Are you aware of Lupus (Systemic Lupus Erythematosus - SLE)? Let's talk about it!

Do you sometimes feel unimaginable fatigue, body aches, joint pain, or a rash on your skin? If you experience these things not just once or twice, but several at once, the cause may be a disease called lupus. Don't worry, even though this name may sound like a big deal, it is a condition that can be controlled to a large extent if you are properly informed and receive proper treatment. Today, we will talk about lupus in a simple way that you can understand.

What is Lupus? Let's understand it simply.

Simply put, lupus is a disease caused by a malfunction in our body's immune system . Normally, our immune system protects us from diseases and germs. But what happens in the body of a person with lupus is that this immune system mistakenly attacks the healthy cells and tissues of their own body. Imagine, what happens here is like the army that protects our country, mistakenly attacking the people of our own country. Doctors call this an ` autoimmune disease`.

When the immune system attacks in this way, inflammation , which means swelling, redness, and pain, can occur in various parts of the body. This can affect any part of the body. For example:

• Your skin
• Blood
• Junctions
• Kidneys
• Brain
• Heart
• Lungs

It is very important to see a doctor if you notice any new pain, a skin rash, or changes in your skin, hair, or eyes.

What are the main types of lupus?

When doctors talk about lupus, they often call it ``Systemic Lupus Erythematosus (SLE)''. This is the most common type of lupus. ``SLE'' means that the condition affects your entire body. There are also several other types:

• Cutaneous lupus erythematosus: In this type of lupus, the condition only affects your skin .
• Drug-induced lupus: Some medications can cause lupus symptoms as a side effect. However, this is often temporary . This means that the symptoms may go away after the medication is stopped.
• Neonatal lupus: This is very rare. Sometimes newborn babies can have lupus. Not all babies born to mothers with lupus will develop lupus, but there may be a small risk.

What are the symptoms of lupus?

Lupus is a disease that manifests itself in different ways. This means that symptoms can vary from person to person , and the severity of the disease also varies. Some people have very severe symptoms, while others have milder symptoms.

Lupus symptoms are not usually continuous . They come and go. Periods of increased symptoms are called "flare-ups." During these periods, symptoms can be so severe that they can't even function normally. There are also periods of reduced or no symptoms. These are called "remissions."

Symptoms usually develop gradually . Initially, only one or two symptoms may appear, but later more symptoms may appear or the existing ones may change.

Here are some of the most common symptoms:

• Joint pain, muscle pain, chest pain (especially when taking a deep breath)
• Headache
• Skin rash (often a butterfly-shaped rash that runs across the cheeks and nose on both sides of the face - ``Butterfly rash`` - can be seen)
• Fever
• Hair loss
• Mouth sores
• Chronic fatigue (feeling tired all the time)
• Difficulty breathing (`(Dyspnea)`)
• Swollen glands
• Swelling of the hands, feet, or face
• Confusion
• Blood clots

Lupus can sometimes cause other health problems, such as:

• Photosensitivity ( sensitivity to sunlight)
• Dry eye
• Depression or other mental health problems
• Epileptic conditions (`Seizures`)
• Decreased hemoglobin in the blood (anemia)
• Raynaud's syndrome (paleness, blueness of the fingers and toes in cold weather)
• Osteoporosis (thinning of the bones)
• Heart disease
• Kidney disease

What causes lupus?

Experts still don't know the exact cause of lupus , but research has found that certain things can contribute to the development of lupus.

• Genetic factors: You are more likely to develop lupus if you have certain changes (genetic mutations) in your genes. This means that if someone in your family has it, you have a small chance of developing it too.
• Hormones: The body's response to certain hormones, especially estrogen, is thought to play a role in the development of lupus. This is why lupus is more common in women.
• Environmental factors: Things in the environment you live in, for example, air pollution and sun exposure, can affect your risk of lupus.
• Your health history: If you are a smoker, have a lot of stress, or have other autoimmune diseases, your risk of developing lupus may increase.

Who is at higher risk of developing lupus?

Anyone can develop lupus, but some groups are at higher risk:

• Women: Especially women between the ages of 15 and 44.
• Black people.
• Hispanics.
• Asians (we belong to this group too).
• Native Americans, Alaska Natives, and First Nations people.
• Pacific Islanders.
• People who have one parent with lupus.

How is lupus diagnosed?

Diagnosing lupus can sometimes be a bit challenging. Because it affects so many different parts of the body, the symptoms can be very varied. A doctor will diagnose lupus by doing a physical exam and doing some tests .

The doctor or nurse will listen carefully to your symptoms. Tell them everything you know about when you first started having symptoms, what changes you've noticed, and any previous illnesses you've had and any medications you're currently taking.

Don't be afraid to tell your doctor anything that feels strange to you, even if it's something small. No one knows your body better than you do.

What tests are done to diagnose lupus?

There is no single test that can confirm that you have lupus. Doctors usually use a ``differential diagnosis`` to rule out other diseases . This means that they do several tests to find out what is causing your symptoms and make sure that other diseases are not to blame before concluding that you have lupus. Some of the tests that can be used for this are:

• Blood tests: These check how your immune system is working, whether you have infections, conditions like anemia, or low blood cell counts.
• Urinalysis: This helps check your urine for signs of infection or other health conditions.
• Antinuclear antibody (ANA) test: This tests for antibodies. Antibodies are protein markers that show our body's history of fighting disease. Many people with lupus have high levels of these ANA antibodies. This shows that the immune system is overactive.
• Skin or kidney biopsy: Sometimes a small piece of tissue is taken from the skin or kidney and examined under a microscope to see if it has been damaged by the immune system.

What are the treatments for lupus?

Your doctor will recommend treatment for lupus to control and manage your symptoms . The main goals here are:

• Minimizing damage to body organs.
• Reducing the impact of lupus on your daily life.
• Preventing flare-ups.
• Reducing the severity of symptoms during periods of severe exacerbation.

Many lupus patients need a combination of medications . Here are some of the medications you may need:

• Hydroxychloroquine: This is a drug in a class called a disease-modifying antirheumatic drug (DMARD). It helps relieve lupus symptoms and control the progression of the disease.
• Nonsteroidal anti-inflammatory drugs (NSAIDs): These are available over-the-counter (OTC) drugs that reduce pain and inflammation (swelling). Your doctor will tell you which type of NSAID is right for you and how long you should take it. Do not take these for more than 10 days at a time without your doctor's advice.
• Corticosteroids: These are powerful medications prescribed by a doctor to reduce inflammation. Prednisone is a corticosteroid commonly used for lupus. They can be given as pills or as an injection directly into a joint.
• Immunosuppressants: These medications work by reducing and controlling the activity of your immune system, helping to prevent tissue damage and inflammation.

In addition to these main types of medications, you may need separate treatments for specific symptoms you have or for other health problems caused by lupus (e.g. anemia, high blood pressure, thinning bones).

What can you expect if you have lupus?

Lupus is a lifelong (`chronic`) condition . This means that you will have to deal with and manage lupus symptoms throughout your life.

Lupus is very unpredictable . This means that the way it affects you can change from time to time. So, you should see your doctor regularly to monitor changes in your symptoms.

As you learn to live with lupus, you will need to work with a team of doctors . Your family doctor (primary care provider) will recommend the specialists you need. Most often, you will see a rheumatologist — a doctor who specializes in diagnosing and treating autoimmune diseases. The other specialists you need will depend on your symptoms and how they are affecting your body.

Can lupus be completely cured?

Unfortunately, there is currently no cure for lupus . However, your doctor can help you find a combination of treatments that will help control your symptoms and help you achieve a period of remission — a period of time when you have no or very few symptoms.

Can lupus be prevented?

Because experts still don't know exactly what causes lupus, there's no way to prevent it . If one of your parents has lupus, talk to your doctor about your risk.

How to prevent lupus flare-ups?

Although lupus cannot be prevented, there are several things you can do to reduce and prevent flare-ups. This includes avoiding things that make your symptoms worse.

• Avoid sun exposure: For some people, prolonged exposure to the sun can worsen lupus symptoms. So, limit your time outdoors during peak sun hours (usually between 10 a.m. and 4 p.m.). If you do go outside, wear long-sleeved shirts, a hat, and sun-protective clothing. Use a sunscreen with an SPF of at least 50 .
• Stay active: Joint pain can sometimes make it difficult to move or exercise. However, gentle movement and exercise are the best ways to reduce symptoms such as pain and stiffness. Walking, cycling, swimming, yoga, and tai chi are all good ways to move your body without putting too much pressure on your joints. Ask your doctor about exercises that are safe for you to do.
• Get enough sleep and take care of your mental health: Living with lupus can be stressful at times. Getting enough sleep (7-9 hours for an adult) and reducing stress can help some people avoid flare-ups. A psychologist or other mental health counselor can help you develop coping mechanisms.

When should I see a doctor?

If you develop any new symptoms, or if you feel that your symptoms are changing, see a doctor right away. Even small changes in your symptoms can be important.

If you feel that your current treatment is not controlling your lupus symptoms, tell your doctor . If you are having more flare-ups or if your symptoms are getting worse, tell your doctor. Your doctor can help you adjust your treatment as needed.

In an emergency, that is, if you experience symptoms like these, go to a hospital immediately or call 1990:

• If you can't breathe.
• If there is severe pain.
• If you think you are having symptoms of a heart attack.

What questions should I ask my doctor?

When you see a doctor, it's a good idea to ask questions like these:

• Do I have lupus or another autoimmune disease?
• What kind of medications do I need?
• How often should I see you (`follow-up appointments`)?
• Will I need to see other specialists?
• Can you tell me about support groups or other mental health services that might help me?

Finally, what to remember (Take-Home Message)

Lupus can be a frustrating and debilitating condition at times. Living with pain, inflammation, and discomfort throughout your body is not easy. But, don't forget to appreciate yourself . Living with a chronic illness is hard work, so you deserve to be recognized for the effort you put into managing your symptoms every day.

If you think it would be helpful to talk to someone about your thoughts and feelings, ask your doctor about mental health services and support groups.

Don't be afraid to talk to your doctor and ask questions. Even small changes in your symptoms could be a sign that lupus is affecting you differently. Remember, if you feel something is not right with your body, you are the best judge.

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