What is Lupus?
According to the Lupus Foundation of America, Lupus Awareness Month occurs in May of each year and serves as a chance to bring awareness about the disease and its impacts. In the United States, at least 1.5 million people have lupus, impacting roughly one in 2,000 people, with about 16,000 new cases reported annually. While anyone can develop lupus, women ages 15-44 are at highest risk. In fact, nine out of ten people with lupus are women.
Certain racial and ethnic groups are also at higher risk of developing lupus, including people who are African American, Asian American, Hispanic/Latino, Native American, or Pacific Islander. People who have a family member with lupus or another autoimmune disease are also at risk for developing lupus.
Lupus is a chronic disease that can cause inflammation and pain in any part of the body. An autoimmune disorder, lupus occurs when the body’s immune system, which usually fights infections to keep us healthy, attacks healthy body tissue instead.
Symptoms of lupus can differ greatly from patient to patient and can impact any system in the body. This widespread symptom variation can make lupus difficult to diagnose. Signs and symptoms of lupus may change over time and overlap with those of many other disorders. Additionally, no one test can diagnose lupus. A combination of blood and urine tests, assessment of symptoms, and a physical examination often leads to the diagnosis.
Patients with lupus can have chronic, daily symptoms or may have good and bad days. When people talk about lupus, they’re usually referring to systemic lupus. Symptoms of this type of lupus can include:
- Constitutional symptoms are non-specific and can impact the body as a whole, such as fever, weight loss, fatigue, and muscle and joint aches.
- Arthritis manifests especially in small and medium joints of arms and legs, with swelling, heat in the joints, tenderness, and stiffness present. Patients experiencing this symptom may spend an hour or more working to get their joints moving well.
- Rashes can present in lupus patients as a butterfly rash on nose and cheeks, a discoid rash which scars skin and can cause hair loss, and photosensitive rashes.
- Serositis entails inflammation of the lining of the lungs, heart, or abdomen and can cause abdominal pain, loss of appetite, nausea, and vomiting.
- Kidney complications can vary from mild protein levels in urine to severe forms with blood and protein in urine, potentially leading to kidney failure.
- Hematologic symptoms may manifest as low white blood cells, low platelets, and hemolytic anemia, when blood cells are destroyed faster than they can be made. Ninety-seven percent of patients with lupus will also have positive levels of antinuclear antibodies (ANA), indicating a large number of antibodies that attack normal tissue.
Other symptoms of lupus may include headaches, sensitivity to light, sores in the mouth or nose, and chest pain while breathing deeply.
No one knows exactly what causes lupus, but experts think it may develop in response to certain hormones (including estrogen) or environmental triggers that can bring on symptoms of lupus or make existing symptoms worse. Environmental triggers include ultraviolet light from the sun or fluorescent lights, certain antibiotic drugs, having another infection, exhaustion, bodily stress like an injury, and emotional stress.
The good news is, the vast majority of lupus patients survive and have access to methods that help manage their illness. For the first time in 20 years, there are now three new medications for lupus, two of which are biologic medications that have been hugely impactful in the management of the disease. There are also options available to help manage symptoms like inflammation, swelling, pain, and fever.
People with lupus should visit a rheumatologist, like myself, who specializes in diagnosing and treating diseases in the joints or muscles. Our job is to help patients with lupus get the care they need, so they can live full, happy lives and effectively manage their symptoms.