lupus or other autoimmune illnesses such as arthritis, multiple sclerosis, and rheumatism have the higher probability of developing lupus. Among people who are susceptible to lupus, it is usually activated through sunlight, as a result of shock or stress, after viral infection, hormonal changes (during puberty, menopause, after childbirth).
The actual causal factors of lupus are still not confirmed. According to many scientists; lupus is assumed to be caused by the incorporation of factors both in and out of the body such as:
- Hormones: Researchers have examined the connection between estrogen and lupus.Though no causal effect has been proven yet, high prevalence among women, the inception of flares before menstrual periods and pregnancy indicates a higher level of estrogen might be related to lupus.
- Genetics: Some genes are more commonly found in the people with lupus. Though most of them don’t directly cause it, they are assumed to contribute it. But genes are not enough factors alone.
Certain groups (people of African, Asian, Hispanic/Latino, Native American, Native Hawaiian or Pacific descent) have a higher risk of developing lupus. This may be related to the presence of common genes.
- Environment: Environment factors such as Ultraviolet light (UVA and UVB), infections of some viruses and/or exposure to silica dust etc. can assist to cause lupus.
American college of rheumatology has given the 11 criteria to contribute to the diagnosis of lupus since lupus has many different faces due to which two people suffering from it rarely have exactly same symptoms.
Typically four or more of the criteria must be present to make a confirmed diagnosis of systemic lupus:
- Butterfly shaped rash across cheeks and nose
- Discoid rash: skin rash with raised red patches
- Photosensitivity: skin rash as a result of exposure to sunlight or fluorescent light
- Mouth or nasal ulcers
- Arthritis (non-erosive i.e. bones around the joints not destroyed) including bones/joints stiffness and swelling
- Cardiopulmonary involvement: inflammation of heart lining (pericarditis) and/or lungs lining (pleuritis)
- Disorders of nervous system: seizures and/or psychosis
- Kidney disorders: excessive protein in the urine or cellular casts in the urine
- Blood disorder: hemolytic anemia, low white blood cells count (leucopenia), low platelet count (thrombocytopenia)
- Immune disorder: antibodies level above laboratory reference range against normal cells
- Positive antinuclear antibody (ANA) test
Since the actual cause is still not known, intervening at a specific point to prevent it is difficult.
Scientists believe that one could be born with a gene that increases the probability for him/her to develop lupus when environmental factors are suitable.
If any members of your family have lupus, it makes your possibility to develop lupus higher.
If you already know you might have genes associated with lupus (through family history), you should be concerned about the triggers and get protected. This might be quite helpful in reducing the risk, early diagnosis and preventing complications that follow the disease onset.
There is at present no cure for this disease but careful and consistent watch and condition-specific tailored treatment therapy (since the symptoms vary) can help in lupus management.
The dosage and number of recommended medications can change over a person’s lifetime depending upon how active the disease is.
Most patients are able to live a normal lifespan with the right combination of medications and regular monitoring of disease.
Drugs used to treat this disease like:
- Non-steroidal (aspirin etc),
- Antimalarial like hydro oxy chloroquine (Plaquenil), chloroquine
- Corticosteroids (prednisone)
The patients go through the sequence of flares and remissions. According to the necessity of the illness and effect of medications, the patients need to modify their lifestyle.
- Don’t get exposed to sunlight or fluorescent lights without the use of sunscreen and protective clothing.
- Practice healthy eating
- Get involved in physical training and exercise if you are able
- Get enough sleep and rest
- Maintain your personal hygiene
- Quit smoking (if you do )
- Settle stress properly and avoid it if possible
- Become well aware of this disease
- Get engaged in new hobbies and skills if you are able.