What You Need to Know about Lupus

by Lea Herring

This article was originally published on Sharecare.

Celebrities like Selena Gomez have revealed that they have lupus—and while the condition is relatively rare, it affects about 1.5 million people in the U.S.

GuptaAngelaLupus is a chronic, autoimmune condition that can cause inflammation and damage any part of your body. “Your immune system—which helps protect your body—gets confused and starts attacking itself instead,” says rheumatologist Angela Malani, MD, of St. Joseph Mercy Ann Arbor in Ypsilanti, Michigan. “It can attack your skin, causing skin changes and rashes,” she says. “It can attack your joints, causing arthritis. It can affect your internal organs: your brain, heart, lungs, kidneys and digestive system.”

According to the Lupus Foundation of America, over 16,000 new cases of lupus are identified every year in the U.S. Some who receive the diagnosis assume that because there is no cure, it’s a life-or-death situation. Fortunately, that’s usually not the case. Dr. Malani says that lupus doesn’t affect everyone in the same way. “One patient may just have skin manifestations,” she says. “Another may have skin rashes and arthritis, and still another may have rashes, arthritis and kidney disease. That’s part of what makes it a tricky disease to understand.”

Here’s what you need to know about lupus: risks, symptoms and treatment.

Who’s at risk
Lupus can affect anyone, but environmental factors, such as an infection or medication—or some other unknown environmental factor—can initiate the disease in people who have a genetic disposition to it. Other risk factors include:

  • Age: Lupus usually develops between the ages of 15 and 44.
  • Sex: Mainly women, but men can also be affected by lupus.
  • Race and Ethnicity: Hispanic-American, Asians and African-Americans are at a higher risk than Caucasians. In fact, African-American women are two to three times more likely to develop it than Caucasians.

Common symptoms
Many lupus patients experience their symptoms as joint pain, a red rash resembling a butterfly on their cheeks and nose, and raised red patches. Other common lupus symptoms, which may come and go as flare-ups, include:

  • Dry eyes
  • Extreme fatigue
  • Chest pain when taking deep breaths (pleuritis and other lung problems)
  • Pale or purple toes or fingers, called Raynaud’s Phenomenon
  • Swollen glands
  • Swelling around eyes and leg (edema)

“Many people can control their symptoms, and it’s only a small subset of patients that have the more severe form of the disease,” says Malani. If you experience any of these symptoms, see your healthcare provider.

How to get diagnosed
Lupus is a hard disease to diagnose because its symptoms are similar to other conditions, such as rheumatoid arthritis, fibromyalgia and heart disease. But the earlier it’s detected, the more beneficial your treatment plan. “Your doctor can also watch for new involvement in an organ,” says Malani.

To determine whether or not you have lupus, your rheumatologist will likely run some blood tests first. The anti-nuclear antibody test (ANA) checks for antibodies in your blood. Antibodies are the body’s way of responding to an infection, and 98 percent of lupus patients have a positive ANA test. Your rheumatologist will also review your symptoms, family history and perform a physical to help make the diagnosis.

If there is suspicion that internal organs, such as the kidneys or liver are affected, other specialists, such as a nephrologist, who specializes in kidney diseases, may be called into help make the diagnosis. “If the patient has a skin disease, we’ll call in a dermatologist,” says Malani.

The best treatment for you
A rheumatologist focuses on the disease as a whole and creates the overall lupus treatment plan, working with other specialists as needed. Malani says that nearly all lupus patients end up taking hydroxychloroquine or chloroquine, two anti-malarial drugs. “These medications help calm the overactive immune system,” says Malani. “They’re thought to reduce flares, decrease the risk of future organ damage, improve quality of life and decrease mortality,” she says. If you are taking these immunosuppressive drugs, your healthcare provider will monitor you for retinal toxicity, a side effect that may cause irreversible vision loss. “It’s rare, but it can affect the eye, and someone on this drug needs regular eye exams,” says Malani.

Other anti-inflammatory medications may be taken on a short-term basis:

  • NSAID’s like ibuprofen and naproxen
  • Steroids such as prednisone and methylprednisolone

While medication is a common treatment for lupus patients, Malani also recommends healthy habits to help better manage lupus symptoms. Those that can help include:

  • Managing your stress levels
  • Getting regular exercise
  • Maintaining a healthy diet
  • Getting a good night’s sleep
  • Adequate sun protection. Lupus patients can be especially sensitive to the sun and exposure to ultraviolet (UV) rays can trigger flare-ups. Wear sunscreen that blocks both UV-A and UV-B rays with SPF 55 or greater.

Lupus and pregnancy
If a woman with lupus becomes pregnant, symptoms are trickier to treat because certain medications can become toxic to the baby. “For patients who want to become pregnant, we try to make sure that their disease is quiet for at least six months before they become pregnant,” says Malani. If you’re already pregnant, work closely with your rheumatologist to ensure a successful and healthy pregnancy.

The bottom line
“People can go on to have a very good quality of life by managing their symptoms,” says Malani. If you feel your lupus symptoms worsen, talk to your rheumatologist about more advanced treatment options.

Learn more about Lupus.

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