What are the symptoms of Lupus?
The symptoms of lupus can vary from person to person. This means that not everyone will experience the same symptoms. But there are some common symptoms. Let's take a look at what they are.- A red rash on the face or other parts of the body . Sometimes this can appear on both sides of the face in a butterfly-like shape (butterfly rash).
- Skin becomes very sensitive to sunlight . Even just a short exposure to the sun can cause redness and rashes .
- Feeling extremely tired . No matter how much sleep you get, you may feel like this fatigue won't go away.
- Fever that comes on without a reason .
- Joint pain and swelling . This pain may be worse in the morning.
- Raynaud's syndrome . This is when the fingers and toes suddenly turn pale, blue, numb, and painful when exposed to cold. Then they turn red again.
- Muscle aches .
- Weight loss .
- Sores in the nose, mouth, or throat .
- Swollen glands .
- Bald patches and hair loss .
- A decrease in the number of red blood cells, that is, anemia .
- Tendency to have frequent infections .
- Inflammation of the membranes surrounding the heart, abdomen, or lungs . This can cause chest pain and difficulty breathing.
- Seizures or other neurological problems.
- Kidney problems : Symptoms may include protein in the urine and swelling in the legs.
Remember, just because you have one or two of these symptoms doesn't mean you have lupus. But if you have several of these symptoms in a row, it's best to see a doctor for advice.Lupus is most commonly seen in young women, especially those between the ages of 15 and 45.
What are the main types of lupus?
Even though it's called lupus, there are several main types. Let's take a look at what they are.Systemic Lupus Erythematosus (SLE)
This is the most common type of lupus. The word 'systemic' implies that it affects multiple systems in the body. This means that SLE can affect many different organs, including the skin, joints, kidneys, brain, heart, and lungs. This is why the symptoms are so varied.Cutaneous Lupus
This type mainly affects the skin. There are other subtypes of this type, for example:- Discoid Lupus Erythematosus (DLE) : This causes round, coin-shaped, red, scaly patches to appear on the skin. These are most common on sun-exposed areas such as the face, ears, and scalp. If the rash appears on the scalp, it can cause hair loss and sometimes scarring.
- Subacute Cutaneous Lupus Erythematosus (SCLE) : This can cause red, annular, or papulosquamous lesions. These also occur more often in sun-exposed areas. However, they are less likely to cause scarring than DLE.
Drug-induced Lupus Erythematosus (DILE)
This is a different story. Some medications (for example, some medications for high blood pressure, heart disease, and epilepsy) can cause lupus symptoms as a reaction to long-term use. But the important thing is that these symptoms usually go away within a few months after stopping the medication. And it is much less likely to cause serious damage, such as kidney damage.What are the causes of lupus?
It's hard to pinpoint just one cause of lupus. It's usually caused by a combination of factors. Let's look at the main factors that can contribute to it:- Genetic predisposition : If some people have lupus or other autoimmune diseases in their families, they may have a certain predisposition to developing this disease. This means that genes have some influence on it. However, having genes alone does not cause the disease, other factors must also play a role.
- Environmental triggers: Sometimes this disease can be triggered by things in the external environment.
- Infections : It has been found that lupus symptoms can appear after certain things, such as viral infections.
- Certain medications : As we discussed earlier, lupus can occur as a reaction to certain medications.
- Sunlight (UV radiation) : Exposure to ultraviolet radiation can also cause lupus to flare up or develop in some people.
- Extreme physical or emotional stress : Symptoms can sometimes occur after extremely stressful events, such as a serious accident, surgery, or the death of a loved one.
- Hormones : Because lupus is more common in women, scientists believe that the female hormone estrogen may have something to do with the disease. For example, symptoms may change during pregnancy or at certain times of the menstrual cycle.
This means that for someone to develop lupus, they must have a genetic predisposition to it, and there must be an environmental factor or other cause that activates those genes. This is like pulling the trigger of a gun to fire.
How is Lupus diagnosed?
Recognizing lupus can sometimes be a bit tricky because its symptoms vary from person to person and can mimic those of other diseases. If a doctor suspects lupus, they will do the following:- They will ask you a lot of questions about your symptoms : what are your symptoms, when did they start, how they get worse or better, etc. They may also ask if anyone in your family has had these conditions.
- Physical examination : Checks for skin lesions, swollen joints, lungs, and heart.
- Blood tests : This is very important. Blood tests look for things like:
- Complete Blood Count (CBC) : This checks the number of red blood cells, white blood cells, and platelets. People with lupus may have anemia, low white blood cells, and low platelets.
- Antinuclear Antibody (ANA) test : This is the main test done when lupus is suspected. ANA is a type of antibody that is produced against the nucleus of our body's cells. Most people with lupus have a positive ANA test. However, not everyone who is ANA positive has lupus. ANA can also be positive in other medical conditions and in some healthy people.
- Other specific autoantibodies: If ANA is positive, then we also look for antibodies that are more specific to lupus, such as anti-dsDNA and anti-Sm. If these are positive, they are a great help in confirming lupus.
- ESR (Erythrocyte Sedimentation Rate) and CRP (C-Reactive Protein) : These tests can check for inflammation in the body. These can be elevated during an exacerbation of lupus.
- Urine tests : Urine tests are done to see if the kidneys have been affected. They check for protein and blood in the urine.
- Sometimes a tissue sample (biopsy) may be done : If there is a skin lesion, a small piece of it (skin biopsy) may be taken and examined under a microscope to see if there are any changes related to lupus. Also, if there is a suspicion that the kidneys are affected, a small piece of the kidney may be taken and examined (kidney biopsy).
Diagnosing lupus is like solving a puzzle. Your doctor will put together your symptoms, test results, and other information to arrive at an accurate diagnosis. Therefore, it is difficult to make a definitive diagnosis based on a single test.
What are the treatments for Lupus?
There is currently no cure for lupus. But don't worry, there are many effective treatments available to help control symptoms, reduce flare-ups, and minimize organ damage. Treatment is based on which organs are affected and how severe your symptoms are . A person with lupus usually needs the help of a team of doctors.Help from specialist doctors
Because lupus can affect many different parts of the body, it may require the help of multiple specialists. For example:- Rheumatologist : A doctor who specializes in diseases of the joints, muscles, and connective tissue. A rheumatologist plays a key role in the treatment of lupus.
- Nephrologist : A doctor who specializes in kidney diseases. If the kidneys are affected by lupus, this doctor's help is essential.
- Dermatologist : Treats skin conditions such as blemishes and wounds.
- Cardiologist : If there are any effects on the heart.
- Pulmonologist : If there are effects on the lungs.
- Neurologist : If there is an impact on the brain or nervous system.
- Psychologist or Psychiatrist : To help you deal with the stress and sadness that come with living with a long-term illness like lupus.
Types of medications used
Various medications are used to control the symptoms of lupus and prevent the disease from worsening.- Anti-inflammatory drugs :
- Non-steroidal Anti-Inflammatory Drugs (NSAIDs) : For example, drugs like ibuprofen and naproxen. These are given for things like joint pain, muscle pain, and fever. However, these should only be taken under medical advice, as some people may experience stomach problems and kidney problems.
- Antimalarial drugs : Hydroxychloroquine is the most commonly used drug. Although it is a drug for malaria, it is very helpful in reducing skin rashes, joint pain, and fatigue in lupus. It also reduces the severity of the disease.
- Corticosteroids : Medications like prednisolone. These help reduce inflammation and immune system activity quickly. These medications are used when the disease is severe and when organ damage is life-threatening. However, because these can cause side effects (weight gain, diabetes, thinning bones, and increased susceptibility to infections) when used long-term, doctors try to give them in the lowest possible dose for the shortest possible time.
- Immunosuppressive drugs : Drugs like Azathioprine, Mycophenolate, Cyclophosphamide, and Methotrexate. These work by reducing the activity of the immune system and stopping it from attacking its own body. These drugs are used when there is serious organ damage, especially the kidneys. You should always be under medical supervision while taking these drugs, as the risk of developing infections increases.
- Biologics : Newer medications, such as Belimumab and Rituximab, are now available. These target specific parts of the immune system and may be more effective for some people.
The most important thing is to take the medicine prescribed by your doctor as prescribed, at the prescribed time, and for the prescribed period of time. Your doctor will decide which medicine is right for you and how long you need to take it. Never stop taking your medicine or change the dosage on your own.
What else do you need to know about living with lupus?
Since lupus is a long-term disease, it's important to learn to live with it. In addition to medication, there are some simple changes you can make to your lifestyle that can help manage symptoms and prevent flare-ups.- Protect yourself from the sun.: Many people with lupus are sensitive to sunlight. So avoid going out in the sun between 10 a.m. and 4 p.m. as much as possible. If you do go out, use a sunscreen with an SPF of 30 or higher. Wear long-sleeved clothing, a hat, and sunglasses.
- Get plenty of rest : Fatigue is a major symptom of lupus. So try to get at least 8 hours of sleep a day. It's also good to get some rest during the day. Don't overwork your body.
- Eat a healthy diet : It is very important to eat a balanced diet. Include vegetables, fruits, legumes, fiber-rich foods, and lean proteins (fish, chicken) in your diet. Reduce processed foods, high-sugar foods, and high-fat foods.
- Exercise : Don't just sit in one place because you're tired. Gentle exercises like walking, swimming, and yoga can help reduce joint stiffness, strengthen muscles, reduce fatigue, and improve mental health. But it's best to ask your doctor about what exercises are right for you.
- Stress management : Stress can worsen lupus symptoms. So try to reduce stress through things like meditation, yoga, deep breathing exercises, and engaging in a hobby you enjoy.
- Avoid smoking : Smoking can worsen lupus and increase the risk of heart disease. So if you smoke, get help to quit.
- Go for regular medical checkups : Go to your doctor's appointments exactly as they are scheduled. This is very important to see if the medication is working properly, if there are any side effects, and if the disease is under control.
- Recognize flare-up warning signs : Try to understand what symptoms you have before a flare-up (e.g., increased fatigue, new joint pain, skin rash). If you tell your doctor as soon as you notice these symptoms, you can start treatment early and prevent the disease from getting worse.
- Inform your educational or workplace : If you are a student, tell your teachers and school staff about your condition. Then you can get the support you need. If you are employed, inform your workplace if necessary.
Living with lupus can be challenging, but you are not alone. Get support from your medical team, family, and friends. Be well-informed about the disease.
Take-Home Message
Okay, so I hope you have a good idea about Lupus from what we have discussed. Finally, here are some important things to remember:- Lupus is a long-term disease in which our own immune system attacks our body. It can affect multiple organs.
- Symptoms vary from person to person. Skin rashes, joint pain, extreme fatigue, and fever are some common symptoms.
- Medical advice and tests are essential for an accurate diagnosis. Do not try to diagnose the disease yourself.
- Although lupus cannot be completely cured, there are now very effective treatments to control symptoms and improve quality of life.
- It is very important to use the medication prescribed by the doctor exactly and to go for the prescribed tests.
- Simple lifestyle changes (protection from sunlight, healthy diet, exercise, stress management) can go a long way in controlling the disease.
- You are not alone. There are doctors, nurses, counselors, and your loved ones who can help you cope with lupus.
The best way to live successfully with lupus is to be aware of it, talk openly about it, and get the support you need. If you have any concerns, don't be afraid to talk to a doctor.
Lupus, SLE, autoimmunity, symptoms, treatment, Sri Lanka, autoimmunity, joint pain, skin diseases
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