Causative & risk factors
Lupus is an autoimmune disorder in which the body’s immune cells mistakenly identify the body’s own cells as foreign and attack them.
Lupus can be triggered by infections, stress, certain drugs or excessive exposure to sunlight.
About 90% of people affected with lupus are women. Belonging to certain races especially African or Asian is associated with a higher risk of developing lupus.
Clinical presentation
The symptoms of lupus undergo frequent aggravations and remissions (“flares”). The patient develops fever, weakness, aches and pains and extreme sensitivity to the sun.
Skin rashes are characteristic of lupus. DLE produces circular rashes on sun-exposed parts of the skin whereas SLE produces a butterfly shaped rash (lupus rash) across the cheeks and the bridge of the nose.
The circulation to fingers and toes is hampered. Sores may be present on the skin, mouth, nose etc. The patient may suffer from weight loss and hair loss. The lymph nodes may be swollen. Other symptoms include headache, chest pain, confusion, seizures and problems with memory.
Severe or untreated lupus can cause a lot of damage to the kidney, heart, blood vessels, lungs or brain giving rise to several complications which may be fatal.
Investigations
Lupus is a difficult diagnosis to make since the presentation is variable. Antinuclear antibody test combined with presence of lupus symptoms is confirmatory of this condition.
Several other laboratory tests are done to either look for the differential diagnosis or to gauge the extent of damage caused by lupus. These include Complete blood count (CBC), urine analysis, ESR, CRP, complement testing and partial thromboplastin time test.
If damage to any vital organs is suspected, other specific tests will be suggested such as echocardiogram, X-rays, CT scans, MRI scans and biopsy of the affected organs.
Treatment
Lupus is an incurable condition. Treatment is aimed at relieving the symptoms and preventing organ damage.
The patient must follow basic principles of healthy living such as a balanced diet, regular exercise, adequate sleep and freedom from addictions.
Medications for lupus include anti-inflammatory drugs, corticosteroids, immune-suppressive drugs, anti-malarial drugs, anticoagulants and monoclonal antibodies.
Regular intake of vitamin D, fish oil, flaxseed and a hormone DHEA may have a beneficial effect on symptoms of lupus.
Recent updates
A synthetic, plant derived compound has been found to treat lupus with lesser side-effects than the existing drugs. This compound is currently under research study.
