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SLE (Lupus)

Lupus is a systematic autoimmune disease which affects the body’s tissues and organs by your own immune system thinking that they are foreign. Lupus is a chronic inflammatory disease that affects various parts of the body including joints, skin, kidneys, blood cells, brain, heart, and lungs. Lupus is also known as systemic lupus erythematosus or SLE. The exact cause of lupus is very difficult to diagnose, although it’s a combination of genes, hormones and environmental factors. It affects women between 18 and 40 years of age.

Symptoms of lupus is unpredictable, a combination of medications and lifestyle changes can make the person lead a normal life. Lupus is a chronic inflammatory disease with many health risks like cardiovascular disease, kidney disease and stroke. There is a chance of developing atherosclerosis, mayocarditis and endocarditis, which can lead to heart murmurs.

Today, doctors recognize the condition at early stages and there are many ways to manage this disease compare to earlier. Almost the success rate is more than 90%.

How immune system works:

Our immune system protects our body by producing antibodies which attack bacteria and viruses. However, people with lupus produce antibodies that attack their own tissues. These antibodies will cause pain, inflammation and also damage other parts of the body.

Causes of Lupus:

Doctors don’t know the exact reason behind lupus. They think that this autoimmune disease is caused due to genetics, hormones and environment. So if your parents have this disease, you may also likely to develop lupus. However, genes alone are not the reason to get lupus, it occurs due to many other factors which are not yet identified. Other factors which may trigger lupus are

  • Exposure to sunlight, which is common cause of flare-ups.
  • Long term medications or antibiotics may trigger lupus.
  • Viral infections and stress
  • Hormone estrogen may be a reason for lupus because 9 out of 10 are women who are affected. Men and women both make estrogen, but women make more. But this doesn’t conclude that estrogen alone causes lupus.

Symptoms :

No two people with lupus have same symptoms. The symptoms may fluctuate between active periods (flares) and then minimal for sometime (remission). The signs and symptoms of lupus include:

  • Sun sensitive rashes on the face especially on nose and cheeks. It is called as butterfly rash.
  • Joint pains, swelling, fever
  • The painful inflammation in the joints, sometimes mistaken as rheumatoid arthritis.
  • Chest pain, cough and breathing problems
  • Dry eyes, headache, hair loss
  • Fatigue and weight loss
  • Raynauds phenomenon- fingers or toes turn white or blue when exposed to cold.
  • Confusion and memory loss
  • Enlarged lymph nodes
  • Bald patches or hair loss
  • Recurrent miscarriages.
Complications in organs: SLE affects many organs of the body.
Joint pain and stiffness: This is an early symptom occurs almost to everyone with lupus.
Skin changes: Most of the people get butterfly rash. This lasts for few days and often comes back when exposed to sun.
Kidneys: Inflammation in kidney is common in people with lupus. Many people might not have even noticed it until the problem is advanced. Once it advances the person may have bloating, ankle swelling and damage to the glomeruli -that can prevent the kidneys from filtering waste from the bloodstream. Eventually if untreated kidney failure may happen.
Digestive system: The medications given for treating lupus may affect the digestive system. It may cause stomach pain, or sometime stomach ulcers.
Lungs: Pain with breathing and shortness of breath may occur.
Heart: A variety of symptoms may develop if lupus affects the heart or blood vessels such as chest pain with exercise, pain in the chest due to inflammation around the heart, shortness of breath due to heart valve disease.

Diagnosis:

Your doctor will consider the variety of symptoms and review medical history and perform a complete physical examination including blood tests for anti DNA antibodies which is the main reason for lupus. Skin and kidney biopsies are taken to check the extent of the disease, and also to check the abnormalities in blood cells. This also helps the doctor in ruling out the diseases which have similar symptoms. Blood and urine tests are taken to diagnose lupus.

Your doctor will carefully check if there is any early kidney disease, such as protein and other abnormalities in the urine. Lupus also usually accelerates atherosclerosis (hardening of the arteries). So your doctor may also monitor for risk issues like high blood pressure, cholesterol, and diabetes.

Treatment and Prevention:

There is no permanent cure for SLE, the treatment will reduce the symptoms and limit damage to the vital organs. The medications will depend upon how severe the symptoms are.

General medicines prescribed by doctor :

  • Non-steroidal anti-inflammatory drugs (NSAIDs)
  • Oral corticosteroids to reduce inflammation.
  • Antimalarial drugs- some medicines used to treat malaria are used to treat lupus also. They are used treat skin rashes, mouth sores, and joint pain etc.
  • Immunosuppressive agents viz, cyclophosphamide, mycophenolate, azathioprine helps to control the activities of the immune system from attacking the bodies own organs and tissues.

These medications also have few side effects, so carefully consult your doctor if you are allergic to any medicines.

Prevention and lifestyle changes:

You can take simple measures to prevent lupus flares

  • You may consult rheumatologist
  • Sometimes lupus may trigger while pregnancy or it may get worse if you already have. In such a case, you need to consult both rheumatologist and obstetrician.
  • Take rest and learn stress management methods
  • Dental care is very important.
  • Regular exercise is must to keep your bones strong
  • Maintain good healthy diet.
  • Avoid smoking and alcohol
  • If you're taking corticosteroids and other immune-suppressing medications, report any signs of infection to your doctor.
  • Avoid exposure to direct sunlight –always wear hats and sunglasses and wear long sleeved clothing. Use sunscreens with a sun protection factor.

These medications also have few side effects, so carefully consult your doctor if you are allergic to any medicines.

Conclusion:

Lupus is a complex disease and is considered as a long term serious issue. So the challenges living with lupus may lead to other health problems as well. To help yourself from this, it’s very important to follow proper medications and you need a strong and positive mind to fight this disease.

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