Everything You Need to Know About Lupus

Lupus is a chronic condition that can cause inflammation and pain in the skin, organs, and other places in the body. There is currently no cure, but there are treatments available to reduce the symptoms.

Lupus affects around 1.5 million people in the United States. Around 90% of people living with lupus are females, and 20% are children.

This article defines lupus. It also discusses the types, symptoms, causes, and treatment options related to the condition.

Lupus is a long-term autoimmune disease that causes inflammation and pain in various parts of your body. It can also cause:

• mouth sores
• hair loss
• tiredness
• skin rashes

Having an autoimmune disease means that your immune system attacks itself. It becomes dysregulated and cannot tell the difference between healthy tissue, bacteria, viruses, and other foreign substances.

Lupus can occur in anyone, but it is more common among Black and Latina females ages 15–44 years. 

There are different types of lupus. Each type has unique symptoms that can affect the body in various ways.

Systemic lupus erythematosus (SLE) is the most common and serious type of lupus. SLE is an autoimmune disease that causes your immune system to attack your tissues. This causes inflammation to spread throughout your body and can cause tissue damage to various organs.

Specifically, SLE can affect your:

• joints
• brain
• heart
• lungs
• nerves
• kidneys
• skin
• blood vessels

Drug-induced lupus can occur if you take certain medications. Once you stop taking the medication, your lupus-like symptoms will likely disappear within a few months. However, never stop taking your medication without speaking with your doctor first. 

Medications that can cause drug-induced lupus include:

• Hydralazine: This can treat high blood pressure.
• Procainamide: This can treat irregular heart rhythms.
• Isoniazid: This can treat tuberculosis.

Around 5% of people taking hydralazine and 20% of those taking procainamide will develop drug-induced lupus. With most other drugs, the risk of developing drug-induced lupus reduces to less than 1%.

Cutaneous lupus erythematosus is an autoimmune disorder. Your body mistakes healthy cells and tissues as a threat and attacks them. This leads to circular red rashes, sores, or scaly patches.

It is common for a rash to appear in places on your skin where you are likely to experience sun exposure. These places include your:

• face
• scalp
• ears
• neck
• arms
• legs

Your rash may last for a few days or even years. It may also come and go, and it might leave a scar.

Neonatal lupus is rare. It happens when autoantibodies pass from a birthing parent to a fetus. When the baby is born, they may have a skin rash, liver problems, or a low blood cell count. However, these symptoms often go away after 6 months, during which time the parent’s antibodies are broken down.

Visit our hub to read more about lupus.

There are many different symptoms of lupus, and they may vary from person to person. Symptoms include:

• joint and muscle aches and pains
• extreme tiredness and weakness
• a butterfly rash over the cheeks
• fever
• sensitivity to light
• chest pain
• kidney problems
• hair loss
• ulcers
• headaches
• memory problems
• a low blood count
• blood clots
• pregnancy problems

If you are experiencing symptoms of lupus, contact your doctor.

The exact cause of lupus is not known. However, there are various factors that may trigger your immune system and cause the disease. These factors include:

• your genes
• your environment
• how well your body clears damaged or dead cells

Lupus is most common in people ages 15–44 years. Lupus is more common in females. The ratio of females to males who have lupus is around 9 to 1.

Lupus is more common in Black and Latina females. They are two to three times more likely to have lupus than white women.

It can be difficult for doctors to diagnose lupus, as symptoms can vary or indicate another condition. Symptoms can also come and go. When you speak with your doctor about your symptoms, you should mention any symptoms that have now disappeared.

Your doctor may:

• take your medical history
• enquire about your family medical history
• carry out a physical examination
• order blood tests to detect antibodies and your blood count
• collect a urine sample
• take a biopsy of your skin or kidney

There is currently no cure for lupus. However, doctors can treat your symptoms. There are many treatment options available, including medications, lifestyle changes, and alternative treatments.

There are several medications available to treat your symptoms. Your doctor may prescribe different medications as your symptoms change.

Medications for lupus include:

• Nonsteroidal anti-inflammatory drugs: These include ibuprofen and naproxen to reduce mild pain and swelling in the joints and muscles. 
• Corticosteroids: These can help reduce swelling, pain, and tenderness. 
• Antimalarial drugs: These can treat joint pain, skin rashes, tiredness, and body-wide inflammation.
• B cell-specific inhibitors: These can reduce the number of unusual B cells and the proteins they produce in the immune system. B cells make antibodies. 
• Interferon inhibitors: These can cause inflammation when overproduced.
• Anifrolumab: This recently approved medication lowers type I interferons.
• Immunosuppressive agents or chemotherapy: These options can help people with severe lupus when other treatments have not worked. 

Alternative treatments you may wish to try include:

• applying creams
• trying ointments
• taking fish oil
• trying nutritional supplements
• visiting a homeopath or a chiropractor
• eating a low inflammation diet
• undergoing acupuncture
• wearing sun protective clothing and applying sunscreen

Always speak with your doctor before taking any alternative medications in case they interfere with your prescribed medications.

There are various lifestyle changes you can make to help ease your symptoms and manage flare-ups. These include:

• getting plenty of sleep and napping during the day if needed
• exercising regularly
• avoiding direct sunlight on exposed skin
• using heat packs to manage muscle pain or cold packs to reduce inflammation
• avoiding smoking
• eating a healthy and balanced diet
• taking care of your mental and emotional health
• having a support network
• managing your stress levels
• tracking triggers of your flares

Eating a well-balanced diet can help manage your symptoms. This approach may help:

• reduce inflammation
• maintain strong bones
• reduce the risk of heart disease
• ease side effects from your medications

Some research indicates that people with SLE may benefit from:

• eating whole grains instead of refined ones
• using sea salt instead of refined salt
• switching sugar for rice, barley, or maple syrup
• eating fresh vegetables and fruits daily
• eating fresh fish and cold-pressed oil
• eating flaxseeds, pumpkins, nuts, lentils, and tofu

Try to avoid:

• foods with saturated fat, trans fat, and cholesterol
• red meats
• alcohol
• salty foods
• sweetened beverages
• candy
• processed foods

Renal inflammation is one of the most common and serious complications of lupus. Without an early diagnosis, you may need to undergo dialysis if you go into renal failure.

Lupus can lead to cardiovascular disease, which can cause heart attacks, heart failure, and strokes.

Other health complications associated with lupus include:

• osteoporosis
• high blood pressure
• heart and lung disease
• pregnancy complications

There are various autoimmune diseases that can cause swelling, inflammation, pain, and damage to your organs. Because there are so many symptoms of lupus, and because it can affect various parts of your body, it can be difficult to diagnose.

Other conditions that can present like lupus include:

• rheumatoid arthritis
• rosacea and skin rashes
• dermatomyositis
• undifferentiated connective tissue disease
• Hashimoto’s disease
• Sjögren’s disease
• fibromyalgia

Read about seven conditions often confused with lupus here.

The outlook for people with lupus is hopeful, as treatments have improved. Due to this progression, an individual’s quality of life and life expectancy are likely to increase.

Causes of premature death due to SLE are often linked to organ failure, infection, or cardiovascular disease.

Here are some more questions that people asked about lupus. Dr. Nancy Carteron, MD, has provided the answers.

Nephritis refers to inflammation of the kidney, which removes waste products from the body. Inflammation in the filtration units is known as glomerulonephritis, in the supporting tissue is known as interstitial nephritis, and in the cells surrounding the glomeruli is known as podocytopathy. If tissue damage occurs, toxins cannot be removed from the body.

The hallmark of lupus is the production of antibodies targeting intracellular DNA and RNA. These autoantibodies can bind cell components, forming immune complexes.

These particles can trigger numerous pathways of inflammation in various organs. If inflammation is not downregulated, tissue scarring and damage occur.

Autoantibodies, dysregulated immune cells, and the proteins they produce are all mechanisms that are typically associated with changes in brain function. This can occur via the circulatory and lymphatic drainage systems and by local production within the brain.

There are different types of lupus rashes, but the most classic is the malar rash, which occurs over the cheeks and nose. This rash is pink to red and spares the fold between the nose and cheek.

Lupus is an autoimmune disease that can cause pain and inflammation in the organs, joints, and muscles. Lupus can affect anyone, but it is more common in females ages 15–44 years and those from Black and Latin backgrounds.

Lupus can present like other conditions, so you should inform your doctor of all the symptoms you have experienced. Your doctor may carry out a range of tests to diagnose lupus.

There are various treatments available for lupus, including medications, alternative therapies, and lifestyle and diet changes.

Lupus treatments have advanced over the years, and this has helped improve quality of life and life expectancy.