Understanding Lupus and its Symptoms
As much as medical technology and research have advanced, the human body is still highly susceptible to a wide range of illnesses and diseases. Some of these aren’t too serious and come seasonally, such as the common cold. Others can be inherited genetically, and still, others can come out of the blue and by surprise. Whilst various diseases can be avoided through making wise lifestyle and health choices and reducing your risk of exposure to certain strains of bugs, other diseases are unavoidable and can come about through a mixture of environmental and genetic factors, more often than not in a way that’s entirely outside of your control.
Lupus is one such disease that can arrive out of nowhere and, sadly, is a chronic (long-lasting, beyond 3 months or so) disease. Vaccines normally cannot prevent chronic diseases, nor are they easily cured by certain medications. They can often linger for years in a debilitating manner that can affect the patient’s day-to-day living standards and experience. Many treatments for chronic diseases focus on pain management in order to minimize symptoms and provide the best standard of living possible when there’s no medical cure in sight. People who suffer from chronic diseases often require a mixture of treatments that not only deal with their physical symptoms but their mental wellbeing, as living with a chronic disease can lead to mental issues such as anxiety and depression. If you find yourself diagnosed with any form of chronic disease, keep in mind that any process towards healing will require a holistic approach to your health and wellbeing, adopting treatments and habits that encourage your physical, mental and emotional health.
Lupus itself is a disease that occurs in the body’s immune system, making it an autoimmune disease. Because of this, it can affect many different areas of the body, with symptoms occurring beyond a single isolated area. Symptoms can also look different from individual to individual and can change over the course of the lupus disease, with different symptoms flaring up at different times. As such, the path towards an effective treatment is a very individualized process. It’s important that those diagnosed with lupus work with a team of medical professionals covering many specialties in order to receive the care they need.
Unfortunately, there is no single known cause for lupus, which makes it all the more harder not only to avoid but also to treat and ideally cure. Most doctors believe lupus occurs as a combination of both genetic and environmental factors, which contributes to the difficulty in isolating potential causes as a means to reach a cure. Scientists and medical experts have been investigating lupus and its causes for centuries throughout the various forms of medical research available at the time, but it’s only within the past 70 years that much progress has been made after key breakthroughs and discoveries. However, there is hope within the medical community that these discoveries, coupled with the emerging technologies that time is bringing, will lead to a breakthrough in not only effective treatments but an effective cure for lupus that will see its presence abolished in patients’ bodies once and for all.
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There is a variety in the kinds of lupus one may be diagnosed with. Systemic lupus erythematosus, which is known as SLE, has the ability to affect just about any organ or bodily system, leading to widespread symptoms that can manifest in a wide variety of ways. In comparison, Discoid lupus is a less intense version that generally manifests in skin symptoms, causing less pain and suffering to the afflicted individual but often causing a great challenge when it comes to living everyday life normally, due to the presence of intrusive rashes across the skin and face. Beyond that is subacute cutaneous lupus, which is milder again. There’s even lupus which is induced by drugs, but this version of lupus fades away once the medicine which caused its appearance is stopped and does not carry with it long-lasting damage.
There’s also a very rare type of lupus called Neonatal lupus, which affects newborns. However, this type of lupus is not as common as the preceding three kinds, which affect teenagers and adults.
Although lupus is quite a rare disease, it’s interesting to note that the majority of people diagnosed with lupus – roughly 90% – are women, who mainly see the condition develop between the ages of 15 and 45. Many people have lupus lying dormant in their system for years before it finally develops.
The symptoms lupus brings vary from individual to individual and can manifest in many different forms. Common symptoms are pain, stiffness and swelling in joints, and rashes which can break out across the skin. People also experience fevers and a feeling of constant tiredness. Because some of these symptoms are easily assigned to other chronic or shorter diseases, lupus is also difficult to diagnose and requires an elimination process which takes a course over time in order to confirm that lupus is the culprit at work.
Although there is no single known cure to get rid of lupus forever, those who are diagnosed with it are able to find treatment. The majority of people who have lupus are able to manage and minimize the disease’s impact and to continue to enjoy a high quality of life. Diagnosis is the first step in moving forward in finding a treatment that works for each specific individual, taking into account their specific lupus symptoms and their pre-diagnosis lifestyle.
What does Lupus actually do to your body?
Our bodies are marvelously designed to deal with a wide range of needs everyday life throws in its path. The immune system is specifically designed to attack foreign substances that threaten the body with their presence. When it’s functioning properly, the immune system is the gateway that protects the body from intruders that threaten harm and could lead to serious problems. However, a problem arises with this design when lupus is present, as lupus causes the immune system to instead turn its attack onto healthy cells and tissues. The very system designed to protect the body then turns into the system attacking it, leading to a complicated situation where the treatments which could provide assistance often risk reducing the function of one of the body’s core systems.
Many people with lupus experience pain in their joints and skin, which are some of the most painful side effects of lupus that occur. Indeed, the pain even continues on to internal organs, including their kidneys, the heart, the lungs, and blood vessels and all the way up to the brain. Lupus is a disease that affects such a huge range of the body’s moment-to-moment functions – steps to mitigate the pain it causes are essential for those who have a positive diagnosis of the disease.
Lupus can manifest in the following ways…
As a Malar Rash – this is a rash that often takes the shape of a butterfly across the nose and cheeks. These rashes may be subtle, but they can also be extremely visible, causing discomfort on many levels for the individual, as well as a practical challenge when it comes to reducing the appearance of the rash for day-to-day functionality and activity.
Discoid rash – Discoid rashes often appear on the scalp and the ears, taking the form of round lumps. These can be difficult to diagnose given their form and require the insight of a trained doctor familiar with lupus in all of its forms.
Serositis – this is a form of inflammation that occurs in the lungs, the heart and the abdomen, causing pain and discomfort for the patient. This can also lead to further health complications, as these areas are put under strain and their functions are carried out under less than ideal circumstances.
As oral lesions – lupus brings with it a specific kind of oral lesion that appears most often as a sore on the roof of the mouth. Again, these are painful and uncomfortable and can interfere with everyday eating, drinking and talking, not to mention kissing! These can appear throughout the mouth and cause strong discomfort.
one of the common symptoms of lupus is Arthritis, causing mild to an extreme joint pain that focuses on the hands and knees in specific. People diagnosed with arthritis can also be at risk of lupus, but do not always have both diagnosed at the same time. If you’ve already been diagnosed with arthritis, it’s wise to familiarize yourself with the symptoms of lupus, so you can keep an eye on your own body and be vigilant against the disease’s presence.
Lupus Pleuritis – fluid around the lungs that results from lupus causes chest pain with every breath. This reduces everyday function as the individual afflicted struggles to breathe to full capacity.
Lupus Nephritis – lupus also has an impact on the kidneys, leading to a kidney disease of various strengths from person to person. This is most often only found to its full extent upon biopsy.
Lupus throughout the Nervous System – one of the core issues with the diagnosis and treatment of lupus is that it can appear in widely different manners. Lupus in the Nervous System affects the brain and the nervous system and can lead to many physical and emotional syndromes such as anxiety, seizures, memory loss or common headaches. Of course, this is an area that can cause great concern for those with lupus, as these areas can result in a lifetime debilitation.
Fatigue – lupus is an extremely debilitating disease, leading the body to feel tired. This is another way in which those afflicted with lupus find themselves suffering throughout their day to day life, as even their normal routine becomes more taxing and requires greater effort at a higher energy cost.
Fever – this is one of those symptoms that can result because of something else, so this requires the diagnosis of a doctor. If you’re experiencing a fever with a number of other lupus symptoms, it’s wise to let a medical professional confirm or deny the presence of a chronic illness.
Hair loss – this is an unfortunate side effect of lupus that can cause distress for male and female patients alike.
Blood clots – lupus increases the risk of blood clots, which can lead to many other health issues and is particularly problematic for pregnant women and those with an existing high blood pressure, who are already at risk of blood clot complications.
History of Lupus
Lupus is a word attributed to its first use to a physician from the thirteenth century named Rogerius. Rogerius used the word because of its Latin meaning of ‘wolf’, which he linked to the facial lesions that had similarities to a wolf’s bite. Lupus then fades from the history books until the early nineteenth century, when various dermatologists studied the dermatologic features of lupus and created descriptions that grew to be commonly used. As lupus often reveals itself through its skin symptoms, dermatologists are often very familiar with its external presence and are able to alert their patients to a potentially more serious cause behind an external change in the skin.
Published illustrations of lupus were first seen in the 1856 Atlas Of Skin Diseases by Ferdinand von Hebra, an Austrian dermatologist involved in this early study. His work contributed to those who followed in its thoroughness and descriptive nature.
Its first systemic description came via the work of Moritz Kaposi, a dermatologist who in 1872 wrote the following description of lupus’ systemic nature…
‘Experience has shown that lupus erythematosus… may be attended by altogether more severe pathological changes and even dangerous constitutional symptoms may be intimately associated with the process in question, and that death may result from conditions which must be considered to arise from the local malady.’
Kaposi believed there were two types of lupus, one being the discord form and the second a systemic form. He also went on to list symptoms that arose from the presence of lupus in an individual’s system, providing a framework for those who would take up his work at the turn of the century. This work was important as it led to the firm establishment of the existence of systemic lupus later in 1904, when two pathologists in Vienna expanded upon Kaposi’s work, further cementing his research within modern medicine.
However, it was 1948 before the modern era was beckoned in with the discovery of the LE cell. These cells were observed by scientists in the bone marrow of people who had presented with lupus. This marked the beginning of the present time we’re in when immunology is the application of choice in the treatment and study of lupus erythematosus. The revelation of immunology as the way forward in choosing treatment methods to focus on from a research and application perspective came about through the discovery of lupus within the immune system and from within the bone marrow.
1954 marked another important achievement – this was the first time when it was discovered that lupus had a genetic component to its evolution. In the twenty years that followed, further studies focused on the familial aggregation and association of genetic markers with lupus, providing scientists with insight into the direction their research needed to take in order to move towards potential treatment options. Of course, this has proved puzzling for researchers, as a chronic disease with both genetic and environmental factors is far harder not only to control but also to remove.
Animal studies have long been used in the quest for advancements in the study of lupus. The first animal model of this systemic lupus occurred in a mouse, which provided scientists with great insights into how the disease worked, its mechanisms and the evaluation of recently developed treatments. The work carried out in these settings has led to the development of certain prescription drugs which can assist in the pain management whenever someone with lupus is going through a ‘flare’ of symptoms.
Although the history of lupus dates back to at the latest the Middle Ages, the advancements over the past 70 years have allowed for the development of new knowledge, understandings and further insight into how to provide the best and most effective treatment as scientists continue to look for a cure.
What about Lupus and Genetics?
It’s not great news to hear that lupus is often inherited genetically, which gives you little to no control over whether or not the disease will appear in your body.
Lupus is not inherited in the same manner other genetic traits, such as eye colors, are inherited. There are around 40-50 genes which each contributes to the risk for lupus. The irony is that each of these genes, when independent of each other, actually contributes to a stronger and better immune response. The problem occurs when too many of this range of genes is inherited, leading to the abnormal immune response that in turn develops into lupus.
The Human Genome Project is the key that has allowed us this insight into the identification of these different genes via the sequencing of DNA. Because of this, research has been able to show that the same genes that lead to the development of lupus can also be a part of contributing to a well-functioning immune system. This leads to the conclusion that personalized medicine is required, which would allow for the identification of very specific genes in someone’s genetic DNA profile that predicts the risk of the development of lupus throughout the course of their life. If lupus is caught before it has begun to show its symptoms, doctors are able to interfere with the genetic progression and are potentially able to stop lupus in its tracks. There’s a small window of time for this to occur, and genetic mapping, coupled with an understanding of your family’s genetic history and predisposition to lupus, is currently the only way to attempt to stop lupus before it emerges in someone who is genetically destined to be diagnosed with the disease.
Other Diseases Like Lupus
Another area of challenge in the identification and treatment of lupus is the host of other diseases it shares similarities with. There are over 100 autoimmune diseases with symptoms that can overlap, so it requires a trained eye that can identify patterns in these symptoms to differentiate from one autoimmune disease to the next.
Diseases that are commonly mistaken for lupus include Lyme disease, fibromyalgia, hypothyroidism, Multiple Sclerosis (MS) and a range of viral and bacterial infections. These diseases can share common patterns and symptoms. Lupus is known by many as ‘the great imitator’ because of the way it often presents as a different chronic disease, so ensuring your doctor is familiar with lupus and its particulars is crucial if you suspect you may be suffering from its symptoms.
Many symptoms such as aches and pains, fatigue and inflammation throughout the body can cross over into the fields of other chronic diseases. However, lupus will often have a mixture of these symptoms, and it’s this particular cocktail of symptoms that doctors are able to use to finalize a diagnosis.
The marvel of modern medicine means that doctors are now familiar enough with the subtle differences in autoimmune diseases that they can clinically diagnose to great success, by ruling out some symptoms and honing in on the presence of others.
How Lupus Develops
Lupus is not a disease that is fast occurring, and it does not develop over a short time period such as a few hours or a number of days. Research has proven that although the genetic requirements for lupus may be in your body, it could be years before lupus symptoms develop. The autoantibodies that contribute to the disease can be attacking your body in small ways that ultimately mean you still feel completely fine and normal, even as the disease begins to take root and start its impact on your day-to-day life.
This stage is known as pre-lupus and provides a small but important window of time before the appearance of full symptoms in which doctors may be able to intervene early enough in order to block the development of lupus itself. Obviously, this would be the preferred method of treatment – cutting the disease off before it has the time to take root and begin to cause pain and suffering. However, it’s still early days in scientific and medical terms, and further research is needed before doctors will be able to modify or nullify the genes that lead to lupus.
The one benefit individuals with a potentially genetically inherited lupus is, if there’s a strong family history of the disease, doctors may begin treatments for this person before any sign of lupus has developed. Doctors are also able to advise these individuals who are more highly at risk of developing a genetically inherited lupus about how to modify their lifestyle in order to reduce lupus trigger factors that are known. These include refraining from smoking and staying out of direct sunlight.
Best Treatments for Lupus
Lupus is not a disease that is easy to treat, and instead, requires a host of medical experts in order to provide you with the custom care you need for your own specific kind of lupus and its symptoms. Often, a health care team treating a patient suffering from lupus will include a general GP, a rheumatologist (these doctors treat arthritis and other diseases related to swelling and pain in the joints), a clinical immunologist (with a focus on immune system disorders), a nephrologist (the treatment of kidney disease), a hematologist (the treatment of blood disorders), a dermatologist (the treatment of skin diseases), a neurologist (nervous system treatment), a cardiologist (heart and blood vessel treatment), an endocrinologist (the treatment of any problem that relates to hormones or glands) and a psychologist, who keeps an eye on the patient’s mental health as they progress through this wide range of treatments.
The first step in treating lupus is the development of a treatment plan between you and your doctor. This plan should be reviewed regularly with an eye on how your body is responding to the specific range of treatments and plan of attack you’re undertaking. If you develop any new symptoms over the course of this treatment, it’s crucial to report these to your doctor immediately, so that any existing treatment plan can incorporate in a new approach designed to directly deal with the treatment of that specific symptom.
People who suffer from lupus use the terminology of ‘flares’ to describe what occurs when a lupus symptom decides to rear its head. This flare can relate to a wide variety of symptoms, and much of the research on lupus has been focused on how those diagnosed with the disease can be on the lookout for flares, and how to equip people to deal with flares when they inevitably occur. It’s important to know that stress is a major cause of a flare, so keeping calm, relaxing and taking time out for yourself is important in reducing the risk of symptoms suddenly flaring up across your body.
There are also medicines available for the treatment of lupus, with prescriptions and dosages varying on your specific lupus symptoms.
Common medications for lupus include…
Nonsteroidal anti-inflammatory drugs (NSAIDS) – these are drugs which can be given over the counter and are used to treat pain, swelling, and fever. However, to get a stronger NSAID, a prescription is required. It’s best to consult your doctor before undertaking any form of NSAID medication, as side effects can include stomach bleeding and an increased risk of kidney or heart problems.
Antimalarial drugs – interesting, medications, which are used to treat malaria, can also actively help control lupus. However, these drugs also bring their own risk of side effects, including (on rare occasions) damage to the retina.
Corticosteroids – these are one of the most common forms of treatments for lupus, as they work to control the inflammation. Unfortunately, these kinds of drugs can come with a host of side effects that can set in for the long term, including weight gain, osteoporosis, and increased blood pressure. When taking over the long term, these side effect risks increase. This medicine should only be taken after thorough consultation with your doctor, and only as a part of an overall plan of attack for minimizing the symptoms of lupus and bringing balance back into your everyday life.
Immunosuppressants – because the immune system unintentionally becomes a carrier for the damage lupus does to the body, drugs that suppress its activity can be great tools in minimizing lupus’s symptoms and damaging effects. However, as always, these also have their own side effects, namely an increased risk of infection, damage to the liver and a decrease in fertility.
When facing a chronic disease diagnosis, remember that you have a team of trained medical professionals around you to assist in making wise and productive decisions. Many people diagnosed with lupus find they are able to resume their normal, everyday lives once certain treatment plans and approaches are in place.
If you believe you may have lupus, speak to your GP about ruling out any other possible cause for your symptoms and don’t stop until you know what’s going on in your body. Lupus is a disease which rears its head in a variety of ways and the journey looks different for each individual who’s diagnosed with it, so keep a clear head, discover your options, and tackle each symptom one at a time until the pain has been minimized to the fullest extent possible.
Above all, don’t give up – take each day one step at a time and work towards the healthiest version of you possible. There’s too much beauty in life to let a condition like lupus keep you from living it to the fullest. With the support of your friends and family, a strategically designed treatment plan, and an awareness of the life factors that can minimize lupus’s symptoms and impact on your body, there’s lots of hope for the future.