Lupus
(SLE · Systemic Lupus Erythematosus)
In this condition factsheet:
The Facts on Lupus
Lupus, also called systemic lupus erythematosus (SLE), is a chronic inflammatory condition that can affect any part of the body, including the skin, joints, kidneys, heart, lungs, and nervous system. It is one of the most common autoimmune diseases (diseases in which the immune system attacks its own body tissues).
Lupus is an unpredictable lifelong condition that typically affects young women between 18 and 45 years of age, but it can affect men and those older or younger as well. It is estimated that lupus affects over 1 in 1,000 Canadians. Between the ages of 15 to 45, women are diagnosed with lupus 8 times more frequently than men. In the early days of treating lupus, doctors only recognized the most severe cases and there were very limited treatments. As a result, the survival rate was not very good. Today, doctors usually recognize cases much earlier, and more mild cases, and there are now better ways of managing the disease. As a result, while there is still no cure for lupus, the survival rate is more than 95% 10 years after diagnosis.
However, available treatments all have risks and side effects, so people with lupus sometimes have to choose between those risks and the effects of their disease. In some cases, the disease is more moderate and minimal treatment is needed.
Causes of Lupus
It's generally believed that lupus is caused by alterations in the immune system. The body's immune system normally fights foreign bacteria and viruses; however, with lupus, the immune system may fail to recognize "self" substances and will make antibodies that attack the body's own tissue. This is called autoimmunity.
The exact cause of lupus is still unknown. Multiple factors are involved in the development of the disease, including heredity and environmental factors. It is recognized that sunlight causes symptoms to flare up.
Other triggers include viral infections, the stress of illness, sometimes pregnancy, and certain medications. Because more women are affected than men, another theory suggests a relationship with estrogens.
Symptoms and Complications of Lupus
With lupus, symptoms may flare up every once in a while and then go away for a period of time. This symptom-free period is called remission. Unfortunately, it is difficult to determine how long a period of remission will last.
Lupus may be mild or severe, and may result in a range of symptoms such as:
- joint pain, swelling, and redness that comes and goes (the fingers and wrists are commonly affected)
- rashes, especially across the nose and cheeks - known as a "butterfly rash"
- fever
- weight loss
- chest pains due to inflammation of the heart and lungs (serositis)
- coughing and breathing problems
- sensitivity to sunlight, which can sometimes occur even with the use of sun block
- unexplained fatigue
- Raynaud's phenomenon (fingers or toes turn blue on exposure to cold, then white, then red and warm as the blood flow returns to normal)
- hair loss
- headaches
- disordered thinking or confusion
- labile emotions (unsteady and uncontrolled emotions or mood changes)
Complications of lupus may involve inflammation that can affect other areas of the body (such as the kidneys, central nervous system, and heart). If complications occur, they usually appear during the first few years after the initial diagnosis.
Kidney inflammation as a result of lupus is usually without symptoms at first, and unfortunately many people may not even notice it until the problem is advanced. Once it progresses, there may be other signs such as bloating, ankle swelling, and abnormal blood and urine tests. Ultimately kidney failure may develop.
Your doctor should closely monitor you for signs of early kidney disease, such as protein and other abnormalities in the urine.
Lupus also commonly accelerates and worsens atherosclerosis (hardening of the arteries), so your doctor may also monitor for risk factors like high blood pressure, cholesterol, and diabetes. Your doctor may also advise you to not smoke. It is very important to get treatment for atherosclerosis.
