Ask a Doc - Lupus

During the month of May, the Lupus Foundation of America works to raise awareness of the chronic disease that can cause pain and inflammation in any part of the body.  Lupus is an autoimmune disease that is difficult to diagnose because it can affect many different parts of the body and cause numerous symptoms.  In the United States, at least 1.5 million people have lupus and about 16,000 new cases of lupus are reported each year.  People of all ages can develop lupus; however, certain people are at higher risk than others, including women ages 15 to 44 and those who have a family member with the disease or another autoimmune disease.

Lupus occurs when the immune system attacks healthy tissues and organs.  Typically, the immune system protects the body from infection by recognizing and responding to antigens – substances such as viruses, fungi or bacteria.  When an antigen is detected, the immune system produces proteins called antibodies to destroy the substance.  In the case of an individual with lupus, the immune system response is mistakenly directed against healthy body tissue rather than a foreign antigen.  
Inflammation caused by lupus can affect many different body systems – including the joints, skin, kidneys, blood cells, brain, heart, and lungs.  Lupus is difficult to diagnose because its signs and symptoms often mimic those of other ailments. The most distinctive sign of lupus is a facial rash that resembles the wings of a butterfly unfolding across both cheeks.  Symptoms may appear and then subside.  Common symptoms often include:

• Fatigue
• Fever
• Painful or swollen joints
• Swelling in the feet, legs, hands or around the eyes
• Headaches
• Anemia
• Sensitivity to sunlight or fluorescent light
• Chest pain when breathing deeply 
• Abnormal blood clotting
• Mouth or nose ulcers

 
Properly diagnosing the disease requires a thorough evaluation of patient history, symptoms, and a number of laboratory tests.
 
The exact cause of lupus is unknown at this time; however, researchers believe the disease develops in response to a combination of factors both inside and outside the body, including hormones, genetics, and environment.  Hormones are a regulatory substance transported in blood and other bodily fluids to stimulate specific cells or tissues into action, and are responsible for regulating many of the body’s functions.  Researchers are investigating a relationship between estrogen and lupus because 9 out of 10 people with lupus are women, but no causal effect has been proven at this time. 

In genetic research, there has been success in identifying genes associated with lupus.  So far, more than 50 genes have been discovered that are more commonly present in people with lupus than in those without the disease.  While no direct cause has been proven, most of these genes are believed to contribute to lupus.  A family history of autoimmune disease is likely in many, but not all, patients who develop lupus. 

Researchers now are focused on trying to determine an environmental agent, such as a virus or possibly a chemical that may trigger the disease when randomly encountered by a genetically susceptible individual.  A specific environmental agent has not been identified as of yet, but the most commonly cited are ultraviolet light, infections, and exposure to silica dust in agricultural or industrial settings.
Early diagnosis, as well as avoiding triggers for the disease, such as excessive exposure to the sun, can aid in the management of lupus.  A number of medications are available that can effectively slow the progress of disease; however, therapy is often tailored to lessen the individual’s particular symptoms.  In addition to controlling their disease, it is vital that patients with lupus engage in regular exercise and lower other risk factors for heart disease, such as smoking, high blood pressure, and high cholesterol.

| Posted On : 9/8/2020 10:29:11 AM