Lupus Erythematosus: Information on Causes, Diagnosis & Treatments
Lupus erythematosus is also referred to as systemic lupus erythematosus autoimmune disease that refers to numerous chronic disorders affecting the body's immune system. Without treatment, the damage caused by the autoimmune disease can affect joints, skin, and body organs. Because the condition is chronic, many of the symptoms and signs associated with the disease last between six weeks and a lifetime.
The condition develops because something went wrong with the immune system that is designed to protect the body against foreign invaders including germs, bacteria, and viruses. When the autoimmune disease is acquired, the body's immune system can no longer differentiate between healthy tissue and foreign invaders. Because of that, it will create autoantibodies that will destroy healthy tissue. These autoantibodies can cause damage, pain, and inflammation all around the body.
The disease is not contagious, even through direct or sexual contact and cannot be given to or caught from others, nor does it spread by cancer. However, many doctors prescribe immunosuppressive medications to treat lupus, which are often the same drugs used in chemotherapy to treat some forms of cancer.
- Who Is at Risk for Lupus Erythematosus?
- Lupus Erythematosus Symptoms
- Diagnosing Lupus Erythematosus
- Treating the Condition
Who Is at Risk for Lupus Erythematosus?
The Centers for Disease Control and Prevention (CDC) estimates that 16,000 cases of lupus erythematosus will be diagnosed this year in the United States. This is in addition to the 1.5 million men and women in America who suffer from the condition. It is estimated that more than five million individuals worldwide suffer from some form of lupus.
Doctors have yet to determine the exact cause of the abnormal autoimmune reaction caused by lupus erythematosus. However, it is believed that specific drugs, exposure to ultraviolet light, viruses, and inherited genes play some role in its development. Doctors do know that the condition is not caused by infectious microorganisms. However, individuals who have a genetic predisposition to autoimmune thyroid disorders, rheumatoid arthritis, scleroderma, and other autoimmune diseases are more likely to develop lupus erythematosus compared to those without the gene mutation.
Some research indicates that lupus erythematosus is caused by the stimulation of external factors including exposure to ultraviolet light and being bombarded by viruses that are agitated with exposure to the sun. Other known risk factors for developing the disease include:
- Gender – Women are more likely to develop lupus than men
- Ethnicity – The condition is more common among African-American, Asian, Hispanic, and Native American women compared to Caucasian women
- Familial History – Lupus erythematosus is known to run families even though the risk is still quite low if the patient's sister, brother, child or parent also suffered from the disease.
Lupus Erythematosus Symptoms
Every individual suffering from lupus erythematosus will experience different symptoms. Many of them range from mild to severe and can dissipate and return over time. That said, the most common lupus erythematosus symptoms include:
- Swollen and painful joints
- Extreme fatigue
- Unexplained fever
- Swollen glands
- Unusual loss of hair
- Mouth ulcers
- A Butterfly (Malar) Rash appearing across the cheeks and nose
- Photosensitivity rashes occurring on the upper arms, ears, face, chest, hands, and shoulders due to exposure to the sun
- Kidney Problems including nephritis (kidney inflammation) that impairs ridding the body of waste products and toxins
- Lung Problems including pleuritis (inflammation of the chest cavity lining that produces difficulty in breathing and chest pain
- Central Nervous System (CNS) Problems that attacks the CNS or brain causing headaches, depression, dizziness, vision problems, memory disturbances, stroke, seizures, or behavioral changes
- Blood Vessel Problems that lead to vasculitis (blood vessel inflammation) that affects how blood circulates in the bloodstream that could lead to hardening of the arteries (atherosclerosis)
- Blood Problems that develop leukopenia (decreased white blood cell count), anemia, and thrombocytopenia (decreasing blood platelet count).
- Heart Problems including myocarditis (heart muscle inflammation), endocarditis (heart valve damage) and pericarditis (heart muscle lining) leading to chest pains and other serious symptoms.
Diagnosing Lupus Erythematosus
Diagnosing lupus erythematosus can be extremely challenging. That is because no single test can determine the presence of the disease. However, there are numerous laboratory tests that can assist the doctor in making an accurate diagnosis of the condition.
It might take the doctor months or years to formally confirm a diagnosis based on symptoms, an accurate medical history, biopsy results, and tests. Most doctors will use a variety of diagnostic tools to verify the existence of lupus erythematosus. These include:
- Comprehensive Medical History – The doctor will want to know if the patient or family members have any of the signs and symptoms of the disease or has been previously diagnosed with lupus erythematosus.
- Physical Examination – During an exam, the doctor can detect painful or swollen joints, unusual hair loss, ulcers and the mouth, the lupus-associated butterfly rash on the nose and cheeks, kidney problems (nephritis), lung issues (pleuritis), central nervous system issues including memory loss, vision issues, depression, and heart and blood circulation problems including vasculitis, leukopenia, myocarditis, and pericarditis.
- Laboratory Tests – The patient will likely undergo numerous laboratory tests including CBC (complete blood count), ESR (erythrocyte sedimentation rate), complement levels, urinalysis, ANA (anti-nuclear antibiotic test), an anticardiolipin antibody test, anti-DNA autoantibody test, and others.
- Skin Biopsies – This test determines specific conditions, fungal infections, bacterial infections and cancer of the skin.
- Kidney Biopsy – This test can identify kidney disease, kidney problems, and information concerning tumors developing in the kidney.
Diagnosing lupus erythematosus often requires a team effort between competent healthcare professionals and the patient. Likely, an accurate diagnosis will be verified by a rheumatologist or internist who specializes in the body's immune system. However, it might also involve clinical immunologists, nephrologists, dermatologists, hematologists, neurologists, and psychologists.
Treating the Condition
No care exists for systemic lupus erythematosus. Typically, the doctor or team of doctors will attempt to control symptoms that involve or impair the kidneys, lungs, heart and other organs. If the individual suffering a mild form of lupus erythematosus, they may be recommended a treatment of:
- Corticosteroids in low doses including prednisone to diminish arthritis and skin symptoms
- NSAIDs (nonsteroidal anti-inflammatory drugs) to treat pleurisy and joint symptoms
- Corticosteroid creams to treat skin rashes and other skin conditions
- Belimumab that helps some individuals treat the symptoms associated with an overaggressive immune response
- Hydrochloroquine which is an anti-inflammation medication to treat rheumatoid arthritis and lupus erythematosus
The doctor may prescribe additional treatments if the lupus erythematosus symptoms are more severe. These include:
- High doses of corticosteroids
- Coumadin, and other blood thinners, to treat clotting disorders
- Immunosuppressive medications that suppress or dampen the immune system when other treatments including corticosteroids have been ineffective
There are steps that patients suffering from lupus can do to minimize many of the symptoms from becoming worse or prevent others from developing. These include:
- Wearing protective sunglasses, clothing, and sunscreen when exposed to sun rays
- Receive preventative heart care from a competent medical professional
- Ensure all immunizations are up-to-date
- Avoid alcohol consumption and smoking tobacco products
- Have an osteoporosis screen test that identifies the thinning of the bones
In addition, there are support groups and counselors who can assist individuals who are having emotional issues that are common with systemic lupus erythematosus.