MAY10th is World Lupus Day

What is Lupus?

Lupus is an autoimmune disease that causes your immune system to attack your body’s own tissues. It can cause inflammation in many different parts of your body.

Who develops Lupus?

Usually women are likely to get lupus six times more when compared to men. The main trigger of lupus is hormonal activity and change, and it can often trigger after childbirth, at the menopause or during puberty and usually between the ages of 15 and 55.

What causes lupus?

It is not known why lupus occurs. Possible triggers of lupus include infections, medicines (for example, minocycline or hydralazine) or sunlight. Hormonal changes may play a role in lupus, which could explain why it is much more common in women.

What are the symptoms?

It varies between people. Many people have tiredness, weight loss and a mild raised temperature. In addition, joint pains, muscle pains, skin rashes, mouth ulcers, hair loss and blood abnormalities can also develop. Sometimes the tissues that cover the heart and lung may become inflamed. Around 1 in 3 people with lupus may develop inflammation of the kidneys, which can lead to the kidneys leaking protein and blood into the urine. Mental health problems are fairly common and include depression and anxiety. Occasionally, inflammation of the brain can lead to epilepsy, headaches, migraines and other conditions. Typically, there are times when the disease flares up (relapses) and symptoms become worse for a few weeks, sometimes longer.

How is lupus diagnosed?

If your symptoms suggest lupus then your doctor will usually do some blood tests such as antinuclear antibody (ANA), anti-double-stranded DNA (anti-dsDNA) and complement tests.

What is the treatment?

Although there is no cure for lupus, this condition can usually be controlled, and symptoms eased. Most people with lupus are seen regularly by a Rheumatologist who advises on treatment. The treatments may vary from time to time, depending on the severity of the disease or flare-up of symptoms and also which parts of the body are affected. You may even not need any treatment if you have very mild symptoms. Treatment options include the following:

Non-steroidal anti-inflammatory drugs (NSAIDs)

These are often called anti-inflammatory painkillers and are commonly prescribed to ease joint or muscle pains.

Hydroxychloroquine

Hydroxychloroquine is often effective and may take 6-12 weeks for it to become fully effective. The dose is often reduced to a lower ‘maintenance’ dose once symptoms have eased. Side-effects are uncommon. The most serious is damage to the eye, which is unusual. Your doctor is likely to check your vision before you start it and then every year.

Steroids

Steroid tablets are usually advised if you develop more severe symptoms and to reduce inflammation. Steroids may cause side-effects if taken for long periods. Hence the doctor always monitors the dose regularly to ensure safety.

Immunosuppressants

Medicines such as azathioprine, ciclosporin, cyclophosphamide, methotrexate and mycophenolate mofetil may be advised if you have severe lupus. These medicines are known as ‘immunosuppressive’ because they work by suppressing the immune system. One side-effect of these medicines is that you will be more prone to developing infections. If you take one of these, you need to have regular blood and urine tests to look out for possible side-effects. There are also medicines called biologics that can be used for severe lupus such as belimumab and rituximab.

What is the prognosis?

Most people with lupus lead active, normal lives. The outlook for people with lupus is much better than it was in the past. Modern treatments are more effective. For many people with lupus, symptoms are mild or moderate with little risk to life. The joint and skin symptoms may continue but can usually be eased with treatment. For a few people, lupus is severe and can be life-threatening.

Are there any tips?

Avoid the sun. Strong sunlight can aggravate symptoms of lupus. Long-sleeved clothing and wide-brimmed hats are best in sunny weather. On hot sunny days you should wear a sunblock on exposed skin, with a protection factor of 25 or above that protects against UVA and UVB.

Try to avoid infections. If you have lupus you are more prone to infection, particularly if you take steroids or immunosuppressant medication. Avoid contact with people who have infections.