Lupus is an autoimmune disease that affects an estimated 1.5 million to 2 million people in the United States, according to the Lupus Foundation of America. The majority of lupus patients are women who develop the disease between the ages of 15 and 45. Minorities, such as Latinos, African Americans, Asians and Native Americans, are also at a higher risk for developing the disease. If you belong to an at-risk group, it is important to be educated about lupus, its symptoms and treatment options.
What is lupus?
In lupus — short for systemic lupus erythematosus, the most common form of the disease — the body’s immune system, which normally fends against viruses and bacteria, attacks healthy tissue. This self-inflicted attack results in inflammation, which can be painful and damaging to the tissue. The organs most affected are the kidneys, heart, lungs, nervous system or blood cells, though all areas of the body are at risk.
The symptoms of lupus tend to come and go. Most commonly you will experience pain and swelling in your joints, a fever, skin rash and exhaustion. If these symptoms occur on a regular basis, you should ask your doctor to test you for lupus.
Testing and diagnosis
No single test can determine if a person has lupus. The diagnosis will depend on a complete medical history, physical examination and several laboratory tests.
One significant test is the antinuclear antibody (ANA) test, which looks for antibodies the body makes against itself. Although a positive ANA test is highly indicative of lupus, it is not conclusive. Drugs, infections and other diseases can also cause a positive result.
Other laboratory tests are important — complete blood count, urinalysis, chest X-ray and electrocardiogram. The erythrocyte sedimentation rate, which measures inflammation in the body, is essential, as are biopsies of the kidney and skin.
There are several drugs that your doctor may prescribe to control your symptoms. Steroids are commonly used to reduce swelling, tenderness and pain. These steroids are different from those used by some people who play sports or lift weights. Steroid creams are applied to the skin to cause a rash to subside. Steroids are also taken by mouth or injections.
You may also take nonsteroidal anti-inflammatory drugs, such as aspirin and ibuprofen, to treat joint pain and stiffness. Anti-malarial medications are also used to treat joint pain, skin rashes and mouth sores.
More severe cases of lupus are treated with immunosuppressive agents and chemotherapy.
While treatments help control the symptoms, they take their toll in other ways. Steroids can result in osteoporosis, or weakening of the bones, and you may need to take calcium and vitamin D to counter those effects. Immunosuppressants also leave you much more susceptible to disease and infection.
Because lupus affects primarily women of childbearing age, women with lupus should understand the risks involved with pregnancy. Experts agree that women with lupus can now safely become pregnant and suffer few or no flares, especially if the disease is under control or in remission for a period of time.
However, complications can arise. According to rheumatologists at the Johns Hopkins Arthritis Center, about 10 percent of pregnancies end in miscarriage. Miscarriages that occur after the first trimester are more associated with signs of active lupus. In addition, about 20 percent of pregnant women with lupus develop preeclampsia, a sudden rise in blood pressure. Pre-eclampsia, a critical condition that requires immediate attention, often results in preterm births.
Because of the risks associated with lupus and pregnancy, it is important to talk to your doctor about how best to keep symptoms down throughout your pregnancy. It is also recommended to find an obstetrician that specializes in high-risk pregnancies who can more efficiently monitor your progress.
Lupus is a chronic condition that requires full-time maintenance. Those with lupus are encouraged to practice a healthy lifestyle to avoid flares and complications. Tips on healthy living include:
• Rest to reduce stress;
• Avoid the sun, and wear sunscreen and protective clothing when outside;
• Exercise regularly to prevent joint stiffness, fatigue and depression;
• Stop smoking. Tobacco increases inflammation of the arteries;
• Learn as much as you can about lupus; and
• Work closely with your doctor.
In general, the best thing you can do, if you’ve been diagnosed with lupus, is to maintain your treatment regimen and visit your doctor on a regular basis. Because the types of lupus and the affected areas can vary so greatly, only your doctor can create a truly effective treatment plan. You will also begin to recognize the activities and behaviors that cause your symptoms to flare up and you’ll learn to avoid them. You should also check with your health insurance company to see which treatment options are covered by your health plan.