10 Things You Should Know About Lupus

Lupus is a complicated disease. Whether it has been suggested you may have lupus, or you have a definitive diagnosis, you should know these 10 basic facts about lupus.

In lupus, the immune system of the body attacks its own cells and tissues. Specifically, the joints, skin, kidneys, lungs, heart, nervous system, and other organs of the body are affected.

1. Systemic lupus erythematosus: affects joints and organs.
2. Discoid lupus: affects the skin.
3. Sub-acute cutaneous lupus erythematosus: characterized by a specific, non-scarring skin lesion.
4. Drug-induced lupus: develops after a drug reaction.
5. Neonatal lupus: affects newborns.

Lupus affects roughly 10 times as many women as men. Most often, lupus develops in people 18 to 45 years old. Though lupus is most prevalent among women, it also may affect men and children, as well as people of all ages.

Lupus is differentiated from other connective tissue diseases, based on eleven criteria offered by the American College of Rheumatology for classification purposes.

• Butterfly-shaped rash across cheeks and nose
• Scaly disk-shaped rash on face, neck, ears, scalp, chest
• Sunlight sensitivity
• Mouth sores, tongue sores, inside nose sores
• Arthritis pain in joints
• Pain in chest and side when breathing or moving
• Kidney problems
• Neurologic problems
• Blood problems such as anemia, low white cell count
• Immune system malfunction
• Antinuclear antibodies

It is recommended that if you have four or more of the eleven criteria, you should consult with a rheumatologist.

Lupus is considered an unpredictable disease, with no two cases exactly the same. The unique pattern of symptoms associated with lupus has caused some to say that lupus is like a snowflake. No two are alike. There are several symptoms of lupus which mimic other rheumatic diseases (e.g., severe fatigue), making the diagnostic process difficult.

Conservative treatment with NSAIDs (i.e., nonsteroidal anti-inflammatory drugs like ibuprofen) and Plaquenil may be appropriate for lupus patients with non-life threatening symptoms such as joint pain, muscle pain, fatigue, and skin rashes. More aggressive treatment which may include high dose corticosteroids or immunosuppressive drugs is used when there are severe organ complications. The benefits and risks of treatment must be weighed by each patient and their doctor.

Though the Lupus Foundation of America estimates that 1.5 million Americans have lupus, the Centers for Disease Control and Prevention offer a more conservative estimate of 237,000. Approximately 70 percent of lupus cases are systemic. In 50 percent of those cases, it is a major organ which is affected.

According to the Lupus Foundation of America, lupus is two to three times more prevalent among people of color, including African-Americans, Hispanics, Asians, and Native Americans.

With careful monitoring of lupus and treatment adjustments as needed, most lupus patients lead normal lives. There may be some limitations and the disease may impose restrictions at times but with good disease management quality of life can be sustained. The worst adversary comes from within, when the patient loses hope, loses will, and gives in to frustration and depression.

Your primary care doctor can refer you to a rheumatologist, or you can get an appointment through self-referral if your health insurance allows it. Evaluation by a rheumatologist is important so that a patient can develop a treatment plan.